The issue of allergic sensitization and/or local toxicity to dental materials as potential causative factors for burning mouth disorder (BMD) raises important and interesting questions as Costa and colleagues point out. In our fMRI study of BMD patients (Albuquerque et al., 2006) we did not focus our investigative efforts towards the specific causes of the disorder, but rather studied changes in brain activity patterns associated with this debilitating malady. In their letter, Costa et al. expressed concerns about the main focus of our manuscript being on central nervous system (CNS) disturbances rather than on peripheral neurological abnormalities. Peripheral neuropathy may in fact be an important component of BMD, as documented by Lauria et al. Our study does not contest the observation of peripheral neuropathic alterations in BMD patients, instead, it adds important information regarding possible maladaptive central mechanisms that seem unique to BMD patients compared to age and gender matched pain-free individuals.