Burning Mouth Syndrome — MFDS Part 1 MCQ

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ModerateOral MedicineBurning Mouth SyndromeMFDS Part 1

A 60-year-old woman reports a bilateral burning sensation affecting the anterior tongue for 6 months. It occurs every day for several hours and there are no visible oral mucosal abnormalities. A medication and medical review identifies no cause; full blood count, ferritin, folate, vitamin B12 and HbA1c are normal, and testing for oral candidiasis is negative. What is the most likely diagnosis?

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Correct answer: D — Burning mouth syndrome

The correct answer is D, burning mouth syndrome. It is characterised by recurrent daily intraoral burning or dysaesthesia, typically lasting more than 2 hours per day for more than 3 months, without a causative lesion or abnormality on appropriate investigation. The anterior tongue is commonly affected, and older women are disproportionately represented. Oral candidiasis is excluded by negative testing and would often produce erythema or removable plaques. Oral lichen planus usually causes visible reticular, plaque-like or erosive changes, while pemphigus vulgaris produces fragile bullae or persistent erosions. Vitamin B12 deficiency can cause oral soreness or atrophic glossitis but is excluded by the normal blood result. Burning mouth syndrome is therefore a diagnosis made after relevant local and systemic causes have been excluded.

Reference: Currie CC et al. Developing a research diagnostic criteria for burning mouth syndrome: Results from an international Delphi process. Journal of Oral Rehabilitation. 2021;48(3):308-331. https://pubmed.ncbi.nlm.nih.gov/33155292/