Therapeutic methods for burning mouth syndrome: an umbrella review

Background: An umbrella review on the treatment of burning mouth syndrome (BMS) may aid clinicians in selecting the most effective treatment modality to improve patients’ symptoms based on the best available evidence. Aim: The aim of the study was to perform an umbrella review of available systematic reviews on therapeutic methods used to alleviate BMS symptoms. Methods: This study was conducted following the Preferred Reporting for Systematic Reviews and Meta-analyses and is registered with the Prospective Register of Systematic Reviews (registration number CRD42021268587). The following databases were searched: PubMed, the Cochrane Library, Scopus, Embase, and Web of Science. The PICOT question was “For the relief of symptomatology, discomfort, and burning sensation caused by BMS, what is the best strategy?” A total of 197 articles were retrieved. After eliminating duplicates, 101 studies were evaluated for inclusion. Finally, eight articles were included in the study.Results: The most indicated pharmacological measure was clonazepam with short- and longterm effects on symptomatology relief. However, a standardized BMS treatment protocol is not described in the literature, since non-pharmacological therapeutic measures, such as psychotherapy and placebos, reduce the symptomatology of the pathology. The quality of the studies was analyzed through the evaluation of systematic reviews in dentistry (Glenny scale) and the Assessment of the Methodological Quality of Systematic Reviews (AMSTAR 2). According to the Glenny scale, the included studies are of moderate-to-high quality. However, according to AMSTAR 2, only two studies are of a high-quality level, while the others are classified as critically low. Conclusion: The use of pharmacological (clonazepam) and non-pharmacological (psychotherapy and placebo) measures reduces BMS symptoms. Relevance for Patients: This review on BMS treatment may aid clinicians in making better-informed decisions regarding treatment modality based on the best available evidence.