Management of burning mouth syndrome.

Sir,

The article “burning mouth syndrome (BMS)” was read with keen interest and curiosity.[1] However, all the management modalities of BMS was not mentioned in the article. Additional management modalities of BMS which were not found in that article are mentioned here.

Laser phototherapy (LPT) is an alternative treatment modality in BMS. Reduced burning intensity as evidenced by reduced Visual Analogue Scale scores are observed in BMS patients after weekly LPT sessions (40 mW, 10 J cm2, 0.4 J per point, 10 s) for total duration of 10 weeks.[2] Simple measures like sucking on ice chips, intake of frequent cold water, avoiding food and conditions that cause symptoms of BMS will help in the initial stages. Cognitive behavioral therapy is of help to BMS patients as it reduces pain and anxiety.[34]

Topical application of 0.025% capsaicin, 0.15% benzydamine hydrochloride, lactoperoxidase, cyclosporine mouth wash, 5% doxepin, mouth rinse made up of tabasco sauce and water, mouthwashes containing hot pepper and water are useful in managing the symptoms of BMS patients.[56] Systemic capsaicin (0.025%), Vitamin B12, folic acid, iron and zinc supplements are also of benefit to these patients.[5] Duloxetine and amisulpride are of help to patients with central type of BMS, whereas peripheral type of BMS responds to topical clonazepam.[7] Treatment with acupuncture, catuama, paroxetine, Hypericum perforatum has also been attempted on patients with BMS, but with disappointing results or with questionable methodologies.[8]

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Conflicts of interest

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