Objectives
The aim of this study was to characterize the diagnostic process that patients with
burning mouth syndrome (BMS) undergo and to identify the potential pitfalls encountered
in the workup and management of BMS.
Study Design
A retrospective chart review of patients with BMS seen at the Oral Medicine clinic
at Brigham and Women's Hospital (Boston, MA) was conducted from January 2014 to April
2017. Abstracted data focused on the period from onset of symptoms to referral to
the Oral Medicine clinic for definitive diagnosis and included providers consulted,
symptom characteristics, diagnostic tests performed, and provisional diagnoses and
treatments offered.
Results
One hundred and two patients (86.3% females) were included (median age 60 years).
Median time from onset of symptoms to referral to the Oral Medicine clinic was 12
months (range 4-370 months). Patients saw a median of 3 providers (range 1-7); 30.4%
had undergone a diagnostic test; 63.7% had been given a provisional diagnosis; and
78.4% had received treatment. Candidiasis was the most common misdiagnosis (25.5%),
and antifungal medication was the most frequently prescribed therapy (27.5%).
Conclusions
Patients with BMS experience delay in diagnosis and management despite seeking and
receiving professional care. Many undergo unnecessary tests and tend to be misdiagnosed
or receive no diagnosis at all. Even those correctly diagnosed with BMS often receive
inappropriate or ineffective treatment.
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Article info
Publication history
Published online: October 12, 2019
Accepted:
September 30,
2019
Received in revised form:
September 27,
2019
Received:
August 28,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
