Burning Mouth Syndrome.

Burning mouth syndrome is a chronic condition characterized by an intraoral burning sensation in the absence of a local or systemic cause.

History of burning mouth syndrome (1800-1950): A review.

This medical history historic literature review aims at understanding the evolution of the medical existence of burning mouth syndrome (BMS) over times. Three historic research tools were used (Medic@, IndexCat, Gallica) with several keywords, exploring the years 1800-1950. One hundred and fifty documents were obtained dating from 1803 to 1937, including 55 reviews, 44 original articles, 40 quotations, and 11 medical dictionaries. A total of 199 cases of BMS were reported which allowed for a narrative review of the early history of BMS (1800-1950). This review spans from the description of the first clinical cases by several authors in Europe to the creation of the syndrome by the French Academy of Medicine, its intellectual sponsorship by the emerging discipline of neuropsychiatry, to its subsequent evolution until the conceptual shift of the American authors. A better knowledge of the evolution of the nosology of BMS throughout history should bring a better understanding of current approaches for treating such an affection.

[Burning mouth syndrome - a joint biopsychosocial approach]. / Approche biopsychosociale des stomatodynies: prise en charge conjointe.

Burning mouth syndrome (BMS) is a medical condition that is often refractory to conventional diagnostic and therapeutic methods. Patients suffering from BMS can benefit from a biopsychosocial approach in a joint, medical-psychological consultation model. Such a consultation exists at Geneva University Hospitals, involving the collaboration of the maxillo-facial and oral surgery division and the division of liaison psychiatry and crisis intervention, in order to take into account the multiple factors involved in BMS onset and persistence. This article will describe BMS clinical presentation, and present an integrate approach to treat these patients.

[Glossodynia or burning mouth syndrome: equivalence or difference].

The term "Burning Mouth Syndrome (BMS)" is being used much more often than "Glossodynia", complicating diagnostic and treatment tactic choice. The aim of the study was to determine the difference between "Glossodynia" and "BMS" considering absence or presence of intraoral metal prosthetic devices and burning sensation in the mouth. To establish the frequency of glossodynia and BMS 2355 patient records were analyzed admitting consultation for oral diseases for the last 10 years. Clinically we examined 408 patients aged 40 to 70. The research results showed that 17% of patients complained of "burning mouth": 10.2% of them had these symptoms due to oral mucosa diseases; 58.0% had glossodynia, 27.4% had discomfort because of intolerance to metal prosthodontic materials and 4.4% had combined pathology. Glossodynia and intolerance to metal prosthodontic materials had much in common in terms of clinical features, but the last one may be specified by changes in saliva composition. BMS thus proved to be the common definition corresponding to various diseases of oral mucosa and intolerance to intraoral metal appliances, while glossoldynia is a distinct neurogenic disease which is difficult to treat and requires comprehensive approach involving neurologist and physician.

Epidemiological and etiological aspects of burning mouth syndrome.

Burning mouth syndrome (BMS) is defined as a chronic pain condition characterized by a burning sensation in clinically healthy oral mucosa. Incidence BMS diagnosed in the Department of Oral Medicine - Oral Pathology Dental Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy Bucharest is 16,23%. The etiology of BMS remains far less known. This article makes an overview of the latest theories about possible etiopathogenic factors involved in the occurrence of BMS.

Effect of glycemic control on self-perceived oral health, periodontal parameters, and alveolar bone loss among patients with prediabetes.

BACKGROUND: The effect of glycemic control on severity of periodontal inflammatory parameters in patients with prediabetes is unknown. The aim of the present study is to assess the effects of glycemic control on self-perceived oral health, periodontal parameters, and marginal bone loss (MBL) in patients with prediabetes. METHODS: A total of 303 individuals were included. Hemoglobin A1c (HbA1c) and fasting blood glucose levels (FBGLs) were recorded. Participants were divided into three groups: 1) group A: 75 patients with prediabetes (FBGLs = 100 to 125 mg/dL [HbA1c ≥5%]); 2) group B: 78 individuals previously considered prediabetic but having FBGLs <100 mg/dL (HbA1c <5%) resulting from dietary control; and 3) control group: 150 medically healthy individuals. Self-perceived oral health, socioeconomic status, and education status were determined using a questionnaire. Plaque index (PI), bleeding on probing (BOP), probing depth (PD), and clinical attachment loss (AL) were recorded. Premolar and molar MBLs were measured on panoramic radiographs. RESULTS: Periodontal parameters (PI, BOP, PD, and AL) (P <0.01) and MBL (P <0.01) were worse among individuals in group A than those in group B. Self-perceived gingival bleeding (P <0.001), pain on chewing (P <0.001), dry mouth (P <0.001), and oral burning sensations (P <0.05) were worse among patients in group A than those in group B. There was no difference in periodontal parameters, MBL, and self-perceived oral symptoms among patients with prediabetes in group B and healthy controls. CONCLUSIONS: Self-perceived oral health, severity of periodontal parameters, and MBL are worse in patients with prediabetes than controls. Glycemic control significantly reduces the severity of these parameters as well as the state of prediabetes in affected individuals.

Burning mouth syndrome: a review on diagnosis and treatment.

Burning mouth syndrome (BMS) is defined as a chronic pain condition characterized by a burning sensation in the clinically healthy oral mucosa. It is difficult to diagnose BMS because there is a discrepancy between the severity, extensive objective pain felt by the patient and the absence of any clinical changes of the oral mucosa. This review presents some aspects of BMS, including its clinical diagnosis, classification, differential diagnosis, general treatment, evolution and prognosis.

Psychiatric morbidity among patients with oral submucous fibrosis: a controlled study.

AIM: The study aimed to evaluate the association between oral submucous fibrosis (OSF) and psychiatric morbidity in a controlled manner. METHODS: Matched patients were divided into three groups: Those with areca nut chewing habits with OSF (Group 1; n=50); those with areca nut chewing habits without OSF (Group 2; n=50); those without areca habits and with dental problems other than OSF (Group 3; n=50). The Mini International Neuropsychiatric Interview was used to assess psychiatric morbidity. Dependence to areca products was also assessed. RESULTS: Sixteen (32%) Group 1 patients had psychiatric morbidity compared to one (2%) in Group 2 and two (4%) in Group 3 (P<0.001). Further, psychiatric morbidity was significantly higher among patients with advanced stages of OSF. In Groups 1 and 2, 49 (98%) and 47 (94%) patients, respectively, had dependence on areca products. CONCLUSION: This study has suggested the association of substantial psychiatric morbidity among patients with OSF. In addition to mandatory psychiatric management of these patients, future research should be targeted at a prospective evaluation of a cause and effect relationship as well as at psychiatric interventions.

Validity and reliability of patient-centered outcome measures in oral dysesthesia.

OBJECTIVE: The objective of this study was to investigate the validity and reliability of a quality of life instrument in patients with oral dysesthesia. STUDY DESIGN: Forty-five individuals newly diagnosed with oral dysesthesia (37 women, 8 men) were enrolled in this study. Individuals were interviewed using the Visual Analogue Scale (VAS), and the Oral Health Impact Profile (OHIP-14). Construct validity and internal reliability were examined. RESULTS: Patient rating of pain experienced, using VAS, correlated with OHIP-14 scores (P < .05), demonstrating construct validity. OHIP-14 demonstrated good internal consistency with Cronbach's alpha of 0.79. The corrected item-total correlations for items 3 (painful aching) and 12 (difficulty doing usual jobs) were below the recommended minimum of 0.20. Cronbach's alpha increased to 0.81 with the exclusion of these 2 items from OHIP-14. CONCLUSIONS: The OHIP-14 questionnaire appeared to perform relatively well in the 45 patients with oral dysesthesia enrolled in this study, demonstrating validity and reliability in the assessment of the effect of oral dysesthesia on quality of life. However, the exclusion of items 3 and 12 from the questionnaire should be considered in future studies with this patient population.

Unexplained somatic comorbidities in patients with burning mouth syndrome: a controlled clinical study.

AIMS: To evaluate the prevalence of unexplained extraoral symptoms in a group of patients with burning mouth syndrome (BMS) and compare the prevalence with that in patients with oral lichen planus (OLP) and age- and gender-matched controls. METHODS: The occurrence of extraoral symptoms was analyzed in a group of 124 BMS patients, a group of 112 oral lichen planus (OLP) patients, and a group of 102 healthy patients. Oral symptoms were collected by a specialist in oral medicine and a general dentist, while data concerning unexplained extraoral symptoms were gathered by each specialist ward, ie, ophthalmology, gynecology, otolaryngology, gastroenterology, neurology, cardiology, internal medicine, and dermatology. A Fisher exact test (α = .05) and Kruskal-Wallis test (α = .05) were performed for statistical analysis. RESULTS: In the BMS group, 98 (96.1%) patients reported unexplained extraoral symptoms, while 4 (3.9%) patients reported only oral symptoms. A painful symptomatology in different bodily regions was reported more frequently by BMS patients (83.3%) than by OLP patients (1.8%) and healthy patients (11.7%) (P < .0001). The differences in the overall unexplained extraoral symptoms between BMS (96.1%) and OLP patients (9.3%) (P < .0001) and between BMS (96.1%) and healthy patients (15.7%) (P < .0001) were statistically significant. The unexplained extraoral symptoms in BMS patients consisted of pain perceived in different bodily areas (odds ratio [OR]: 255; 95% confidence interval [CI]: 58.4-1112), ear-nose-throat symptoms (OR: 399.7; 95%CI: 89.2-1790), neurological symptoms (OR: 393; 95% CI: 23.8-6481), ophthalmological symptoms (OR: 232.3; 95% CI: 14.1-3823), gastrointestinal complaints (OR: 111.2; 95% CI: 42.2-293), skin/gland complaints (OR: 63.5; 95% CI: 3.8-1055), urogenital complaints (OR: 35; 95% CI: 12-101), and cardiopulmonary symptoms (OR: 19; 95% CI: 4.5-82). CONCLUSION: The great majority of BMS patients presented with several additional unexplained extraoral comorbidities, indicating that various medical disciplines should be involved in the BMS diagnostic process. Furthermore, the results suggest that BMS may be classified as a complex somatoform disorder rather than a neuropathic pain entity.

[The value of allergy survey in a retrospective series of 40 patients with burning-mouth syndrome (stomatodynia)]. / Stomatodynies: intérêt de l'enquête allergologique dans une série rétrospective de 40 malades.

BACKGROUND: By definition, stomatodynia or burning-mouth syndrome involves oral pain with no causes being found on history taking or examination. An allergic origin is often suspected by doctors and patients alike. In this study, we attempted to assess the value of epicutaneous tests in demonstrating allergic causes for patients presenting stomatodynia. PATIENTS AND METHODS: This was a single-centre retrospective study of patients undergoing epicutaneous tests between 1996 and 2003 to screen for allergic causes of mouth pain not accounted for by any abnormalities seen during examination performed at consultations for mouth disease. RESULTS: Forty patients were included (11 male, 29 female; mean age: 58 years), and 39 were excluded. Sixteen patients presented at least one positive test, with a total of 35 positive tests in all. In decreasing order of frequency, the causes were metals, mercury derivatives (nickel salts: n=5; chrome salts: n=3; palladium salts: n=2; phenylmercuric acetate: n=2; thiomersal: n=2; cobalt salts: n=1; gold salts: n=1; mercury: n=1) and resins (acrylates: n=4). The relevance of these test results was considered probable in three cases and possible in five cases, associated with the existence of metals or resins in patients' mouths. The Peru balm test was positive in four cases but was not relevant. Tests for personal products were negative in all cases, with the exception of one case of resin from a prosthesis and one case of tixocortol pivalate. COMMENTS: Type I stomatodynia (daily occurrence with gradually increase in discomfort throughout the day) and type II stomatodynia (permanent) are not normally attributable to allergies. However, for type III stomatodynia (non-permanent, with acute episodes followed by remission), an allergy survey guided by questioning may be undertaken to determine the cause, primarily prostheses or diet. The relevance of positive test results must be interpreted with caution in view of the incidence of positive epicutaneous tests for metals and Peru balm among the general population studied.

The burning mouth.

Burning in the mouth in and of itself is not all that uncommon. It may result from a variety of local or generalized oral mucosal disorders, or may be secondary to referred phenomena from other locations. Primary burning mouth syndrome, on the other hand, is relatively uncommon. Burning mouth syndrome is an idiopathic pain disorder, which appears to be neuropathic in origin. Thoughts on management of secondary and particularly primary burning mouth syndrome are discussed.

Burning mouth syndrome: an update on recent findings.

Burning mouth syndrome (BMS) is characterized by a burning sensation of the oral mucosa in the absence of mucosal abnormality. Various local, systemic and psychological factors are associated with BMS, but its aetiology is not fully understood. Recently, significant inroads have been made, producing a better understanding of this complex condition. The aim of the current paper is to explore the condition of BMS in an educational context with the specific outcome of increasing awareness of the condition.

Periodontal diseases and awareness among patients.

Awareness of periodontal problems and how they interpret this and their timely intervention affects periodontal health. Many people neither recognize the symptoms of periodontal disease nor do they associate existing symptoms with the disease. Hence one should ensure that the routes of science transfer are open so that the appropriate knowledge regarding the prevention and control of periodontal diseases are available to the public.

Update on burning mouth syndrome: overview and patient management.

Burning Mouth Syndrome (BMS) is a chronic pain syndrome that mainly affects middle-aged/old women with hormonal changes or psychological disorders. This condition is probably of multifactorial origin, often idiopathic, and its etiopathogenesis remains largely enigmatic. The present paper discusses several aspects of BMS, updates current knowledge, and provides guidelines for patient management. There is no consensus on the diagnosis and classification of BMS. The etiopathogenesis seems to be complex and in a large number of patients probably involves interactions among local, systemic, and/or psychogenic factors. In the remaining cases, new interesting associations have recently emerged between BMS and either peripheral nerve damage or dopaminergic system disorders, emphasizing the neuropathic background in BMS. Based on these recent data, we have introduced the concepts of "primary" (idiopathic) and "secondary" (resulting from identified precipitating factors) BMS, since this allows for a more systematic approach to patient management. The latter starts with a differential diagnosis based on the exclusion of both other orofacial chronic pain conditions and painful oral diseases exhibiting muco-sal lesions. However, the occurrence of overlapping/overwhelming oral mucosal pathologies, such as infections, may cause difficulties in the diagnosis ("complicated BMS"). BMS treatment is still unsatisfactory, and there is no definitive cure. As a result, a multidisciplinary approach is required to bring the condition under better control. Importantly, BMS patients should be offered regular follow-up during the symptomatic periods and psychological support for alleviating the psychogenic component of the pain. More research is necessary to confirm the association between BMS and systemic disorders, as well as to investigate possible pathogenic mechanisms involving potential nerve damage. If this goal is to be achieved, a uniform definition of BMS and strict criteria for its classification are mandatory.

Síndrome de Boca Ardiente: actualización / Burning Mouth syndrome: actualization

El síndrome de la boca ardiente (SBA) es una entidad nosológica, más frecuente en mujeres menopáusicas. Su principal característica es una sintomatología urente y/o dolorosa de la mucosa bucal (principalmente en la lengua), sin hallazgos clínicos aparentes que expliquen la aparición de esta sensación. Se encuentra relacionado con una serie de factores locales, sistémicos posibles desencadenantes, por lo que se considera de etiología multifactorial. El tratamiento va dirigido a mejorar la sintomatología y controlar los factores. Las terapias propuestas consistentes en control de factores locales, factores sistémicos y psicológicos y algunas indicaciones farmacológicas, proporcionan resultados mediocres. En términos generales, el SBA continúa siendo objeto de estudios en el ámbito de la medicina bucal en busca de un diagnóstico más preciso y de una terapéutica más eficaz (AU)

Burning mouth syndrome (BMS) is a nosological entity, frequent in women in the menopausal period, which principal characteristic is a burning and/or pain sensation of the oral cavity (principally in the tongue). However, the oral mucosa often appears normal, with no apparent organic cause to account for the symptomatology. This syndrome is found to be related which a series of local and systemic factors as possible cause. Therefore is to be considerate a pathology with multifactorial etiology. The treatment is directed to improve the symptomatology and to control the factors. The proposal therapies, related to the control of local, systemic and psychological factors and some pharmacological indications, provide poor results. In general terms the BMS is still the object of many studies in the environment of the oral medicine, in order to search several aspects of diagnose and a more effective therapy (AU)

Burning mouth syndrome. A retrospective analysis of clinical characteristics and treatment outcomes.

Burning mouth syndrome is a condition characterized by burning sensations of the oral cavity in the absence of physical abnormalities of the mucosa or a detectable underlying medical disorder. It is a multifactorial disorder with unclear etiology, affecting predominatly middle-aged women. Multiple approaches to treatment have been described in the literature, with few controlled clinical trials regarding their efficacy. The objectives of this retrospective study were to: 1. determine the epidemiologic characteristics of BMS patients referred to an oral medicine practice; 2. determine if BMS classification correlates with response to treatment; 3. determine the efficacy of a variety of known therapies for BMS. A database was constructed from the charts of 150 consecutive patients diagnosed with BMS; and these charts were reviewed. Patients were classified according to previously published criteria for BMS. Presumed etiologies were grouped into depression/anxiety-associated; hematinic deficiencies, including iron, folate and vitamin B complex; oral habits: and idiopathic BMS. Treatment approaches were divided into seven categories: soft desensitizing appliance; tricyclic antidepressants (TCA); benzodiazepines (BZD); topical analgesics; hematinic supplements; habit awareness counseling; and multi-modal therapy (combining two or more of the above). Improvement was recorded using a zero to 100% VAS scale and classified as no relief (0%); mild (0-40%); meaningful/moderate (41-80%); and profound relief (81-100%). Burning mouth syndrome without any identifiable cause (idiopathic) was diagnosed in 33 patients (46.6%). Patients were followed up at one month (4 weeks) after the initial visit. Nine patients (12.7%) reported profound relief; 17 patients (23.9%) reported meaningful relief; 39 patients (54.9%) reported mild relief. This retrospective review showed no significant correlation between classification of BMS and response to therapy. The most effective treatment modalities were habit awareness, followed by TCAs.