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

Milda Chmieliauskaite, Elisabeth A. Stelson, Joel B. Epstein, Gary D. Klasser, Arwa Farag, Barbara Carey, Rui Albuquerque, Lina Mejia, Anura Ariyawardana, Cibele Nasri-Heir, Andrea Sardella, Charles Carlson, Craig S. Miller

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


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.

Original languageEnglish
Pages (from-to)2548-2557
Number of pages10
Issue number10
StatePublished - Oct 1 2021

Bibliographical note

Funding Information:
Research described in this publication was supported by award R25CA057711 and 2T32CA057711-26 from the National Cancer Institute of the National Institutes of Health. The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.


  • Burning mouth syndrome
  • Delphi method
  • Diagnostic criteria
  • Disease definition
  • ICD-11

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Anesthesiology and Pain Medicine


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