Department of Oral Medicine, Sedation & Maxillofacial Imaging

Non burning, non painful burning mouth syndrome?

Gilad Wasserman DMD/MScDepartment of Oral Medicine, Sedation, and Maxillofacial Radiology

The Center for Diagnosis of Taste and Smell DisordersHadassah-Hebrew University Faculty of Dental Medicine and Hadassah Medical Center

Department of Oral Medicine, Sedation & Maxillofacial Imaging

Burning mouth syndrome (BMS)• Intraoral burning or dysaesthetic sensation• NO evident causative lesions.

Diagnostic criteria:A. Oral pain fulfilling criteria B and CB. Daily: >2 hours; >3 monthsC. Pain is burning and felt superficially

ICHD-3 Cephalalgia 2018, Vol. 38(1) 1–211

Clinical Features• Mild upon awakening, worsening throughout the day• Alleviated during eating• Associated with taste disturbance and xerostomia.

Klasser et al, Oral Maxillofacial Surg Clin N Am 28 (2016) 381–396

Non burning, non painful burning mouth syndrome?

Treatment: Challenging & Frustrating!• α-Lipoic acid• Clonazepam (topical)• Capsaicin(topical)• Gabapentin• CBT• LLLT• more, more, more…. No predictable Tx

Kim et al, J Clin Exp Dent. 2018;10(4):e321-6.Dr. G Wasserman

Department of Oral Medicine, Sedation & Maxillofacial Imaging

8 Patients - 4M, 4F ; mean age 62 (range 24-94)Similar presentation:• Phantom taste (foul, bitter, or sour) • Daily: >2 hours; >3 months • Mild symptoms upon awakening, worsening throughout the day • Alleviated during eating

NO contributory medical history or clinical findingsNO PAIN or BURNINGMost were normosmic and normogeusic upon chemosensory workup.3 cases benefited, at least partially, from topical clonazepam.

Non burning, non painful burning mouth syndrome?

New entity or subtype of BMS?

Dr. G Wasserman

Department of Oral Medicine, Sedation & Maxillofacial Imaging

Questions? Comments?

gilad.wasserman@gmail.com@giladwas

THANK YOU!

Non burning, non painful burning mouth syndrome?