Management strategies for burning mouth syndrome: a comprehensive review

Burning Mouth Syndrome (BMS) is a complex chronic neuropathic orofacial pain disorder characterized by a persistent burning or dysesthetic sensation in the oral cavity without an identifiable organic cause. The management of BMS has evolved beyond symptom relief to focus on achieving full functional recovery (FFR), which encompasses restoring patients to their usual activities without restrictions, addressing both physical and psychological dimensions. Key pharmacological treatments such as clonazepam and capsaicin are explored in detail, alongside the potential of newer agents like various classes of antidepressants (including tricyclic antidepressants, selective serotonin reuptake inhibitors, and serotonin and noradrenaline reuptake inhibitors, vortioxetine) and antiepileptics showing promise in addressing the multifactorial nature of BMS. Non-pharmacological interventions, such as cognitive-behavioral therapy (CBT), low-level laser therapy (LLLT), and transcranial magnetic stimulation (TMS), are highlighted for their potential to complement pharmacological treatments. These interventions aim to modify pain perception, reduce psychological burdens, and enhance overall quality of life. Lifestyle modifications, including dietary changes, stress management techniques, improved sleep hygiene, and regular physical activity, are essential components of a holistic treatment plan that addresses modifiable risk factors affecting brain health. The integration of telemedicine and digital health resources is proposed to enhance patient management and accessibility to multidisciplinary care. This review provides a comprehensive update on all available therapeutic approaches for BMS, encompassing pharmacological treatments, non-pharmacotherapeutic interventions, and lifestyle optimization strategies, offering a holistic perspective on managing this condition.