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Burning mouth syndrome (BMS) has been considered an enigmatic condition because the intensity of pain rarely corresponds to the clinical signs of the disease. As a result, BMS patients have variously been labelled as depressed, anxious or hypochondriacal and have often been underserviced by the medical and dental communities. Recently, there has been a resurgence of interest in this disorder with the discovery that the pain of BMS may be neuropathic in origin and originate both centrally and peripherally. This chapter discusses some of our recent understandings of the etiology and pathogenesis of BMS as well as the role of pharmacotherapeutic management in this disorder.

Clonazepam appears to have a positive effect on pain in BMS patients.

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This paper presents data from a mail survey on dental and facial pain. The survey was conducted in the City of Toronto in 1986. The aim of the study was to obtain estimates of the prevalence of such pain and its impact on daily life. A random sample of 1014 names was drawn from the voters' list, and, as a result of four mailings, information was obtained on 71.6% of the eligible sample. Of those returning questionnaires, 39.7% reported dental or facial pain in the previous four weeks. A psychological impact in the form of worry or concern was reported by 70.3% of those experiencing pain, while 58.0% reported one or more behavioral impacts. The most common behavioral impacts were consulting a dentist or doctor, avoiding certain foods, taking medication, and disturbance of sleep. Severe behavioral impacts such as work disability, need for bed rest, and reduced social contacts were also reported by some of those having pain. The results suggest that dental and facial pain imposes a significant burden on the community. Further research is indicated, with more sensitive impact measures being used.