What are the treatment options for Burning Mouth Syndrome (BMS)?

From the Guidelines

Burning Mouth Syndrome (BMS) treatment options include gabapentin, high potency topical steroids, or viscous lidocaine, as well as dietary modifications and assessment of pain location and character. According to the most recent guidelines 1, management of oral dysesthesia, which includes BMS, involves holding immunotherapy and using medications such as gabapentin, high potency topical steroids, or viscous lidocaine for moderate to severe cases.

Treatment Options

• Gabapentin: has been shown to reduce burning sensation in some patients with BMS 1
• High potency topical steroids: may be used to manage oral dysesthesia, including BMS 1
• Viscous lidocaine: can be used as a topical measure to provide temporary relief 1
• Dietary modifications: are recommended, including avoiding spicy foods and acidic beverages
• Assessment of pain location and character: is essential to rule out other causes of oral pain

Self-Care Strategies

• Avoiding irritants such as tobacco and alcohol
• Sipping water frequently to stay hydrated
• Using alcohol-free mouthwashes
• Switching to mild toothpaste without sodium lauryl sulfate
• Managing stress through relaxation techniques
• Chewing sugar-free gum to stimulate saliva production

It's worth noting that the prognosis for BMS is generally poor, with only a small number of patients experiencing full resolution of symptoms 1. However, patients can be reassured that the condition will not worsen, and treatment can help manage symptoms and improve quality of life.

From the Research

Treatment Options for Burning Mouth Syndrome (BMS)

The treatment options for Burning Mouth Syndrome (BMS) can be categorized into pharmacological and non-pharmacological approaches.

• Pharmacological treatments include:
  • Alpha-lipoic acid (ALA) 2, 3, 4, 5, 6
  • Clonazepam 2, 3, 4, 5, 6
  • Capsaicin 2, 3, 4, 5, 6
  • Anticonvulsant and antidepressant agents 3, 4, 5, 6
  • Gabapentin 4, 6
  • Pregabalin 4
  • Duloxetine 4
  • Amitriptyline 4
  • Low-dose aripiprazole 4
  • Ultra-micronized palmitoylethanolamide 4
• Non-pharmacological therapies include:
  • Low-level laser therapy (LLLT) 2, 3
  • Cognitive behavior therapy 3, 4, 5
  • Electroconvulsive therapy 4
  • Acupuncture and auriculotherapy 4
  • Transcranial Magnetic Stimulation (rTMS) 3, 4
  • Salivary Mechanical Stimulation 4
  • Botulinum Toxin 4
  • Psychotherapy and behavioral feedback 5

Efficacy of Treatment Options

The efficacy of these treatment options varies, with some studies showing modest evidence of pain reduction 3, 6.

• Alpha-lipoic acid (ALA) has been shown to have a positive effect on pain score improvement, especially in long-term assessment 3.
• Clonazepam and capsaicin have demonstrated favorable outcomes in both short- and long-term assessments 3.
• Cognitive behavior therapy has also shown promising results in reducing BMS symptoms 3, 4, 5.
• Low-level laser therapy (LLLT) has been found to be effective in reducing pain symptoms 2, 3.