Interventions for the treatment of burning mouth syndrome

  • Review
  • Intervention




The complaint of a burning sensation in the mouth can be said to be a symptom of other disease or a syndrome in its own right of unknown aetiology. In patients where no underlying dental or medical causes are identified and no oral signs are found, the term burning mouth syndrome (BMS) should be used. The prominent feature is the symptom of burning pain which can be localised just to the tongue and/or lips but can be more widespread and involve the whole of the oral cavity. Reported prevalence rates in general populations vary from 0.7% to 15%. Many of these patients show evidence of anxiety, depression and personality disorders.


The objectives of this review are to determine the effectiveness and safety of any intervention versus placebo for relief of symptoms and improvement in quality of life and to assess the quality of the studies.

Search methods

We searched the Cochrane Oral Health Group Trials Register (20 October 2004), CENTRAL (The Cochrane Library 2004, Issue 4), MEDLINE (January 1966 to October 2004), EMBASE (January 1980 to October). Clinical Evidence Issue No. 10 2004, conference proceedings and bibliographies of identified publications were searched to identify the relevant literature, irrespective of language of publication.

Selection criteria

Studies were selected if they met the following criteria: study design - randomised controlled trials (RCTs) and controlled clinical trials (CCTs) which compared a placebo against one or more treatments; participants - patients with burning mouth syndrome, that is, oral mucosal pain with no dental or medical cause for such symptoms; interventions - all treatments that were evaluated in placebo-controlled trials; primary outcome - relief of burning/discomfort.

Data collection and analysis

Articles were screened independently by two reviewers to confirm eligibility and extract data. The reviewers were not blinded to the identity of the studies. The quality of the included trials was assessed independently by two reviewers, with particular attention given to allocation concealment, blinding and the handling of withdrawals and drop outs. Due to both clinical and statistical heterogeneity statistical pooling of the data was inappropriate.

Main results

Nine trials were included in the review. The interventions examined were antidepressants (two trials), cognitive behavioural therapy (one trial), analgesics (one trial), hormone replacement therapy (one trial), alpha-lipoic acid (three trials) and anticonvulsants (one trial). Diagnostic criteria were not always clearly reported. Out of the nine trials included in the review, only three interventions demonstrated a reduction in BMS symptoms: alpha-lipoic acid (three trials), the anticonvulsant clonazepam (one trial) and cognitive behavioural therapy (one trial). Only two of these studies reported using blind outcome assessment. Although none of the other treatments examined in the included studies demonstrated a significant reduction in BMS symptoms, this may be due to methodological flaws in the trial design, or small sample size, rather than a true lack of effect.

Authors' conclusions

Given the chronic nature of BMS, the need to identify an effective mode of treatment for sufferers is vital. However, there is little research evidence that provides clear guidance for those treating patients with BMS. Further trials, of high methodological quality, need to be undertaken in order to establish effective forms of treatment for patients suffering from BMS.



灼口症(Burning mouth syndrome)之治療策略

口腔內有燒灼般的不適感可能是某些疾病的症狀之一, 或是來自於未知原因的一種症候群. 對於一些沒有潛在牙齒方面或身體上其他疾病, 或口內其他徵狀的患者, 應使用“灼口症”一詞來稱之. 主要的特點 是患者會有燒灼般的疼痛感, 可能侷限於舌頭以及/或是嘴唇, 也可能較廣泛至涵蓋整個口腔構造. 過去報告指出的盛行率在一般人口當中從0.7%到15%不等. 許多患有此疾的病人會表現出焦慮, 憂鬱以及人個失調等問題.


本文獻回顧之目的在確定任何介入治療相對於安慰劑在緩解症狀以及增進生活品質方面之效果以及安全性, 以及評估這些研究的品質.


我們搜尋了the Cochrane Oral Health Group Trials Register (20 October 2004), the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 4, 2004), MEDLINE (January 1966 to October 2004), EMBASE (January 1980 to October). Clinical Evidence Issue No. 10 2004 等資料庫及期刊. 不論出版的語言種類, 相關會議之會報以及參考書目也加以搜尋以找出有關之文獻.


符合以下條件的研究會被納入:研究設計比較安慰劑以及一種以上之治療方法的隨機臨床試驗及控制臨床試驗. 受試者灼口症患者, 意即患有口腔黏膜疼痛, 且沒有牙齒及身體疾病會造成相關症狀者. 介入方法所有被有安慰劑控制的臨床試驗評估之治療方法. 初步結果緩解燒灼感/不適感.


文獻分別為兩位回顧員獨立篩選以確認符合條件及摘錄資料. 回顧員對於這些研究的本體都是可知的. 被選取的試驗其品質亦由兩位回顧員分別獨立評估, 尤其著重於分組隱匿/遮盲(allocation concealment), 盲法(blinding), 及中斷與退出治療者的處理. 由於臨床及數據上的異質性, 資料數據的匯集是不恰當的.


九個臨床試驗有被包含在此文獻回顧中.被檢視的治療方法包含抗憂鬱劑(兩個試驗), 認知行為療法(一個試驗), 止痛劑(一個試驗), 賀爾蒙補充療法(一個試驗), 硫辛酸療法(三個試驗)及抗癲癇藥物療法(一個試驗). 診斷條件並非全部都有被清楚報告. 在九個被納入的試驗當中, 只有三個治療方法顯示出灼口症症狀的減輕: 硫辛酸療法(三個試驗), 抗癲癇藥物clonazepam(一個試驗)及認知行為療法(一個試驗). 而這些試驗中只有兩個有使用盲性結果評估(blind outcome assessment). 而雖然其他療法在這些被選取的研究當中無法顯示出顯著降低灼口症症狀, 這可能是由於實驗設計中在方法上的缺失, 或是受試者數目太小, 而非真正缺乏療效.


由於灼口症的病程是慢性的, 所以確認一個對患者有效的治療模式是極重要的. 然而, 過去研究證據當中提供治療灼口症患者的明確指引卻很少. 為了建立出對灼口症患者的有效治療形式與方法, 未來更多有高方法學品質的臨床試驗是需要的.



此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。


目前仍尚未有足夠的證據顯示止痛劑, 荷爾蒙, 及抗憂鬱劑對於灼口症的治療是有效的. 但有某些證據顯示, 學習與此不適感共處, 抗癲癇藥物, 及硫辛酸對治療灼口症可能有幫助. 在嘴唇, 舌頭或口內的燒灼感, 當其成因不明且並非其他疾病所造成時 我們稱之為灼口症. 其他症狀包括口乾以及味覺異常. 此症候群亦常見於焦慮, 憂鬱, 及人格失調患者. 停經後婦女是患有此疾候群的最高風險族群. 止痛劑, 荷爾蒙補充療法, 及抗憂鬱劑均有被嘗試做為可能的治療方法; 但本篇文獻回顧並未發現足夠證據支持它們的療效. 而設計被用來幫助這些患者與此不適感共處的治療, 以及硫辛酸的使用可能對此病有助益. 關於這方面還需要更進一步的研究.




口腔の灼熱感の訴えは、他の疾患の症状や未知の病因が本来持っている症候と言われています。口腔灼熱症候群(口腔内灼熱症候群・バーニングマウスシンドローム・burning mouth syndrome(BMS):本邦で使われる舌痛症(glossodynia)とほぼ同じと考えられる)の用語は、もともとの歯科または医科的な原因が同定されず、口腔内に所見がない患者に使われる。その特徴は、舌・口唇に限局した灼熱痛であり、さらに広範囲や口腔内全体に及ぶことはない。一般人口での有病割合の報告では、0.7%から15%とばらつきがある。それらの患者の多くが、不安症、うつ病、パーソナリティ障害であるとされている。




Cochrane Oral Health Group Trials Register(2004年10月20日)とCochrane Central Register of Controlled Trials(CENTRAL, The Cochrane Library, Issue 4, 2004)とMEDLINE(1966年1月~2004年10月)とEMBASE(1980年1月~2004年10月)を検索した。Clinical Evidence Issue No. 10(2004年)と会議録と出版されている図書目録が、出版物の言語に関係なく、関連文献を同定するために検索された。










監  訳: 湯浅 秀道,松香 芳三,JCOHR,2008.4.1

実施組織: 厚生労働省委託事業によりMindsが実施した。

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Plain language summary

Interventions for the treatment of burning mouth syndrome

There is insufficient evidence to show the effect of painkillers, hormones or antidepressants for 'burning mouth syndrome' but there is some evidence that learning to cope with the disorder, anticonvulsants and alpha-lipoic acid may help.
A burning sensation on the lips, tongue or within the mouth is called 'burning mouth syndrome' when the cause is unknown and it is not a symptom of another disease. Other symptoms include dryness and altered taste and it is common in people with anxiety, depression and personality disorders. Women after menopause are at highest risk of this syndrome. Painkillers, hormone therapies, antidepressants have all been tried as possible cures. This review did not find enough evidence to show their effects. Treatments designed to help people cope with the discomfort and the use of alpha-lipoic acid may be beneficial. More research is needed.