Abstract
The pathophysiology of primary burning mouth syndrome (BMS) has been extensively debated but is poorly understood despite a large number of hypotheses attempting to explain its etiopathogenic mechanisms. The aim of the present work was to systematically review papers that could provide arguments in favour of the neuropathic and psychogenic components of primary BMS for a better understanding of the disease. This systematic review (SR) was registered in PROSPERO (CRD42021224160). The search was limited to articles in English or French from 1990 to 01 December 2020. A total of 113 articles were considered for data extraction. We divided them into four subgroups: pharmacological and nonpharmacological management studies (n = 23); neurophysiological studies (n = 35); biohistopathological studies (n = 25); and questionnaire-based studies (n = 30). Several of these studies have shown neuropathic involvement at various levels of the neuraxis in BMS with the contribution of quantitative sensory testing (QST), functional brain imaging, and biohistopathological or pharmacologic studies. On the other hand, the role of psychological factors in BMS has also been the focus of several studies and has shown a link with psychiatric disorders such as anxiety and/or depression symptoms. Depending on the patient, the neuropathic and psychogenic components may exist simultaneously, with a preponderance of one or the other, or exist individually. These two components cannot be dissociated to define BMS. Consequently, BMS may be considered nociplastic pain.
Highlights
The International Headache Society (IHS) defines burning mouth syndrome (BMS)as “an intraoral burning sensation for which no medical or dental cause can be found”.IHS diagnostic criteria include constant pain, a normal appearance of the oral mucosa, and exclusion of any local or systemic diseases [1]
The results suggested that Level Laser Therapy (LLLT) and alpha-lipoic acid (ALA) are both effective therapies for reducing burning mouth symptoms and that LLLT is more effective than ALA
IL-8 increased in BMS compared to healthy control
Summary
The International Headache Society (IHS) defines burning mouth syndrome (BMS)as “an intraoral burning sensation for which no medical or dental cause can be found”.IHS diagnostic criteria include constant pain, a normal appearance of the oral mucosa, and exclusion of any local or systemic diseases [1]. The International Headache Society (IHS) defines burning mouth syndrome (BMS). As “an intraoral burning sensation for which no medical or dental cause can be found”. IHS diagnostic criteria include constant pain, a normal appearance of the oral mucosa, and exclusion of any local or systemic diseases [1]. The pathophysiology of primary BMS is extensively debated but poorly understood despite a large number of hypotheses attempting to explain its etiopathogenic mechanisms. Studies often highlighted psychological causes [6,7], and primary BMS was initially classified as psychogenic pain [8]. It has been shown that several neuropathic mechanisms may contribute to the primary BMS pathophysiology. Neurophysiologic, psychophysical and functional imaging studies [9,10,11,12,13] have suggested pathophysiological alterations at different levels of
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