Burning mouth syndrome (stomatodynia)

Abstract

A recent paper by a research group from the University of Kentucky has shed new light on the pathophysiology of burning mouth syndrome (BMS), an enigmatic disorder causing chronic pain of the intra-oral soft tissues.1 The researchers used functional magnetic resonance imaging (fMRI) to show that patients with BMS have a specific qualitative and quantitative pattern of brain activation, leading to a net brain hypo-activity. Their findings suggest that BMS patients may have impaired brain network dynamics essential for descending inhibition, leading to diminished inhibitory control of sensory experience; as a consequence they may experience intra-oral proprioception as burning pain.1 These results may have significant clinical relevance; the pathophysiology of BMS has been ill-understood, causing difficulties in providing effective therapies. But what exactly is BMS? BMS is synonymous with stomatodynia, oral dysaesthesia, glossodynia, glossopyrosis, and stomatopyrosis. The International Association for the Study of Pain and International Headache Society defines it as a ‘distinctive nosological entity‘, including ‘all forms of burning sensation in the mouth, including complaints described as stinging sensation or pain, in association with an oral mucosa that appears clinically normal in the absence of local or systemic diseases or alterations’.2–5 Many systemic and local disorders can cause a burning sensation localized at the oral mucosa, but ‘true’ idiopathic BMS is defined as a burning pain in the tongue or other oral mucosal membrane in absence of clinical and laboratory abnormalities.2–6 In brief, the term is applied to those patients with chronic oral pain or burning sensation of the mouth which appears …