Chmieliauskaite, Milda, Stelson, Elisabeth A., Epstein, Joel B., Klasser, Gary D., Farag, Arwa, Carey, Barbara, Albuquerque, Rui, Mejia, Lina, Ariyawardana, Anura, Nasri-Heir, Cibele, Sardella, Andrea, Carlson, Charles, and Miller, Craig S. (2021) Consensus agreement to rename burning mouth syndrome and improve International Classification of Diseases-11 disease criteria: an international Delphi study. Pain, 162 (10). pp. 2548-2557.

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Abstract

The International Classification of Diseases (ICD-11) proposes revisions in the nomenclature, disease definition, and diagnostic criteria for “burning mouth syndrome” (BMS). This process could benefit from additional systematically collected expert input. Thus, the purpose of this study was to use the Delphi method to (1) determine whether revision in nomenclature and alternative names for “BMS” are warranted and (2) identify areas of consensus among experts for changes to the disease description and proposed diagnostic criteria of “BMS,” as described in the ICD-11 (World Health Organization). From 31 international invited experts, 23 who expressed interest were sent the survey. The study used 4 iterative surveys, each with a response rate of ≥82%. Consensus was predefined as 70% of participants in agreement. Data were summarized using both descriptive statistics and qualitative thematic analysis. Consensus indicated that BMS should not be classified as a syndrome and recommended instead renaming to “burning mouth disorder.” Consensus included deletion of 2 diagnostic criteria: (1) emotional distress or functional disability and (2) the number of hours symptoms occur per day. Additional items that reached consensus clarified the disease definition and proposed more separate diagnostic criteria, including a list of local and systemic factors to evaluate as potential secondary causes of oral burning. Experts in this study recommended and came to consensus on select revisions to the proposed ICD-11 BMS nomenclature, diagnostic criteria, and disease definition. The revisions recommended have the potential to improve clarity, consistency, and accuracy of diagnosis for this disorder.

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