Not all burning mouths are the result of burning mouth syndrome (BMS), and physicians and researchers need better standards for an appropriate diagnosis, according to researchers at the Case Western Reserve University School of Dental Medicine.
BMS is associated with chronic or recurring a burning, scalding, or tingling feeling sometimes accompanied by a metallic taste or dry mouth sensation. But other conditions have similar symptoms, so diagnosing BMS can be difficult, the researchers reported.
“The issues with misdiagnosis depend to some extent on the context but include resources, money, and patient discomfort,” said Milda Chmieliauskaite, DMD, MPH, a researcher and assistant professor of oral and maxillofacial medicine at the dental school.
If a patient is misdiagnosed with BMS but actually suffers from burning due to dry mouth, the patient will receive treatment for the wrong condition, and the symptoms of burning will not improve, the researchers said.
“Often, these patients see several providers, taking up a lot of healthcare resources, before they find out what’s going on,” said Chmieliauskaite.
That’s because many dentists and clinicians aren’t well trained on the topic, Chmieliauskaite added. The current method for making a diagnosis is ruling out other disorders, so treating BMS should be approached with caution, she said.
“A lot of the other things that cause burning in the mouth such as diabetes, anemia, and dry mouth can be easily treated,” Chmieliauskaite said.
The specific cause of BMS is uncertain, Chmieliauskaite said, but some evidence shows that it may be related to nerve dysfunction. Sometimes, chewing gum or eating certain foods reduces the pain.
Best estimates are that between 0.1% and 4% of the population is affected by BMS, Chmieliauskaite said, affecting females more.
In a review of clinical trials conducted internationally between 1994 and 2017, Chmieliauskaite and an international research team found that many of the participants may have had an underlying condition that could have explained their BMS symptoms. She also said that BMS clinical trials need more rigorous standards.
“We need a consensus for a single definition of BMS that includes specific inclusion and exclusion criteria,” she said. “This will help us in moving the field forward in understanding of the actual disease. And there’s still a lot more we need to study.”
The study, “World Workshop on Oral Medicine VII: Burning Mouth Syndrome: A Systematic Review of Disease Definitions and Diagnostic Criteria Utilized in Randomized Clinical Trials,” was published by Oral Diseases.