Little evidence to support or refute interventions for the management of burning mouth syndrome.

Data sourcesCochrane Oral Health's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Medline Ovid, Embase Ovid, US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform. Handsearch of the proceedings from the British Society for Oral Medicine (BSOM), British Society for Dental Research (BSDR) and the International Association for Dental Research (IADR).Study selectionAll included studies were randomised placebo controlled trials comparing a treatment to placebo with no language or year of publication restrictions. Symptom relief and changes in quality of life were considered primary outcomes.Data extraction and synthesisTeams of two authors independently screened for inclusion, extracted data using an ad-hoc tool and assessed the risk of bias using the Cochrane's tool. Outcomes were analysed for <3 months (short term) and ≥3 to ≤6 months (long term). For single studies with multiple interventions, the number of participants in the control group was adjusted to half before combining the results. For crossover studies without washout periods, the first period was analysed. RRs (risk ratios) and 85% confidence intervals were calculated for dichotomous outcomes and MDs (mean differences) and 95% confidence intervals for continuous data.ResultsA total of 23 studies encompassing 1121 patients were included. One study was considered as having overall low risk of bias, four unclear and the rest as high risk of bias. The interventions were grouped into: antidepressants and antipsychotics, anticonvulsants, benzodiazepines, cholinergics, dietary supplements, electromagnetic radiation, physical barriers, psychological therapies and topical treatments. Short-term symptom relief was demonstrated by: energy waves (one study, 58 participants) MD -30.36, 95% CI -44.22 to -16.50, physical barriers (one study, 50 participants) MD -1.1 95% CI -2.14 to 0.06, the anticonvulsant gabapentin (one study, 100 participants) RR 4.00, 95% CI 2.09 to 7.67 and topical benzodiazepine (two studies, 111 participants) MD -1.89 95% CI -2.19 to -1.59. Long term symptom relief was achieved with topical benzodiazepine (one study, 66 participants) MD -1.39 95% CI -1.96 to 0.83ConclusionsFrom studies mostly classified as high risk of bias, there is insufficient evidence to support or refute the use of any particular intervention for the management of BMS.