Impact of criteria-based diagnosis of burning mouth syndrome on treatment outcome.
OBJECTIVE
Burning mouth syndrome (BMS) primarily affects postmenopausal women and is often difficult to treat successfully. Treatment outcomes have been problematic because of failure to distinguish between patients with BMS and patients presenting with oral burning (OB) resulting from other clinical abnormalities. The purpose of this study was to determine characteristics that might uniquely identify BMS patients from patients with OB and to determine whether proper classification influences treatment outcome.


METHODS
The clinical sample consisted of 69 patients (83% female) with an average age of 62 years, pain duration of 2.45 years, and visual analog scale pain rating of 49 mm (rated from 0 to 100 mm). All patients underwent a clinical exam and completed the Multidimensional Pain Inventory and Symptom Checklist 90-Revised.


RESULTS
There were no differences between the BMS and OB groups with respect to age, pain duration, pain intensity, life interference, and levels of psychologic distress. Patients with OB demonstrated more clinical abnormalities than BMS patients. Hyposalivation and greater use of prescription medications, most notably hormone replacement therapy, were more common in the OB group compared with the BMS group. When treatment was provided that corrected an identifiable abnormality, significantly more OB than BMS patients reported greater than 50% relief from baseline pain rating.


CONCLUSIONS
These data indicate that while BMS and OB groups may initially present with similar clinical and psychosocial features, they are distinguishable with careful diagnosis that often enables successful management of symptoms for each group.
Danhauer
Suzanne C
SC
Department of Psychology, Orofacial Pain Center, University of Kentucky, Lexington, Kentucky 40506-0044, USA.
Miller
Craig S
CS
Rhodus
Nelson L
NL
Carlson
Charles R
CR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D002054:Burning Mouth Syndrome / Q000145:classification / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology; D002220:Carbamazepine / Q000627:therapeutic use; D016009:Chi-Square Distribution; D002908:Chronic Disease; D002998:Clonazepam / Q000627:therapeutic use; D003891:Desipramine / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy; D008875:Middle Aged; D010100:Oxygen / Q000627:therapeutic use; D010147:Pain Measurement; D011594:Psychometrics; D016896:Treatment Outcome
D014151:Anti-Anxiety Agents; D000927:Anticonvulsants; D002220:Carbamazepine; D002998:Clonazepam; D010100:Oxygen; D003891:Desipramine