Developing a research diagnostic criteria for burning mouth syndrome: Results from an international Delphi process

Abstract

Objective To develop a beta version of a preliminary set of empirically derived research diagnostic criteria (RDC) for burning mouth syndrome (BMS) through expert consensus, which can then be taken into a test period before publication of a final RDC/BMS. Design A 6 round Delphi process with twelve experts in the field of BMS was used. The first round formed a focus group during which the purpose of the RDC and the definition of BMS was agreed upon, as well as the structure and contents. The remaining rounds were carried out virtually via email to achieve a consensus of the beta version of the RDC/BMS. Results The definition of BMS was agreed to be ‘an intraoral burning or dysaesthetic sensation, recurring daily for more than 2 hours per day over more than 3 months, without evident causative lesions on clinical examination and investigation’. The RDC was based upon the already developed and validated RDC/TMD and formed three main parts: patient self‐report; examination; and psychosocial self‐report. A fourth additional part was also developed listing aspirational biomarkers which could be used as part of the BMS diagnosis where available, or to inform future research. Conclusion This Delphi process has created a beta version of an RDC for use with BMS. This will allow future clinical research within BMS to be carried out to a higher standard, ensuring only patients with true BMS are included. Further validation studies will be required alongside refinement of the RDC as trialling progresses.

Consensus agreement to rename burning mouth syndrome and improve International Classification of Diseases-11 disease criteria: an international Delphi study

“…This finding is consistent with the beta version of the RDC/BMS. [9] Moreover, the proposed ICD-11 criteria regarding emotional distress and functional disability lack clear operationalized definitions and thresholds for diagnosis. In the proposed criteria, functional disability is narrowly defined to oral function such as "eating, yawning, and speaking."…”

“…[45] The International Headache Society (IHS) [2], and International Association for the Study of Pain (IASP) [29] also have revisited the classification of orofacial pain, yet the diagnostic criteria for BMS amongst these entities continue to differ. More recently, a committee from the International Network for Orofacial Pain and Related Disorders Methodology (INfORM) developed a Beta version of the research diagnostic criteria for BMS (RDC/BMS) [9] using the ICOP definition. However, the new RDC have not been tested and serve a unique role compared with the ICD-11.…”

Chemosensory Function in Burning Mouth Syndrome a Comparative Cross-Sectional Study

“…Other studies [42,43]. have indeed used similar taste strips containing other bitter-tasting compounds, such as PTC/) and salicin [44], to investigate specific bitter perceptions Studies on taste dysfunction in patients with BMS pose problems, particularly in relation to the diagnosis and classification of cases as corresponding to either primary or secondary BMS [1][2][3]. Some studies offer little or no information on patient selection or details of the methods used.…”

“…Burning mouth syndrome (BMS) is a chronic condition characterized by pain and/or burning sensation in the oral cavity, in the presence of an oral mucosa of normal appearance and with no local or systemic disorders [1][2][3]. The prevalence of BMS ranges widely from 1-14.8%, depending on the diagnostic criteria used [1][2][3]. The syndrome affects mainly women, particularly after menopause [1][2][3][4][5].…”

“…The prevalence of BMS ranges widely from 1-14.8%, depending on the diagnostic criteria used [1][2][3]. The syndrome affects mainly women, particularly after menopause [1][2][3][4][5]. While the etiopathogenesis of BMS is not fully clear, there is growing evidence defining it as a neuropathic pain disorder and, thus, a direct consequence of a lesion or disorder affecting the somatosensory system [4,5], but the gustatory system has also been implicated in this condition [2].…”