Prevalence and Symptoms

BMS is a complicated oral condition that affects more than one million people in the United States.3 Complaint of a burning mouth is an increasingly common problem in the older population.4 This has remained a puzzle for health care professionals, as visible pathologic lesions are not usually evident. Dental treatment, candidiasis, contact allergies, food allergies or sensitiv-ities, geographic tongue, lichen planus, xerostomia, lip licking and sucking, and mouth breathing have all been associated with BMS. Symptoms of oral burning are also associated with systemic disorders, such as anemia, diabetes, vitamin B and folic acid deficiencies, depression, anxiety, and other endocrine and immunologic disorders.5 Middle- aged women are particularly affected by the condition and report symptoms seven times more frequently than men.3

BMS is characterized by a burning sensation in the oral cavity, although the oral mucosa appears clinically normal. The most prevalent site for burning sensations is the anterior tongue.6 The pain is chronic (at least six months), continuous, and progressive throughout the day, with no apparent cause.3 Clients with BMS are often evaluated by physicians, so it is imperative for both physicians and oral health care professionals to recognize the condition.3

Hyposalivation or alterations in the composition of saliva have been associated with BMS, as have temporomandibular joint (TMJ) pain, face pain, oral sores, and burning mouth. Radiation of the head and neck, Sjogren’s syndrome, and certain medications that cause xerostomia also have been linked to BMS. Bergdahl studied oral complaints and salivary flow in men and women. Subjective indicators, such as oral dryness, age, medication, taste disturbances, intake of L-thyroxines, illness, stimulated salivary flow rate, depression, and anxiety were factors associated with BMS. The study concluded that BMS should be seen as a marker of illness and/or distress and suggested that the complex etiology of BMS demands treatment by a specialist.6

Another study investigated gender differences in orofacial pain symptoms—including burning mouth—in a sample of elderly adults. Findings were consistent with other epidemiological and clinical studies—females were more likely to report TMJ pain and face pain than males.7

Those affected by BMS experience a great deal of discomfort and pain. It is associated with varying symptoms and conditions and may be indicative of systemic disease. Careful assessment and diagnosis is necessary to alleviate pain and restore the client to a state of oral health and comfort.