Treatment of burning mouth syndrome with topical clonazepam

Burning mouth syndrome (BMS) was first identified many years ago but is still a difficult disease for patients and clinicians. Moreover, there is no completely effective treatment. Clinically, BMS manifests as burning or pain in an area of the oral mucosa not caused by any apparent lesion that could explain these symptoms. BMS occurs mainly in postmenopausal women, who are usually affected for prolonged periods. This syndrome can be accompanied by other alterations such as a sensation or dryness or alterations in taste. Objectives: To evaluate the response to topical clonazepam treatment in a sample of patients with BMS and describe the epidemiological factors, diseases and drugs administered in these patients. Patients and methods: The sample was composed of 66 patients who consulted for burning mouth at the Dental Clinic of the University of Barcelona. A double-blind study was performed: 33 patients were treated with sublingual clonazepam tablets and another group of 33 patients was treated with placebo. Symptoms were evaluated after 1 and 6 months of treatment and were scored on an analogical scale from 0 to 10. Results: After 1 month of treatment, symptoms were reduced by more than 50% in 23 of the 33 patients treated with clonazepam. In contrast, significant improvement was found in only four patients in the placebo group. After 6 months, significant differences were obtained again: improvement was found in 23 of the 33 patients treated with clonazepam and in only two of those treated with placebo. However, when measured in terms of complete cure (lack of symptoms), these differences were not significant. Only five of the patients treated with clonazepam and only one in the placebo group were asymptomatic. Conclusions: In our sample, topical clonazepam was useful in reducing the symptoms of BMS in a high proportion of patients. © 2011 Elsevier España, S.L. All rights reserved.