EPMA Journal

pp 1–11 | Cite as

Oral burning: local and systemic connection for a patient-centric approach

  • Jaisri Thoppay
  • Bhavik DesaiEmail author


Burning symptoms in the oral cavity are caused by a range of systemic and local factors, in addition to the neuropathic pain disorder burning mouth syndrome (BMS). Patients may state oral burning as a standalone symptom or may report as a secondary symptom in association with other factors, most commonly with oral dryness, oral mucosal lesions, or certain systemic conditions. There is a level of uncertainty in the presentation of this condition which creates a diagnostic challenge from both the patient’s perspective and the practitioner evaluating these individuals. The diagnoses are complicated due to the lack of a clear definition of BMS and clinical guidelines to distinguish BMS from other conditions that are responsible for oral burning symptoms. A clinician should be able to differentiate oral burning from burning mouth syndrome. This integrative review discusses on local and systemic etiologies of oral burning based on current evidence that needs to be excluded for a diagnosis of BMS. It also provides an algorithm for diagnostic workup and therapeutic management to medical providers for patients experiencing oral burning symptoms. This comprehensive system provides a systematic stepwise workup in diagnosing and managing patients presenting with a complaint of oral burning that optimally meets a predictive, preventive, and personalized medicine (PPPM) approach.


Oral burning Burning mouth Xerostomia Predictive preventive personalized medicine 


Compliance with ethical standards

Conflicts of interest

The submitted documents represent original work that has not been published previously. The manuscript is not currently submitted for publication elsewhere. All authors have read and approved the manuscript. We also report no conflicts of interest.


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Copyright information

© European Association for Predictive, Preventive and Personalised Medicine (EPMA) 2019

Authors and Affiliations

  1. 1.Oral Medicine, Orofacial Pain and Geriatric ProgramsVirginia Commonwealth UniversityRichmondUSA
  2. 2.Oral Health and Diagnostic Sciences, Oral Medicine SectionDental College of Georgia at Augusta UniversityAugustaUSA

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