17 - Burning Mouth Syndrome

Abstract

Burning mouth syndrome is an infrequent but serious cause of oral pain. Although mouth pain has many causes with readily demonstrable pathological conditions, such as herpes simplex infections and aphthous ulcers, burning mouth syndrome is the diagnosis given to patients who complain of mouth and tongue pain in the presence of a completely normal physical examination. Therefore burning mouth syndrome is by definition a diagnosis of exclusion. Included in the diagnosis of burning mouth syndrome are the clinical syndromes of burning tongue syndrome, glossalgia, glossodynia, stomatodynia, and oral dysesthesia syndrome. Affecting females 7 to 8 times more frequently than men, burning mouth syndrome is a disease of the fifth decade and beyond. The pain of burning mouth syndrome is characterized as a burning, hot, or scalded sensation of the mouth and tongue that may be accompanied by tingling. Most commonly the anterior two thirds of the tongue, palate, gingiva of the upper and lower alveolar region, and lips are involved, with the sublingual region less commonly affected. The exact pathophysiology responsible for burning mouth syndrome remains elusive, and the putative causes in most cases are multifactorial. Underlying nutritional disorders, psychiatric illness, allergic stomatitis, xerostomia, diabetes mellitus, menopause, and other endocrinopathies are often identified in patients with burning mouth syndrome, even though the oral examination is completely negative.