Psychological Aspects of Burning Mouth Syndrome

  • Kim, Cheul (Department of Oral Medicine and Diagnosis, College of Dentistry and Research Institute of Oral Science, Gangneung-Wonju National University)
  • Received : 2015.01.05
  • Accepted : 2015.01.21
  • Published : 2015.03.30


The etiopathogenesis of burning mouth syndrome (BMS) seems to be complex and many patients probably involves interactions among local, systemic, and/or psychological factors in the pathophysiologic mechanism. Although there are controversies over whether the psychological factor is a cause or a result of BMS, several studies have supported strong relationships between psychological factors and chronic pain. It has been suggested that somatic complaints from unfavorable life experiences may influence both individual personality and mood changes; however, initiation of BMS symptoms is not necessarily correlated with stressful life events despite their elevated psychological stress. If the psychological distress is not a causal factor of BMS, it seems that BMS patients may be particularly vulnerable to psychological problems, primarily depression, anxiety, and hostility due to the characteristic entities of BMS such as chronic persistent pain itself. It seems likely that both physiological and psychological factors play a role in causing, perpetuating and/or exacerbating BMS; therefore, both two components of the patient's symptoms must be addressed. The acceptance of psychological factors by the patient is often an important element of BMS, management. The evaluation of psychological and emotional status of BMS patient enables clinicians to recognize prolonged negative and subclinical factors which can complicate the management of pain or indirectly perpetuate other physical factors. This evaluation improves the doctor-patient relationships, motivation, and compliance through a correct understanding of the clinical problem. Appropriate emotional and psychological evaluation may be required prior to developing a treatment plan in order to gain the successful treatment outcome.


Burning mouth syndrome;Chronic pain;Psychological factor


  1. Abetz LM, Savage NW. Burning mouth syndrome and psychological disorders. Aust Dent J 2009;54:84-93.
  2. Barker KE, Savage NW. Burning mouth syndrome: an update on recent findings. Aust Dent J 2005;50:220-223.
  3. Maltsman-Tseikhin A, Moricca P, Niv D. Burning mouth syndrome: will better understanding yield better management? Pain Pract 2007;7:151-162.
  4. Lopez-Jornet P, Camacho-Alonso F, Lucero-Berdugo M. Quality of life in patients with burning mouth syndrome. J Oral Pathol Med 2008;37:389-394.
  5. Lopez-Jornet P, Camacho-Alonso F, Andujar-Mateos P, Sanchez-Siles M, Gomez-Garcia F. Burning mouth syndrome: an update. Med Oral Patol Oral Cir Bucal 2010;15:e562-e568.
  6. Savage NW, Boras VV, Barker K. Burning mouth syndrome: clinical presentation, diagnosis and treatment. Australas J Dermatol 2006;47:77-83.
  7. Drage LA, Rogers RS 3rd. Burning mouth syndrome. Dermatol Clin 2003;21:135-145.
  8. Bergdahl J, Anneroth G, Perris H. Personality characteristics of patients with resistant burning mouth syndrome. Acta Odontol Scand 1995;53:7-11.
  9. Bogetto F, Maina G, Ferro G, Carbone M, Gandolfo S. Psychiatric comorbidity in patients with burning mouth syndrome. Psychosom Med 1998;60:378-385.
  10. Browning S, Hislop S, Scully C, Shirlaw P. The association between burning mouth syndrome and psychosocial disorders. Oral Surg Oral Med Oral Pathol 1987;64:171-174.
  11. Carlson CR, Miller CS, Reid KI. Psychosocial profiles of patients with burning mouth syndrome. J Orofac Pain 2000;14:59-64.
  12. Eli I, Kleinhauz M, Baht R, Littner M. Antecedents of burning mouth syndrome (glossodynia)--recent life events vs. psychopathologic aspects. J Dent Res 1994;73:567-572.
  13. Pokupec-Gruden JS, Cekic-Arambasin A, Gruden V. Psychogenic factors in the aetiology of stomatopyrosis. Coll Antropol 2000;24(Suppl 1):119-126.
  14. Amenabar JM, Pawlowski J, Hilgert JB, et al. Anxiety and salivary cortisol levels in patients with burning mouth syndrome: case-control study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;10:460-465.
  15. Gao J, Chen L, Zhou J, Peng J. A case-control study on etiological factors involved in patients with burning mouth syndrome. J Oral Pathol Med 2009;38:24-28.
  16. Lamey PJ. Burning mouth syndrome. Dermatol Clin 1996;14:339-354.
  17. Scala A, Checchi L, Montevecchi M, Marini I, Giamberardino MA. Update on burning mouth syndrome: overview and patient management. Crit Rev Oral Biol Med 2003;14:275-291.
  18. Lamey PJ, Lamb AB, Hughes A, Milligan KA, Forsyth A. Type 3 burning mouth syndrome: psychological and allergic aspects. J Oral Pathol Med 1994;23:216-219.
  19. Al Quran FA. Psychological profile in burning mouth syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;97:339-344.
  20. Grushka M, Sessle BJ, Miller R. Pain and personality profiles in burning mouth syndrome. Pain 1987;28:155-167.
  21. Lamey PJ, Freeman R, Eddie SA, Pankhurst C, Rees T. Vulnerability and presenting symptoms in burning mouth syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;99:48-54.
  22. Brufau-Redondo C, Martin-Brufau R, Corbalan-Velez R, de Concepcion-Salesa A. Burning mouth syndrome. Actas Dermosifiliogr 2008;99:431-440.
  23. Jerlang BB. Burning mouth syndrome (BMS) and the concept of alexithymia--a preliminary study. J Oral Pathol Med 1997;26:249-253.
  24. Lamey PJ, Lamb AB. Prospective study of aetiological factors in burning mouth syndrome. Br Med J (Clin Res Ed) 1988;296:1243-1246.
  25. Yue Y, Chen Q, Lin M, Li B. Psychological aspects of patients with burning mouth syndrome: an investigation of personality, psychopathological profiles and social life background stress. Hua Xi Kou Qiang Yi Xue Za Zhi 1999;17:36-38.
  26. Hakeberg M, Hallberg LR, Berggren U. Burning mouth syndrome: experiences from the perspective of female patients. Eur J Oral Sci 2003;111:305-311.
  27. Woda A, Pionchon P. A unified concept of idiopathic orofacial pain: clinical features. J Orofac Pain 1999;13:172-184; discussion 185-195.
  28. Hampf G, Vikkula J, Ylipaavalniemi P, Aalberg V. Psychiatric disorders in orofacial dysaesthesia. Int J Oral Maxillofac Surg 1987;16:402-407.
  29. Grushka M, Epstein JB, Gorsky M. Burning mouth syndrome. Am Fam Physician 2002;65:615-620.
  30. van der Ploeg HM, van der Wal N, Eijkman MA, van der Waal I. Psychological aspects of patients with burning mouth syndrome. Oral Surg Oral Med Oral Pathol 1987;63:664-668.
  31. Sardella A, Lodi G, Demarosi F, Uglietti D, Carrassi A. Causative or precipitating aspects of burning mouth syndrome: a casecontrol study. J Oral Pathol Med 2006;35:466-471.
  32. Lamb AB, Lamey PJ, Reeve PE. Burning mouth syndrome: psychological aspects. Br Dent J 1988;165:256-260.
  33. Bergdahl J, Anneroth G, Perris H. Cognitive therapy in the treatment of patients with resistant burning mouth syndrome: a controlled study. J Oral Pathol Med 1995;24:213-215.
  34. Van Houdenhove B, Joostens P. Burning mouth syndrome. Successful treatment with combined psychotherapy and psychopharmacotherapy. Gen Hosp Psychiatry 1995;17:385-388.
  35. Danhauer SC, Miller CS, Rhodus NL, Carlson CR. Impact of criteria-based diagnosis of burning mouth syndrome on treatment outcome. J Orofac Pain 2002;16:305-311.
  36. Mott AE, Grushka M, Sessle BJ. Diagnosis and management of taste disorders and burning mouth syndrome. Dent Clin North Am 1993;37:33-71.
  37. Hexel M, Sonneck G. Somatoform symptoms, anxiety, and depression in the context of traumatic life experiences by comparing participants with and without psychiatric diagnoses. Psychopathology 2002;35:303-312.
  38. Maina G, Vitalucci A, Gandolfo S, Bogetto F. Comparative efficacy of SSRIs and amisulpride in burning mouth syndrome: a single-blind study. J Clin Psychiatry 2002;63:38-43.
  39. Woda A, Dao T, Gremeau-Richard C. Steroid dysregulation and stomatodynia (burning mouth syndrome). J Orofac Pain 2009;23:202-210.
  40. Patton LL, Siegel MA, Benoliel R, De Laat A. Management of burning mouth syndrome: systematic review and management recommendations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103(Suppl):S39.e1-S39.e13.
  41. Eccleston C. Role of psychology in pain management. Br J Anaesth 2001;87:144-152.
  42. Miziara ID, Filho BC, Oliveira R, Rodrigues dos Santos RM. Group psychotherapy: an additional approach to burning mouth syndrome. J Psychosom Res 2009;67:443-448.