Comparative Study of Clinical Characteristics According to Pain Distribution in Lingual Burning Mouth Syndrome

Background The pathophysiology of burning mouth syndrome (BMS) remains unclear. Objectives To compare the clinical characteristics of patients with lingual BMS according to pain distribution. Methods The medical records of patients with lingual BMS who visited the oral clinic of Kyung Hee University Korean Medicine Hospital between January 2023 and December 2024 were retrospectively reviewed. Patients were classified according to tongue pain distribution as follows: laterality (unilateral vs. bilateral), extent (localised vs. generalised) and central tongue involvement (non‐central vs. central involvement). Group differences and associations among clinical characteristics, including pain intensity (visual analog scale [VAS]), quality of life, salivary flow and taste disturbance, were assessed. Results In total, 256 patients were included. Patients with bilateral pain showed significantly higher pain intensity than those with unilateral pain. Patients with generalised pain reported significantly higher pain intensity than those with localised pain. Patients with central involvement showed significantly higher pain intensity than those with non‐central involvement. Pain intensity was negatively associated with quality of life in most subgroups, except the unilateral subgroup. Taste disturbance was associated with clinically significant pain (VAS ≥ 4) in the unilateral and localised subgroups, whereas reduced salivary flow was associated with clinically significant pain in the central involvement subgroup. Conclusions Pain distribution may help identify clinical subtypes of lingual BMS and support individualised assessment. Herein, pain distribution was associated with differences in pain intensity, quality of life, taste disturbance and salivary flow, underscoring the heterogeneous and multifactorial pathophysiology of lingual BMS and the need for tailored management.