Etiology Of Burning Mouth Syndrome Research Articles

Is Burning Mouth Syndrome Associated with Extraoral Dryness? A Systematic Review.

Burning mouth syndrome (BMS) is characterized by a persistent intraoral burning sensation, often experienced by postmenopausal women. The etiology of BMS remains partially understood, and consequently, treatments remain suboptimal. Extraoral manifestations of BMS, such as extraoral dryness, are less studied. However, it has been suggested that the identification of the frequency and patterns of extraoral dryness and potential underlying mechanisms are essential to optimize treatment strategies and reduce the burden of disease. Therefore, we conducted this systematic review to provide existing evidence about extraoral dryness in BMS. The guidelines for the conduction and reporting of systematic reviews were followed. An electronic search was conducted in four major databases-PubMed, Web of Science, COCHRANE Library, and EBSCOhost-and the grey literature was assessed through Google Scholar. From each included article, information on extraoral dryness in BMS was extracted, and odds ratios were calculated for extraoral dryness among BMS patients compared with non-BMS controls. The findings demonstrated higher odds of the prevalence of extraoral dryness in BMS, which was found to a high degree in the lips, eyes, skin, and genitalia. The pattern of spread and locations of extraoral dryness propose a potential central mechanism. Based on our findings, we encourage the standardization of the assessment, recording, and reporting of the extraoral characteristics of BMS, including extraoral dryness, which can lead to better management strategies and enhance the quality of life of the affected patients.

Pitfalls for diagnosis of burning mouth-like syndrome

This research gives a scientific framework for burning mouth syndrome(BMS) etiology and diagnostic approach in clinical dental and medical practice. BMS-like symptoms can be induced by systemic diseases such as diabetes, gastrointestinal, endocrine disorders, allergy etc. or by local oral cavity conditions as candidiasis or geographic tongue or odontogenic causes. Because the etiology of BMS is multifactorial, treatment can only be distinctive, and is aimed at relieving symptoms. The complexity of BMS symptoms and associated psychosocial infirmities, anxiety and depression raise the need for a multidisciplinary and individualised approach.

Proteomics-Based Identification of Salivary Changes in Patients with Burning Mouth Syndrome.

Simple SummaryBurning mouth syndrome (BMS) is a chronic oral condition characterized by an intraoral burning sensation, taste alterations, and dry mouth sensations. The disease affects 0.7–15% of the general population, being most common in post-menopausal women. Although BMS is related to anxiety and/or depression and sleep disturbances, its etiology as well as its diagnosis remain unclear. Therefore, the present study aimed to contribute to the knowledge about this syndrome and to look for objective diagnostic tools. Therefore, whole saliva proteomes of patients suffering from BMS were compared to those of healthy persons. The results of this study manifest alterations in salivary proteins related to stress, immune system, and inflammation and, therefore, suggest implication of these pathways in BMS development. Moreover, biomarkers related to stress, immune system, and inflammation, such as salivary amyloid A, immunoglobulins, or leukocyte elastase inhibitors, among others, could contribute to BMC management, although further research is needed to confirm these suppositions.Burning mouth syndrome (BMS) is a chronic oral condition characterized by an intraoral burning sensation, taste alterations, and dry mouth sensations. Although a number of factors have been closely related to the appearance of the symptoms, including anxiety, depression, and sleep disturbances, the etiology of BMS remains unclear. Furthermore, currently no objective diagnostic tools exist, making its diagnosis challenging. Therefore, to contribute to the knowledge about BMS etiology and look for objective tools for its diagnosis, the present study was conducted. Thus, the aim of this study was to analyze the proteomic profile of the resting whole saliva of patients with BMS and age and sex-matched controls using two-dimensional electrophoresis. The results showed evidence of changes in saliva at the level of proteins related to important pathways such as stress (sAA), immune system (Ig), and inflammation (leukocyte elastase inhibitor). While some of our findings have been previously described others, such as the deregulation of the coiled-coin domain containing protein 25 in BMS, are presented here for the first time to our knowledge. Thus, saliva provides us with relevant information about BMS pathophysiology and could be considered a suitable biofluid for its study and/or diagnosis.

Burning mouth syndrome – a burning enigma

Burning Mouth Syndrome (BMS) is a chronic pain condition characterized by an intraoral burning sensation and an absence of oral mucosal lesions and disturbances in laboratory findings. Burning symptoms usually affect the anterior two-thirds of the tongue, its lateral borders, hard palate and labial mucosa, but other oral cavity sites may also be affected. Taste alterations and a decrease in the salivary flow rate frequently accompany the burning symptoms. This condition mostly affects peri- and postmenopausal women. To date, the etiology of BMS remains unclear. This unknown etiology means that no appropriate treatment is currently available. A large number of the treatments and medications have been tried for BMS, but treatment management remains unsatisfactory in some patients. The purpose of this article is to present current knowledge on the treatment of BMS.

Taste is improved with reduction in reported pain in burning mouth syndrome

Objective Burning mouth syndrome (BMS) is commonly associated with complaints of dysgeusia or phantogeusia and a burning pain sensation that typically increases in intensity over the day. Previous studies have documented taste changes in BMS. This study was designed to compare taste perception before and after successful treatment in BMS. Study Design A retrospective study was conducted at a private oral medicine clinic. Thirty-two patients diagnosed with primary BMS, who had spatial taste testing with 4 supersaturated salt (1 M sodium chloride [NaCl]), sweet (1 M sucrose), sour (0.032 M citric acid), and bitter (0.001 M quinine hydrochloride) solutions and 50% ethanol, with self-rated pain intensity on a generalized labeled magnitude scale (gLMS) at the initial and final visits, were included in the study. Analysis was performed with Wilcoxon's signed-rank test, Spearman's correlation, and Mann-Whitney U test, with a significance of P = .05. This study was approved by the Research Ethics Board of the William Osler Health System. Results Twenty-seven female and 5 male patients with primary BMS, mean age 57.1 ± 1.5 years, were included in the study. Treatment duration ranged from 1 month to 22 months. Self-rated maximum (60.7 ± 20.58; 25.3 ± 19.1; P Conclusions In this study, it was found that in BMS, taste improved with reduction in pain. This supports the theory that impairment in taste may be involved in the etiology of BMS, which appears to improve after pain decreases.

Co-occurrence of Pain Symptoms and Somatosensory Sensitivity in Burning Mouth Syndrome: A Systematic Review.

BackgroundBurning mouth syndrome (BMS) is a chronic and spontaneous oral pain with burning quality in the tongue or other oral mucosa without any identifiable oral lesion or laboratory finding. Pathogenesis and etiology of BMS are still unknown. However, BMS has been associated with other chronic pain syndromes including other idiopathic orofacial pain, the dynias group and the family of central sensitivity syndromes. This would imply that BMS shares common mechanisms with other cephalic and/or extracephalic chronic pains. The primary aim of this systematic review was to determine whether BMS is actually associated with other pain syndromes, and to analyze cephalic and extracephalic somatosensory sensitivity in these patients.MethodsThis report followed the PRISMA Statement. An electronic search was performed until January 2015 in PubMed, Cochrane library, Wiley and ScienceDirect. Searched terms included “burning mouth syndrome OR stomatodynia OR glossodynia OR burning tongue OR oral burning”. Studies were selected according to predefined inclusion criteria (report of an association between BMS and other pain(s) symptoms or of cutaneous cephalic and/or extracephalic quantitative sensory testing in BMS patients), and a descriptive analysis conducted.ResultsThe search retrieved 1512 reports. Out of these, twelve articles met criteria for co-occurring pain symptoms and nine studies for quantitative sensory testing (QST) in BMS patients. The analysis reveals that in BMS patients co-occurring pain symptoms are rare, assessed by only 0.8% (12 of 1512) of the retrieved studies. BMS was associated with headaches, TMD, atypical facial pain, trigeminal neuralgia, post-herpetic facial pain, back pain, fibromyalgia, joint pain, abdominal pain, rectal pain or vulvodynia. However, the prevalence of pain symptoms in BMS patients is not different from that in the age-matched general population. QST studies reveal no or inconsistent evidence of abnormal cutaneous cephalic and extracephalic somatosensory sensitivity.ConclusionsThere is no evidence for a high rate of other pain symptoms or somatosensory impairments co-occurring with BMS. These results thus suggest that BMS rather depends on specific mechanisms, likely at the trigeminal level. Nevertheless, more thoroughly conducted research is required to draw definitive conclusion.

Characteristic changes of saliva and taste in burning mouth syndrome patients.

Burning mouth syndrome (BMS) is characterized by chronic pain with a burning sensation of the tongue and oral mucosa and reported to be often accompanied by subjective xerostomia and dysgeusia. Since the etiology of BMS has not been elucidated, to understand the characteristics of BMS, we measured some components of saliva and taste sensitivity and compared the measured values between BMS and healthy subjects. Unstimulated saliva was collected from 15 female BMS patients and 30 healthy women. The flow rate, viscosity (spinnability) and concentration of secretory IgA (SIgA) of saliva and serum antioxidant capacity were measured. The recognition thresholds for sweet, salty, sour, bitter, and umami tastes were measured by whole-mouth method. The statistical analyses were performed using Student's t-test, and P < 0.05 was considered to be significant. In BMS group, the flow rate of saliva was significantly lower and the spinnability was significantly higher compared with healthy group. The secreted amount of SIgA per min and serum antioxidant capacity was significantly lower in the patients. The threshold for sourness in patients was significantly higher, while those for other tastes did not differ from healthy group. BMS patients showed lower salivary flow and higher salivary spinnability. These results together with decreased SIgA amount, suggest that BMS may be relevant to the deterioration of salivary condition, which could in turn affect taste function. Furthermore, the lower antioxidant capacity in patient's serum suggests that it can serve as a diagnostic tool for BMS.

Burning Mouth Syndrome. Update

Burning Mouth Syndrome (BMS) is a chronic disorder that predominately affects middle-aged women in the postmenopausal period. The condition is distinguished by burning symptoms of the oral mucosa and the absence of any clinical signs. The etiology of BMS is complex and it includes a variety of factors. Local, systemic and psychological factors such as stress, anxiety and depression are listed among the possible causes of BMS. BMS may sometimes be classified as BMS Type I, II or III. Although this syndrome is not accompanied by evident organic alterations and it does not present health risks, it can significantly reduce the patient's quality of life. This study analyzes the available literature related to BMS, and makes special reference to its therapeutic management. The pages that follow will also discuss the diagnostic criteria that should be respected, etiological factors, and clinical aspects. We used the PubMed database and searched it by using the keywords "burning mouth syndrome", "BMS and review", and "burning mouth and review", in the title or abstract of the publication. BMS treatment usually steers towards the management of the symptoms; however, the specific local factors that could play a significant role in worsening the oral burning sensation should be eradicated. The most widely accepted treatment options that show variable results include tricyclic antidepressants, benzodiazepines and antipsychotic drugs; nevertheless there are other therapies that can also be carried out. Professionals that work in the field of dentistry should formulate standardized symptomatic and diagnostic criteria in order to more easily identify the most effective and reliable strategies in BMS treatment through multidisciplinary research.

Participation of micro-organisms of dental interest in the etiology of Burning Mouth Syndrome: literature review

The Burning Mouth Syndrome (BMS) is a pathologic entity characterized by the presence of chronic symptoms of burning or pain in normal oral mucosa. It mainly affects women in the postmenopausal period, and its cause is unknown, but as there is an association with biological and psychological factors, it may assume a multifactorial etiology. Considering the unclear etiology of BMS, studies that contribute to its understanding are of great importance. In order to achieve a better understanding regarding microbial etiological factors of this disease, the aim of this review is to compile studies on possible involvement of micro-organisms of dental interest in the etiology of BMS. Studies have reported that patients with BMS harbor greater amount of intra-oral Candida and Enterobacteriaceae than patients without clinical manifestations of this disease.Different sources such as articles, books and journals, published in the world literature, were used in this research. These sources were accessed by databases like PubMed, SciELO, Scopus or search of full text. Studies in the literature have suggested that Candida and Enterococcus were correlated with BMS, although they might not necessarily be considered as an etiological factor but a predisposing factor. However, further studies that aim to elucidate relation between BMS and infectious factors are necessary.KeywordsCandida; Enterobacteriaceae; Burning mouth syndrome.

가철성 유해자극차단장치를 이용한 구강작열감증후군의 치료 증례

구강작열감증후군(Burning Mouth Syndrome: BMS)은 특기할 임상적인 증상 없이, 구강 내에 나타나는 병적인 작열감 또는 통증을 지칭한다. 구강작열감증후군은 주로 혀 전방 그리고 측방에 증상이 나타나며, 경구개 전방, 입술 등의 다른 구강점막에도 나타나는 것으로 보고되고 있다. 구강작열감증후군의 원인은 분명하게 밝혀져 있지 않으며, 여러 가지 요인들이 작용하는 것으로 알려져 있다. 감염과 외상 같은 국소적 요인, 내분비 변화, 당뇨, 영양결핍(비타민, 아연 등), 철분 또는 엽산 결핍과 관련된 빈혈과 같은 전신적인 요인 등이 영향을 미치는 것으로 알려져 있고, 불안, 우울, 암공포증과 같은 심리적 요인 또한 영향을 미치는 것으로 알려져 있다. 최근의 연구는 구강작열감증후군이 신경학적 병변에 의한 신경병변성 통증의 특성을 나타냄을 보고하고 있다. 구강작열감증후군의 치료는 알려진 원인이 분명하지 않기 때문에 치료 또한 여러 각도로 시행되고 있다. 그 중, clonazepam의 국소적 적용, capsaicin, alpha lipoic acid 투여 등의 약물요법이 주로 이루어지며, 저주파 에너지 레이저 조사, 침술요법과 같은 치료법도 보고되고 있다. 최근의 몇몇 연구들은 혀를 국소적 자극요인으로부터 보호하여 구강작열감증후군의 증상을 완화시킨 사례들을 보고하고 있다. 본 연구는 구강작열감증후군 증상을 보이는 환자에게 하악 치아에 가철성 유해자극차단장치를 장착하여 증상이 개선된 증례를 소개하고, 구강 이상악습관과 구강작열감증후군의 연관성 및 이에 대한 치료법을 소개하고자 한다. Burning mouth syndrome(BMS) refers to a chronic orofacial pain disorder usually unaccompanied by mucosal lesions or other clinical signs. Tongue(anterior and lateral border) is found to be the most common site for the burning sensations in the oral cavity, and various oral sites may be affected including hard palate and lips. The etiology of this disorder remains poorly understood, but the various factors might be related with the pathogenesis of the BMS. These factors have been devided into local, systemic and psychological. Recently, there have been increasing reports that the pain of BMS may be neuropathic in origin. The complex and multifactorial etiology of BMS necessitates multidisciplinary approach for the management of these patients. Recently, several studies have reported that oral parafunctional habits could be related the pathogenesis of BMS, and tried to control the symptom of BMS with various methods. We reported the cases who had the symptom of burning mouth syndrome with removable anti-nociceptive appliance in the lower dentition.

Etiology of burning mouth syndrome: A review and update

Burning mouth syndrome (BMS) is characterized by an oral burning sensation in the absence of any organic disorders of the oral cavity. Although the cause of BMS is not known, a complex association of biological and psychological factors has been identified, suggesting the existence of a multifactorial etiology. A PubMed/Medline search was used to identify articles describing the different hypotheses regarding the etiology of BMS, as well as the psychological and anatomical data upon which such hypotheses are fundamented. A review and update was made of the different hypotheses relating to the etiology of BMS (psychogenic factors, hormone disorders, neuropathic alterations, oral phantom pain, neuroplasticity and neuroinflammation), with a view to globally establishing possible relationships among them. In-depth investigation is needed to clarify the etiopathogenic mechanisms of BMS and its triggering factors, in order to develop effective and individualized management strategies that can be extended to patients in each different BMS subgroup.

Zinc deficiency may be a cause of burning mouth syndrome as zinc replacement therapy has therapeutic effects

Zinc is known to play an important role for growth and development, the immune response, neurological function, and reproduction. Although the etiology of burning mouth syndrome (BMS) is unknown, zinc deficiency may be implicated in the pathogenesis of BMS. The aim of this study was to demonstrate a causal relationship between zinc deficiency and BMS and to assess whether zinc replacement is an effective therapy for BMS. Serum zinc level was evaluated in 276 patients with BMS. To assess the therapeutic effect of zinc replacement, patients with zinc deficiency were administered a zinc supplement (14.1 mg/day). Pain intensity 6 months after zinc replacement was evaluated using an 11-point numerical scale. We also developed an animal model of zinc deficiency to assess the effects of zinc deficiency on the oral mucosa. Of the 276 patients with BMS, 74 (26.8%) had low serum zinc levels. Zinc replacement therapy lowered the mean numerical pain scale in these patients from 8.1 to 4.1, compared with a mean decrease from 7.7 to 6.7 in a control group (P = 0.004). In our animal model of zinc deficiency, the main pathologic findings were hyperkeratinization and increased mitosis on the dorsum of the tongue, although there were no gross oral mucosal lesions. Zinc deficiency might play a role in some patients with BMS. In such patients, appropriate zinc replacement therapy is effective in relieving symptoms.

Salivary interleukin‐6 and tumor necrosis factor‐α in patients with burning mouth syndrome

Burning mouth syndrome (BMS) is characterized by burning symptoms on the clinically healthy oral mucosa. To date, etiology of BMS is still unknown. We hypothesized that maybe inflammation which is not clinically apparent might lead to burning symptoms which would then result in altered cytokine profile. In the 28 female patients with BMS (age range 48-80 years, mean 64.05 years) and 28 female controls (age range 40-75 years, mean 63.82 years) by use of enzyme-linked immunosorbent assay, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) levels were determined. Statistical analysis included use of independent sample t-test and P < 0.05 was considered as significant. Our results show no significant differences between patients and controls regarding salivary IL-6 and TNF-alpha.

Burning Mouth: An Initial Examination of a Potential Role of Herpes Virus Infection

Burning Mouth Syndrome (BMS) is a burning sensation of the oral mucosa that occurs in the absence of a clinical or laboratory finding. Since herpes virus infections are common in the oropharynx, a possible association between BMS and post-herpetic neuralgia was speculated. The purpose of the present study was to evaluate a potential viral role in the etiology of BMS. Materials and Methods: Viral serology (HSV, CMV, VZV IgM and IgG) obtained from 9 patients with BMS was compared to that of 13 patients with other oral mucosal conditions.Results and Discussion: The general profile of the BMS patients in this trial fits the profile of these patients reported in the literature. No IgM seropositivity for any of the 3 viruses was recorded in the BMS patients. Although most subjects in the two groups were positive for HSV, CMV, and HZV IgG, no difference in the prevalence was noted between burning mouth and the control groups. The positive IgG findings indicate past exposure to the viruses as expected in the general population. Although no evidence was found that would support the presence of an active viral infection in BMS subjects, the possibility of a “hit and run” role for viral damage in BMS could not be ruled out based on the present sample.

Sensory dysfunction in burning mouth syndrome

Our preliminary observations on a small group of burning mouth syndrome (BMS) patients indicated a change in the non-nociceptive, tactile sensory function in BMS and provided evidence for the hypothesis of a neuropathic etiology of BMS. In the present clinical study on a group of 52 BMS patients, we used quantitative sensory tests (QST) in addition to the blink reflex (BR) recordings in order to gain further insight into the neural mechanisms of BMS pain. Based on electrophysiologic findings, the BMS patients could be grouped into four different categories: (1) The results of the BR were suggestive of brainstem pathology or peripheral trigeminal neuropathy in ten (19%) patients. In most of the cases, the abnormalities in the BR seemed to represent subclinical changes of the trigeminal system. (2) Increased excitability of the BR was found in the form of deficient habituation of the R2 component of the BR in 11 (21%) of the patients. Two of these patients also showed signs of warm allodynia in QST. (3) One or more of the sensory thresholds were abnormal indicating thin fiber dysfunction in altogether 35 patients (76%) out of the 46 tested with QST. Thirty-three of these patients showed signs of hypoesthesia. (4) There were only five patients with normal findings in both tests. The present findings with strong evidence for neuropathic background in BMS will hopefully provide insights for new therapeutic strategies.