Efficacy of criteria-based assessment in identifying burning mouth syndrome's patients

Purpose: Burning Mouth Syndrome (BSM) is a chronic pain condition poorly defined by symptoms, without regard to sign(s)/aetiology, and thus difficult to detect/manage. Recently, criteria-based assessment has been reported to simplify procedures for identifying BSM patients (pts) (Scala et al, 2003). The purpose of this study was to verify, in a large cohort of pts, the efficacy of a well-designed diagnostic system in distinguishing burning mouth (BM) symptoms from BMS. Methods: Pts who had attended (2003-2005) a visit for oral mucosal complaints at Universities of Bologna and Milan (italy), were retrospectively evaluated. Clinical/ symptom history, oral/laboratory assessment, were reported on a well-designed clinical schedule. Pts' schedules were divided into two groups: (i) BSM (pts wihout lesions); (ii) BM (pts with lesions). Comparisons between groups were performed. Results: We analyzed 264 pts, and carried out a diagnostic schedule subdivided in sections: structured interview exploring symptoms (pain/dysgeusia,/xerostomia/others) and psychological profile; topographic pain map; oral examination; laboratory tests. BMS pts were 1400 (22M-118F, range = 38-82 years) BM pts were 124 (31M-93F, range = 22-85 years). Most significant (P < 0.0001) symptomatic differences between groups were found in pain both overall duration and daily evolution. Conclusions: This study suggests that: (i) BMS is a distinct nosological entity characterized by a specific spettrum/pattern of oral symptoms; (ii) a well-designed structured interview exploring patients complaints may be effective in identifying BMS pts since the first visit. Relevance chance to quickly achieve BMS diagnosis, allows clinicians: (i) to prescribe prompt supportive cares focused on bringing chronic symptoms under control; (ii) to improve pts' quality of life.