Management strategies for burning mouth syndrome: a comprehensive review

TL;DR

This paper reviews various treatment strategies for Burning Mouth Syndrome, including medications, therapies, and lifestyle changes to improve patient outcomes.

Contribution

The paper provides a comprehensive overview of evolving management strategies for BMS, emphasizing functional recovery and multidisciplinary approaches.

Findings

Pharmacological treatments like clonazepam and antidepressants show promise in managing BMS.

Non-pharmacological interventions such as CBT and TMS can complement drug therapies.

Lifestyle modifications and digital health resources are essential for holistic BMS management.

Abstract

Burning Mouth Syndrome (BMS) is a complex chronic neuropathic orofacial pain
disorder characterized by a persistent burning or dysesthetic sensation in the
oral cavity without an identifiable organic cause. The management of BMS has
evolved beyond symptom relief to focus on achieving full functional recovery
(FFR), which encompasses restoring patients to their usual activities without
restrictions, addressing both physical and psychological dimensions. Key
pharmacological treatments such as clonazepam and capsaicin are explored in
detail, alongside the potential of newer agents like various classes of
antidepressants (including tricyclic antidepressants, selective serotonin
reuptake inhibitors, and serotonin and noradrenaline reuptake inhibitors,
vortioxetine) and antiepileptics showing promise in addressing the multifactorial
nature of BMS. Non-pharmacological interventions, such as cognitive-behavioral
therapy (CBT), low-level laser therapy (LLLT), and transcranial magnetic
stimulation (TMS), are highlighted for their potential to complement
pharmacological treatments. These interventions aim to modify pain perception,
reduce psychological burdens, and enhance overall quality of life. Lifestyle
modifications, including dietary changes, stress management techniques, improved
sleep hygiene, and regular physical activity, are essential components of a
holistic treatment plan that addresses modifiable risk factors affecting brain
health. The integration of telemedicine and digital health resources is proposed
to enhance patient management and accessibility to multidisciplinary
care. This review provides a comprehensive update on all available
therapeutic approaches for BMS, encompassing pharmacological treatments,
non-pharmacotherapeutic interventions, and lifestyle optimization strategies,
offering a holistic perspective on managing this condition.

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