Role of contact sensitizers in the burning mouth syndrome

The "burning mouth syndrome" is characterized by burning sensations sometimes associated with erythema, edema, and erosions. Seventy-two patients, 61 females and 11 males, who had burning sensations in their oral cavity were patch tested with the International Contact Dermatitis Research Group (ICDRG) standard series and our dental series. Twenty-five patients (34.7%), 24 females and 1 male, showed positive patch test reactions to one or more substances. Oral mucosal alterations were present in 19 cases. The positive patch test reactions were considered clinically relevant in 12 cases. Although in most patients affected by burning mouth syndrome a precise diagnosis is very difficult, in our opinion contact sensitization by dental materials may account for some of the cases of oral symptoms. Consequently, patch tests may be useful in identifying the allergic nature of oral discomfort, especially in patients without a history of systemic disorders who suspect dental materials as the cause of their symptoms.