1. Objectives:

To evaluate the clinical efficacy and tolerability of systemic alpha-lipoic acid (ALA) in patients with primary Burning Mouth Syndrome (BMS), a chronic neuropathic orofacial pain disorder with limited effective treatment options.

1. Methods:

A retrospective observational pilot study, lacked control group, was conducted on 32 patients clinically diagnosed with BMS and treated with  alpha-lipoic acid at a dose of 300 mg twice daily for eight weeks. Symptom severity was assessed using a 10-point Visual Analogue Scale (VAS) at baseline and after treatment. Treatment response was categorized as marked (≥50% VAS reduction), moderate (30–49%), or minimal (<30%). Statistical analysis was performed using the paired Student’s t-test., with p < 0.05 considered statistically significant.

1. Results:

The mean baseline VAS score was 7.6 ± 1.2. Significant reduction was observed at eight weeks (3.9 ± 1.6) (p < 0.001). Marked improvement was recorded in 20 patients (62.5%), moderate improvement in 8 patients (25%), and minimal or no improvement in 4 patients (12.5%). Mild gastrointestinal discomfort was reported by three patients (9.4%), which resolved without treatment discontinuation. No other serious adverse events were observed.

1. Conclusion:

Alpha-lipoic acid demonstrated significant symptomatic improvement with good tolerability in patients with Burning Mouth Syndrome. Its neuroprotective and antioxidant properties support its role as a safe systemic therapeutic option, particularly in patients with neuropathic features or intolerance to centrally acting agents.

1. Objectives:

To evaluate the clinical efficacy and tolerability of systemic alpha-lipoic acid (ALA) in patients with primary Burning Mouth Syndrome (BMS), a chronic neuropathic orofacial pain disorder with limited effective treatment options.

1. Methods:

A retrospective observational pilot study, lacked control group, was conducted on 32 patients clinically diagnosed with BMS and treated with  alpha-lipoic acid at a dose of 300 mg twice daily for eight weeks. Symptom severity was assessed using a 10-point Visual Analogue Scale (VAS) at baseline and after treatment. Treatment response was categorized as marked (≥50% VAS reduction), moderate (30–49%), or minimal (<30%). Statistical analysis was performed using the paired Student’s t-test., with p < 0.05 considered statistically significant.

1. Results:

The mean baseline VAS score was 7.6 ± 1.2. Significant reduction was observed at eight weeks (3.9 ± 1.6) (p < 0.001). Marked improvement was recorded in 20 patients (62.5%), moderate improvement in 8 patients (25%), and minimal or no improvement in 4 patients (12.5%). Mild gastrointestinal discomfort was reported by three patients (9.4%), which resolved without treatment discontinuation. No other serious adverse events were observed.

1. Conclusion:

Alpha-lipoic acid demonstrated significant symptomatic improvement with good tolerability in patients with Burning Mouth Syndrome. Its neuroprotective and antioxidant properties support its role as a safe systemic therapeutic option, particularly in patients with neuropathic features or intolerance to centrally acting agents.