Burning mouth syndrome

Burning mouth syndrome: prevalence and associated factors

Burning mouth syndrome (BMS) is characterized by a burning sensation in the oral cavity although the oral mucosa is clinically normal. The syndrome mostly affects middle-aged women. Various local, systemic and psychological factors have been found to be associated with BMS, but its etiology is not fully understood. Oral complaints and salivary flow were surveyed in 669 men and 758 women randomly selected from 48,500 individuals between the ages 20 and 69 years. Fifty-three individuals (3.7%), 11 men (1.6%) and 42 women (5.5%), were classified as having BMS. In men, no BMS was found before the age group 40 to 49 years where the prevalence was 0.7%, which increased to 3.6% in the oldest age group. In women, no BMS was found in the youngest age group, but in the age group 30 to 39 years the prevalence was 0.6% and increased to 12.2% in the oldest age group. Subjective oral dryness, age, medication, taste disturbances, intake of L-thyroxines, illness, stimulated salivary flow rate, depression and anxiety were factors associated with BMS. In individuals with BMS, the most prevalent site with burning sensations was the tongue (67.9%). The intensity of the burning sensation was estimated to be 4.6 on a visual analogue scale. There were no increased levels of depression, anxiety or stress among individuals with more pain compared to those with less pain. It was concluded that BMS should be seen as a marker of illness and/or distress, and the complex etiology of BMS demands specialist treatment.

Clinical assessment and outcome in 70 patients with complaints of burning or sore mouth symptoms

OBJECTIVE

To review a series of patients with a burning or sore mouth for elucidation of associated conditions and treatment outcome.

MATERIAL AND METHODS

We retrospectively studied 70 consecutive patients with a burning or sore mouth who were encountered at a tertiary-care center between 1979 and 1992. Clinical and laboratory findings were summarized, and follow-up data were analyzed.

RESULTS

The study cohort of 56 women and 14 men had a mean age of 59 years. They had had a burning or sore mouth for a mean duration of 2.5 years. Multiple etiologic factors for the burning or sore mouth were present in 37% of the study subjects. The most frequently associated conditions were psychiatric disease (30%), xerostomia (24%), geographic tongue (24%), nutritional deficiencies (21%), and allergic contact stomatitis (13%). With a treatment course tailored to the suspected causal factor, 72% of the patients who had follow-up reported improvement.

CONCLUSION

With a directed investigation, one or more causes could be identified in most patients who had a burning or sore mouth. Successful management of these symptoms was possible in a majority of the patients.

Effectiveness of kampo medicine (sai-boku-to) in treatment of patients with glossodynia

OBJECTIVE

The purpose of this study was to evaluate the usefulness of a Kampo medicine (Sai-boku-to) for treatment of patients with glossodynia.

STUDY DESIGN

Sai-boku-to or an antianxiety drug (diazepam) with vitamin B complex was administered orally for 3 months to each of 200 patients with glossodynia. Clinical examination evaluated the following subjective symptoms: pain, burning sensation, and discomfort. Effectiveness was evaluated as follows: "markedly effective," all 3 symptoms disappeared; "effective," pain improved; "ineffective," no improvement in pain.

RESULTS

The effective rates were 70% after 1 month, 85% after 2 months, and 92% after 3 months of administration of Sai-boku-to (the Kampo group) and 74% after 1 month, 71% after 2 months, and 69% after 3 months of administration of the antianxiety drug with vitamin B complex (the control group). No significant side effect was noted in the Kampo group, but sleepiness was recorded in 33 cases in the control group.

CONCLUSIONS

The results indicate that Sai-boku-to may be a clinically useful medicine for the long-term treatment of patients with glossodynia.

Clinical implications of the dry mouth. Oral mucosal diseases

Salivary hypofunction caused by salivary gland disease, medication, or radiation may predispose for secondary oral mucosal diseases. In these patients the protective coating of saliva is reduced or absent, leaving the oral mucosa more vulnerable. Candidiasis, burning mouth syndrome, and white lesions of the oral mucosa are increased in frequency. The aim of management is to prevent oral pathological changes. The management procedure may include proper oral hygiene, saliva-stimulating agents, or saliva substitutes, depending on the severity of the salivary dysfunction. Treatment includes antifungal therapy if candidiasis is diagnosed. In severely distressed patients, local or systemic corticosteroids may be indicated. Precautions, like refraining from smoking and avoiding toothpastes containing sodium lauryl sulfate, should also be taken. In the future, agents combining antibacterial and antiinflammatory actions, like triclosan, may show promising effects in patients with oral mucosal diseases secondary to salivary hypofunction.

Reported burning mouth symptoms among middle-aged and elderly women

The aims of this investigation were to assess the prevalence of burning mouth symptoms (BM) in a representative population of Swedish middle-aged and elderly women (n=1017) and its relation to general and oral health status. BM was reported by 4.6% (n=47), and 85% of the BM subjects had experienced BM for more than 6 months. A stepwise multiple logistic regression with BM/non-BM as dependent variable showed that 7 covariates were found to be predictive of BM. These variables were medication with antihypertensives, sedatives and female sex hormones. Moreover, headache, tinnitus, dry mouth, and reduced chewing ability were included in the final model.