Conclusion

The diagnosis of BMS is a difficult task and is usually based on the exclusion of certain diseases. Its diagnosis and treatment may require collaboration between health care professionals, including the dental hygienist, dentist, nurse practitioner, and physician. The dental hygienist can assist in assessing and treating clients with this disorder by taking a very thorough medical history and asking open-ended questions. An oral examination, along with a comprehensive diagnostic evaluation, are necessary, since oral and systemic complicating factors must be identified.

The client’s physician should treat any systemic conditions present, such as diabetes; anemia; or vitamin B12 , folic acid, or estrogen deficiencies.2 Response to therapy for those contributory factors should be considered and evaluated. If the therapy is partially successful, or not successful, the next stage is to treat the local oral factors, such as inflammatory conditions and xerostomia. Infections should be treated with appropriate antibiotic, antifungal, or antiviral medications. If the client responds to treatment, then true BMS does not exist. If the client does not respond, and BMS is suspected, drugs such as Clonazepam can be used. A combination of treatment modalities may be employed to alleviate the pain or the underlying causes of pain.

Most importantly, the client should be educated in preventive oral health techniques and lifestyle changes that may alleviate the symptoms of BMS. However, clients should be informed that treatment might result in only partial relief of pain and that immediate or complete relief of pain is unlikely. Clients should be monitored and reevaluated for several months after treatment.