Burning mouth syndrome: Analysis of diagnostic delay in 500 patients

• Published in: Oral diseases Vol. 30; no. 3; pp. 1543 - 1554
• Main Authors: Adamo, Daniela, Calabria, Elena, Canfora, Federica, Coppola, Noemi, Pecoraro, Giuseppe, D'Aniello, Luca, Aria, Massimo, Mignogna, Michele Davide, Leuci, Stefania
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01.04.2024
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Burning mouth syndrome; Burning Mouth Syndrome - diagnosis; Candidiasis; Delayed Diagnosis; diagnostic delay; Diagnostic Errors - statistics & numerical data; Dysgeusia - diagnosis; Educational Status; Female; Gastroesophageal reflux; Gastroesophageal Reflux - diagnosis; Humans; Male; Maxillofacial; Medical diagnosis; medically unexplained physical symptoms; Middle Aged; misdiagnosis; Patients; psychological profile; Quality of life; Referral and Consultation; Stomatitis; medically unexplained physical symptoms; diagnostic delay; psychological profile; burning mouth syndrome; misdiagnosis
• ISSN: 1354-523X; 1601-0825; 1601-0825
• DOI: 10.1111/odi.14553

Objectives To assess the diagnostic delay, the number and type of referrals and the clinical and psychological profile in a wide sample of patients with Burning Mouth Syndrome (BMS). Materials and Methods Data on the disease onset, oral symptoms, type and number of practitioners consulted, misdiagnoses, and the presence of medically unexplained extraoral physical symptoms were recorded in 500 BMS patients. Potential predictors of diagnostic delay were also evaluated. Results The mean diagnostic delay was 29.71 ± 47.19 months. An average of 2.61 ± 1.65 practitioners were consulted by each patient, the most frequent being the general physicians (287; 57.4%), maxillofacial surgeons (111; 22.2%), and otolaryngologists (104; 20.8%). The mean number of misdiagnoses was 3.54 ± 1.85. Nonspecific stomatitis, candidiasis, and gastroesophageal reflux were the most common misdiagnoses. Higher age, low education, the presence of dysgeusia, and a previous history of psychiatric illness were predictors of a longer diagnostic delay (p‐value: 0.028, 0.050, 0.007, 0.034, respectively). Conclusions The lack of knowledge among specialists, the high rate of misdiagnosis, and the diagnostic delay of BMS highlight the need to introduce educational interventions in all medical specialties in order to promote an early and appropriate diagnosis, thereby improving the prognosis and quality of life of the patients.