Burning mouth syndrome as a manifestation of an unbalanced psycho-neuro-immuno-endocrine axis in mentally ill women with intestinal dysbiosis: A literature review

Abstract

Background: Burning mouth syndrome is currently defined as a type of chronic orofacial pain of unknown etiology; however, several publications describe this syndrome as a neurological disorder with multifactorial pathogenesis in which psychogenic, endocrine, and neuropathic factors are involved. The objective of this article is to propose an etiopathogenic model of BMS based on clinical and preclinical evidence published to date. Methods: Through a systematic bibliographic search in 4 scientific databases: PubMed, Science Direct, Embase and the Cochrane library, of articles published in English in the last 20 years. Results: We dare to propose BMS as a trigeminal small-fiber sensory neuropathy influenced by low-grade chronic systemic inflammation, in a scenario of intestinal dysbiosis or psychiatric disorders and exacerbated in peri or postmenopausal women, due to neuroprotective steroid deficiency and greater propensity to psychological disturbances. Conclusion: It is necessary to develop lines of research linked to the taxonomic and functional characterization of the intestinal microbiome in patients with BMS and to compare it with that obtained in mentally ill patients without BMS against a control group, in order, to elucidate its pathogenesis and find new therapeutic targets that allow us to better manage the syndrome, with stable responses over time.