Efficacy of different therapeutic options for pain relief and treatment of burning mouth syndrome: a systematic review.

Abstract

<h4>Objectives</h4>This study aimed to evaluate the efficacy of different therapeutic options currently used to treat and relieve the pain of Burning Mouth Syndrome (BMS), in order to provide better clinical guidance for future practice.<h4>Materials and methods</h4>A systematic qualitative synthesis of randomized controlled trials (RCTs) was conducted, grouping evidence by intervention type. Twenty-one RCTs were included, assessing pharmacological, topical, systemic, physical, and combined interventions. Studies were selected if they directly evaluated treatments in patients diagnosed with BMS; non-randomized trials were excluded. Electronic searches were performed in PubMed, Google Scholar, and Scielo using the MeSH terms: "Burning Mouth Syndrome," "Oral Burning," "Treatment," and "Randomized Controlled Trial." Outcomes focused on symptom relief, adverse effects, and comparisons with placebo or other treatments. Methodological quality was assessed using risk of bias criteria. Data extraction followed a systematic, cross-validated protocol. Due to substantial clinical and methodological heterogeneity, only a qualitative synthesis was performed.<h4>Results</h4>Fourteen interventions were identified, including alpha-lipoic acid, topical/systemic clonazepam, low-level laser therapy (LLLT), capsaicin, melatonin, gabapentin, and cognitive-behavioral therapy. Topical clonazepam, alpha-lipoic acid, and LLLT consistently demonstrated the most significant symptom improvement with few mild adverse effects.<h4>Conclusions</h4>While topical clonazepam, alpha-lipoic acid, and low-level laser therapy (LLLT) emerged as potentially effective options in several RCTs, the overall strength of evidence is limited. These therapies appear promising, but further high-quality, larger randomized trials are needed before firm first-line recommendations can be made.<h4>Clinical relevance</h4>This study provides evidence-based guidance for clinicians in selecting effective treatments for BMS, emphasizing tailored therapeutic approaches and the potential benefits of topical clonazepam, alpha-lipoic acid, and low-level laser therapy as first-line options.