Burning mouth syndrome (BMS) is characterized by burning pain in a normal-appearing oral mucosa lasting at least four to six months. The condition is idiopathic, and the underlying pathophysiology is not well understood. Patients with burning mouth syndrome commonly experience changes in gustatory function like parageusia. It is usually seen in females, typically in the peri-menopausal and post-menopausal periods. The diagnosis is made clinically after other etiologies of mouth pain, and changes in gustatory sensation are ruled out.
Studies have shown an association of burning mouth syndrome with Axis I and Axis II psychiatric disorders, psychiatric illness, structural and functional changes in the nervous system, and disruption of the circadian rhythm. Disruptions in the circadian rhythm affect pain perception and mood and can disrupt the hypothalamic-pituitary-adrenal axis.
Lamey and Lewis categorized burning mouth syndrome into three categories based on fluctuations in pain severity over a 24 hour period.
Type 1 typically has no symptoms on waking and progressively worsens throughout the day with variable nighttime symptoms. It may be related to nutritional deficiency or endocrine conditions such as diabetes mellitus.
Type 2 is associated with chronic anxiety and displays symptoms throughout the day.
Type 3 displays intermittent daytime symptoms and may have periods without any symptoms. Food allergy is thought to be a potential underlying mechanism.
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