Oral Dysaesthetic and Perceptual Disorder, a Distinct Subset of Chronic Orofacial Pain Without Burning Symptoms: A Case-Control Study.

Background: According to the ICOP 2020, burning mouth syndrome (BMS) is a chronic orofacial pain disorder characterised by an intraoral burning sensation, which represents the main diagnostic criterion. However, some patients experience other symptoms such as xerostomia, taste alterations and globus, without the burning sensation (non-BMS).

Objective: This study aims to explore non-BMS as a distinct subclinical entity by comparing the classical BMS with this new group of patients in a case-control study, addressing gaps in current diagnostic criteria.

Methods: 83 non-BMS patients were compared with an equal number of BMS patients matched for age and sex. Data on sociodemographic and risk factors, systemic comorbidities and drug intake, symptom patterns, psychological profiles were collected and statistically analysed.

Results: No significant differences between BMS and non-BMS groups were found in sociodemographic characteristics, comorbidities, drug consumption and extraoral symptoms. Both groups reported similar symptoms patterns, with discomfort intensifying in the evening. Although oral symptoms prevalence varied, with the burning sensation exclusive to BMS patients, none of these differences reached statistical significance. Psychological assessments revealed mild depression (17 [14-19] vs. 17 [14-20], p < 0.981), mild to moderate anxiety (18 [15-21] vs. 17 [15-20.5], p < 0.767) and sleep disturbance (5 [4-7] vs. 8 [5-10], p < 0.001) in both groups.

Conclusion: Non-BMS patients exhibit similarities to BMS patients yet remain unclassified under current diagnostic criteria. Therefore, we have suggested the term "Oral Dysaesthetic and Perceptual Disorder (ODPD)" to define these patients (non-BMS). This study emphasises the need to expand diagnostic criteria to better identify and manage ODPD patients.