This study focuses on the possible etiopathogenetic mechanisms underlying burning mouth syndrome and the most appropriate clinical management for its treatment. Burning Mouth Syndrome (BMS) is characterized by an intraoral burning sensation or dysesthesia without any detectable alterations in the oral mucosa, causing significant discomfort in affected patients. The idiopathic nature of that type of chronic orofacial pain makes it challenging to identify specific etiopathogenetic factors and mechanisms. Therefore, the therapeutic strategy for BMS is challenging to choose among, including pharmacological approaches involving synthetic drugs or compounds derived from natural substances. The most appropriate clinical management for its treatment may involve different therapeutic approaches, although a definitive protocol for managing BMS has yet to be established.