Burning Mouth Syndrome: Aetiopathogenesis and Principles of Management

Somatic symptoms that cannot be attributed to organic disease account for 15 to 20% of primary care consultations and up to 50% in specialized settings. About 6% of the general population has chronic somatic symptoms that affect functioning and quality of life. This chapter focuses on the recognition and effective management of patients with excessive and disabling somatic symptoms. The clinical presentation of somatic symptoms is categorized into three groups of patients: those with multiple somatic symptoms, those with health anxiety, and those with conversion disorder. The chapter provides information to assist with making a diagnosis and differential diagnosis. Management includes ways to improve the physician–patient interaction that will benefit the patient, a step-care model based on illness severity and complexity, and psychological and pharmacologic treatment. The chapter is enhanced by figures and tables that summarize health anxiety, symptoms, differential diagnoses, and management strategies, as well as by case studies and examples. This review contains 5 highly rendered figures, 10 tables, and 235 references.

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Management of Somatic Symptoms

10.2310/fm.1300 ◽

2018 ◽

Author(s):

Andreas Schröder ◽

Joel E Dimsdale

Keyword(s):

Clinical Presentation ◽

Health Anxiety ◽

Management Strategies ◽

Somatic Symptoms ◽

Conversion Disorder ◽

Effective Management ◽

Patient Interaction ◽

Step Care ◽

Physician Patient

Somatic symptoms that cannot be attributed to organic disease account for 15 to 20% of primary care consultations and up to 50% in specialized settings. About 6% of the general population has chronic somatic symptoms that affect functioning and quality of life. This chapter focuses on the recognition and effective management of patients with excessive and disabling somatic symptoms. The clinical presentation of somatic symptoms is categorized into three groups of patients: those with multiple somatic symptoms, those with health anxiety, and those with conversion disorder. The chapter provides information to assist with making a diagnosis and differential diagnosis. Management includes ways to improve the physician–patient interaction that will benefit the patient, a step-care model based on illness severity and complexity, and psychological and pharmacologic treatment. The chapter is enhanced by figures and tables that summarize health anxiety, symptoms, differential diagnoses, and management strategies, as well as by case studies and examples. This review contains 5 highly rendered figures, 10 tables, and 235 references.

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Salivary Biomarkers and Their Correlation with Pain and Stress in Patients with Burning Mouth Syndrome

Journal of Clinical Medicine ◽

10.3390/jcm9040929 ◽

2020 ◽

Vol 9 (4) ◽

pp. 929

Author(s):

Pia Lopez-Jornet ◽

Candela Castillo Felipe ◽

Luis Pardo-Marin ◽

Jose J. Ceron ◽

Eduardo Pons-Fuster ◽

...

Keyword(s):

Immunoglobulin A ◽

Salivary Flow ◽

Health Impact ◽

Burning Mouth Syndrome ◽

Salivary Biomarkers ◽

Inflammatory Protein ◽

Whole Saliva ◽

Burning Mouth ◽

Positive Correlations

Objective: To evaluate a panel of salivary analytes involving biomarkers of inflammation, stress, immune system and antioxidant status in patients with burning mouth syndrome (BMS) and to study their relationship with clinical variables. Materials and Methods: A total of 51 patients with BMS and 31 controls were consecutively enrolled in the study, with the recording of oral habits, the severity of pain using a visual analogue scale (VAS), the Hospital Anxiety and Depression (HAD) score and the Oral Health Impact Profile-14 (OHIP14) score. Resting whole saliva was collected with the drainage technique, followed by the measurement of 11 biomarkers. Results: The salivary flow was higher in patients with BMS. Among all the biomarkers studied, significantly higher levels of alpha-amylase, immunoglobulin A (IgA), and macrophage inflammatory protein-4 (MIP4) and lower levels of uric acid and ferric reducing activity of plasma (FRAP) were observed in the saliva of patients with BMS as compared to the controls (p < 0.05 in all cases). Positive correlations were found between pain, oral quality of life and anxiety scores and salivary biomarkers. Conclusions: BMS is associated with changes in salivary biomarkers of inflammation, oxidative stress and stress, being related to the degree of pain and anxiety.

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Update on Burning Mouth Syndrome: Overview and Patient Management

Critical Reviews in Oral Biology & Medicine ◽

10.1177/154411130301400405 ◽

2003 ◽

Vol 14 (4) ◽

pp. 275-291 ◽

Cited By ~ 297

Author(s):

A. Scala ◽

L. Checchi ◽

M. Montevecchi ◽

I. Marini ◽

M.A. Giamberardino

Keyword(s):

Chronic Pain ◽

Patient Management ◽

Current Knowledge ◽

Pain Syndrome ◽

Burning Mouth Syndrome ◽

Nerve Damage ◽

Hormonal Changes ◽

Oral Diseases ◽

Number Of Patients ◽

Burning Mouth

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.

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Burning mouth syndrome- An Oral Physicians Dilemma

International Journal Of Applied Research and Studies ◽

10.20908/ijars.v6i4.7614 ◽

2017 ◽

Vol 6 (4) ◽

Author(s):

N. Kavitaa

Keyword(s):

Oral Mucosa ◽

Facial Pain ◽

Clinical Signs ◽

Burning Mouth Syndrome ◽

Burning Sensation ◽

Pain Disorder ◽

Treatment Modalities ◽

Clear Cut ◽

Burning Mouth

Burning Mouth Syndrome (BMS) is a chronic oro-facial pain disorder that affects both genders, but predominately with higher female predilection. The condition is characterized by burning sensation present over the oral mucosa and tongue, with no definable clinical signs. The etiology for BMS is not clear cut, so does the quality of treating the condition is hampered. The present paper reviews the etiology, pathophysiology, diagnostic criteria’s and treatment modalities in treating BMS which poses as a great challenge for the oral physicians.

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Burning Mouth Syndrome: A Review of the Etiopathologic Factors and Management

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1822 ◽

2016 ◽

Vol 17 (2) ◽

pp. 171-176 ◽

Cited By ~ 11

Author(s):

Sajith Vellappally

Keyword(s):

Blood Test ◽

Multidisciplinary Approach ◽

Current Knowledge ◽

Burning Mouth Syndrome ◽

Number Of Patients ◽

Oral Mucosal Lesions ◽

Mucosal Lesions ◽

Burning Mouth ◽

Etiological Agents ◽

Burning Mouth Sensation

ABSTRACT Burning mouth syndrome (BMS) is characterized by pain in the mouth with or with no inflammatory signs and no specific lesions. Synonyms found in literature include glossodynia, oral dysesthesia, glossopyrosis, glossalgia, stomatopyrosis, and stomatodynia. Burning mouth syndrome generally presents as a triad: Mouth pain, alteration in taste, and altered salivation, in the absence of visible mucosal lesions in the mouth. The syndrome generally manifests spontaneously, and the discomfort is typically of a continuous nature but increases in intensity during evening and at night. The etiopathogenesis seems to be complex and in a large number of patients probably involves interactions among local, systemic, and/or psychogenic factors. The differential diagnosis requires the exclusion of oral mucosal lesions or blood test alterations that can produce burning mouth sensation. Management is always based on the etiological agents involved. If burning persists after local or systemic conditions are treated, then treatment is aimed at controlling neuropathic symptoms. Treatment of BMS is still unsatisfactory, and there is no definitive cure. As a result, a multidisciplinary approach is required to bring the condition under better control. The aim of this review was to discuss several aspects of BMS, update current knowledge, and provide guidelines for patient management. How to cite this article Vellappallay S. Burning Mouth Syndrome: A Review of the Etiopathologic Factors and Management. J Contemp Dent Pract 2016;17(2):171-176.

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