Individual oral symptoms in burning mouth syndrome may be associated differentially with depression and anxiety.

BACKGROUND: Burning mouth syndrome (BMS) is an idiopathic disease characterized by the feeling of burning in the oral cavity. Ten per cent of patients presenting to oral medicine clinics have BMS. Anxiety and depression are common co-morbidities in BMS, but it is not known if they are associated with specific BMS symptoms. OBJECTIVE: In an exploratory analysis, this study examined the association of generalized anxiety and depression with individual BMS symptoms. METHODS: Forty-one patients were recruited from a dental outpatient clinic (30 with BMS and 11 with other oral conditions), evaluating specific BMS symptoms and their intensity. Anxiety and depression symptoms were assessed using a standardized measure (Clinical Interview Schedule-Revised). RESULTS: Taste change (p = 0.007), fear of serious illness (p = 0.011), metallic taste (p = 0.018) and sensation of a film on the gums (p = 0.047) were associated with an excess of psychiatric symptoms. More specifically, metallic taste (coefficient = 0.497, 95% CI = 0.149-0.845; p = 0.006) and sensation of film on gums (coefficient = 0.625, 95% CI = 0.148-1.103; p = 0.012) were associated significantly with higher scores for depressive symptoms; taste change (coefficient = 0.269, 95% CI = 0.077-0.461; p = 0.007), bad breath (coefficient = 0.273, 95% CI = 0.065-0.482; p = 0.012) and fear of serious illness (coefficient = 0.242, 95% CI = 0.036-0.448; p = 0.023) were associated with higher anxiety scores. CONCLUSION: Specific BMS symptoms are associated differentially with generalized anxiety and depression. Dental practitioners should ascertain which BMS symptoms are predominant and be mindful of the association of certain symptoms with anxiety or depression and, where necessary, consider medical consultation.

Dyskeratosis congenita: a case report.

Dyskeratosis congenita (DC) is a rare inherited condition, first described in 1960 as Zinsser-Engmann-Cole syndrome. The condition presents with a classic triad: nail dystrophy, reticulate skin pigmentation over the trunk and neck, and white plaques typically in the oral cavity. White plaques may also affect, although less frequently, the mucosal surfaces of the urethra and vagina. Variable somatic abnormalities may be present; these include: pulmonary, gastrointestinal, genitourinary, cerebral, and dental complications. Pancytopenia eventually develops, progressing to bone marrow failure; the most common cause of death. In the X-linked form, which affects mainly males, mutations arise in the DKC-1 gene which encodes for the protein dyskerin. This report details a variant case of DC affecting a 9-year-old boy. The disease progression did not follow the "classic triad" typically seen in the condition. Longstanding nail dystrophy and oral ulceration were the sole presenting features. The details of the challenges encountered during diagnosis and treatment are further discussed.