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Topical Piperine for the Management of Burning Mouth Syndrome: A Case Series

Varoni EM, Meregalli M, Lodi G, Vitalini S, Iriti M, Sardella A

Journal of clinical medicine, 2026

9 participants

Abstract

Background: Burning Mouth Syndrome (BMS) is a chronic pain characterized by persistent oral burning and itching sensations without identifiable organic causes. In this case series, we explored the role as non-pharmacological therapy effects of topical piperine in reducing BMS-related symptoms. Methods: BMS patients performed a 1 min mouthrinse, twice daily for 8 weeks, with 10 mg of piperine in 20 mL of water. At baseline and post-treatment, pain intensity was evaluated using the Numeric Rating Scale (NRS), while oral-health-related quality of life and sleep quality were assessed using the oral health impact profile (OHIP-14) and Epworth Sleepiness Scale (ESS) questionnaires. Results: After 8 weeks of treatment, 9 of 14 patients (64%) reported improvement in BMS symptoms. Pain intensity significantly decreased (NRS scores reduced from 5.10 ± 1.81 to 3.21 ± 2.12; p = 0.001). OHIP-14 scores also improved (from 17.6 ± 8.9 to 12.3 ± 10.4; p = 0.003), as did ESS scores (from 3.86 ± 3.16 to 2.86 ± 2.96; p = 0.008). No adverse events or symptom worsening were reported. Conclusions: Topical piperine may help relieve symptoms in BMS, but the evidence is preliminary due to the small sample size and lack of a control group. Randomized controlled trials are needed to explore its effectiveness.

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 9 participants or records.

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