title: The diagnosis of burning mouth syndrome represents a challenge for clinicians.
abstract: OBJECTIVE
  To evaluate the occurrence of professional delay in the diagnosis, referral, and treatment of patients with burning mouth syndrome (BMS).
  
  
  METHODS
  Fifty-nine patients (51 women and 8 men; average age, 60.5 years; age range, 32 to 88 years) diagnosed with BMS at our institution were retrospectively studied. Data were collected about the onset of oral symptoms, consultations with medical and dental practitioners, and misdiagnosis before definitive BMS diagnosis and treatment.
  
  
  RESULTS
  The average delay from the onset of the symptoms to definitive diagnosis was 34 months (range, 1 to 348 months; median, 13 months). The average number of medical and dental practitioners consulted by each patient over this period and who initially misdiagnosed BMS was 3.1 (range, 0 to 12; median, 3). Candidiasis and aspecific stomatitis were the most frequent misinterpretations of the symptoms before appropriate referral. In about 30% of cases, no diagnosis of the oral symptoms was made or explanation given.
  
  
  CONCLUSIONS
  Professional delay in diagnosing, referring, and appropriately. managing BMS patients occurred frequently in the group studied. No significant differences were found in the number of medical and dental practitioners who were consulted. Emphasis must therefore be placed upon educational efforts to improve health care providers' awareness of BMS. This should increase the rate of recognition and appropriate referral or treatment of patients with chronic orofacial pain due to BMS.
authors.affiliation: Section of Oral Medicine, Department of Odontostomatological and Maxillofacial Sciences University Federico II of Naples, Naples, Italy. mdmig@tin.it
authors.forename: Michele D
authors.initials: MD
authors.lastname: Mignogna
authors.forename: Stefano
authors.initials: S
authors.lastname: Fedele
authors.forename: Lucio
authors.initials: L
authors.lastname: Lo Russo
authors.forename: Stefania
authors.initials: S
authors.lastname: Leuci
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Lo Muzio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002054:Burning Mouth Syndrome / Q000175:diagnosis* / Q000628:therapy; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012189:Retrospective Studies; D013997:Time Factors