According to a systematic review and meta-analysis published in the Journal of Oral Rehabilitation, Clonazepam and capsaicin are effective for burning mouth syndrome (BMS) and cyclobenzaprine has a positive effect on temporomandibular joint disorders (TMD-J).

Orofacial pain is the most prevalent and debilitating disorder involving the head, face, and neck. This complex disorder represents a challenge to the clinician because this pain can arise from many sources. There are three different divisions of oro-facial pain: temporomandibular muscle disorders (TMDmuscle), temporomandibular joint disorders (TMD-J) and burning mouth syndrome (BMS). Out of these three, BMS is most common in post-menopausal women, with prevalence rates in the general population varying between 0.1%-3.9%2 with a recent population-based study showing a prevalence of 0.11%. 

Debra Fischoff et al conducted this systemic review to evaluate the efficacy of various pharmacologic treatments for three different categories of oro-facial pain. In this trial, the authors included more than ten patients with orofacial pain, and they were divided into following subgroups: TMD-muscle pain (TMD-m), TMD-joint pain (TMD-j), burning mouth syndrome (BMS) and other oro-facial pain. The author evaluates the change in intensity of pain and their effect on the quality of life as a primary and secondary outcome respectively.

The data were evaluated by three authors independently. Swedish Agency for Health Technology Assessment and Assessment of Social Services tool was used to evaluate the risk of bias. Data were extracted according to a modified GRADE system by two authors.

Out of all included studies, 41 were included in patients with TMD-j pain (15 studies, n = 790), TMD-m pain (nine studies, n = 375), BMS (17 studies n = 868) and rated as medium to low risk of bias. For the TMD-j group, five and nine studies support NSAIDs and corticosteroid injections respectively. Eight of the nine TMD-m studies were included in a network meta-analysis (NMA), and the use of cyclobenzaprine, botulinum toxin injections and topical treatment with Ping-On ointment was supported. Five of the 17 BMS studies included in an NMA support topical capsaicin and clonazepam. Of the remaining 12, five showed no effect while the remaining support alpha-lipoic acid, gabapentin, clonazepam, amisulpride, and SSRIs. The authors supported the use of NSAIDs, and corticosteroid and hyaluronate injections for orofacial pain management.