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de Souza L, Marmora B, Rados P, Visioli F. Clin Oral Investig 2018: 22: 1893–1905

Burning mouth syndrome (BMS) is characterised by chronic orofacial pain and the absence of mucosal lesions. It has a prevalence of 5:100,000 people and more frequently occurs in post-menopausal women. The cause is unclear.

From analysis of 29 relevant papers reporting randomised clinical trials, this literature review found five categories of treatment modality – antidepressants, alpha-lipoic acid (ALA), herbal remedies, analgesic/anti-inflammatory agents and non-pharmacological therapies, such as laser techniques, acupuncture and psychotherapy. The antidepressant clonazepam, used topically, and ALA administered systemically both showed promising results but further research is necessary. No study found a consistently successful outcome and some studies showed that the placebo was as equally effective as the trial treatment.

Although no improvements were noted when psychotherapy was used, the authors suggest that the placebo responses highlight the need for a multi-disciplinary approach, including investigating the psychological and/or psychiatric characteristics of the patients.