Burning mouth syndrome (BMS) is defined by the International Association for the Study of Pain1 as burning pain in the tongue or other oral mucous membrane associated with normal signs and laboratory findings lasting at least four to six months.2,3 The International Headache Society in The International Classification of Headache Disorders II4 describes BMS as an intra-oral burning sensation for which no medical or dental cause can be found. They may be present simultaneously.The reticular type is the most common one and usually asymptomatic, whereas the erosive/ulcerative types often accompanied by a burning, stinging pain. We present a case of burning mouth syndrome of 6 months duration in a healthy 65-year-old woman, which was associated with high copy numbers of herpes simplex virus type 1 (HSV-1) DNA in the saliva. Classification of and criteria for nondental conditions that can cause tooth pain appear in a number of sources.1-4 Clinical factors, including the patient’s description of pain; its intensity, quality, and location; what relieves or exacerbates it; and the presence (or absence) of additional symptoms (eg, dysesthesia) may help establish the diagnosis when oral examination findings are negative.Additional imaging studies may be necessary to rule out problems such as salivary or central disease. Treatment of gingivitis by a dentist is important to protect the health of your teeth. The virus commonly causes cold sores around the mouth and lips, but the woman didn’t have any cold sores. Saliva tests conducted on women suffering from burning mouth syndrome showed that the herpes simplex virus type 1 was present.
Cook, AJ. Allscripts EPSi. Of interest, Nagler and Hershkovich17 studied the elderly and found an age-related reduction in salivary flow rate and components when compared to younger subjects. Oral mucositis refers to erythematous and ulcerative lesions of the oral mucosa. 16, 2015. There may also be ocular symptoms. National Institute of Dental and Craniofacial Research.
Instead, it infects the facial nerves, most commonly the trigeminal ganglion, which provides sensation in the face and mouth. Accessed Dec. 15, 2015. Burning mouth syndrome. Misidentification of detected stimuli quality occurred in 19 per cent of BMS women compared to 8 per cent of controls. http://www.aaom.com/index.php?option=com_content&view=article&id=81:burning-mouth-syndrome&catid=22:patient-condition-information&Itemid=120. Accessed Dec.
A more generalized low-grade pain sometimes follows the severe attack. Burning mouth syndrome. National Organization for Rare Disorders. https://rarediseases.org/rare-diseases/burning-mouth-syndrome/. Accessed Dec. 15, 2015. Oral mucosal diseases such as lichen planus, benign migratory glossitis, hairy tongue and fissured tongue have been proposed as causative of BMS.6,7,33,34 Atrophic and ulcerative forms of lichen planus are known to have a burning pain particularly during periods of exacerbation.35 Benign migratory glossitis is usually painless but burning may occur in areas of depapillation which may be exacerbated by spicy foods, alcohol or stress.33,34 Fissured tongue is also usually painless unless grooves and fissures become inflamed or infected due to accumulation of debris resulting in a burning sensation.33 These oral mucosal diseases are all associated with visual clinical findings, yet in BMS patients, the oral mucosa appears normal.
FamilyDoctor.org. http://familydoctor.org/familydoctor/en/diseases-conditions/burning-mouth-syndrome.html. In elderly patients who have PHN involving the face, the condition is typically localized to the first division of the fifth cranial nerve. 15, 2015. AskMayoExpert. Burning mouth syndrome. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
Kohorst JJ, et al. Gastroesophageal reflux disease must be considered in any patient complaining of oral burning. British Journal of Dermatology. 2015;172:1654. Another herpetic condition that causes oral (including tooth) pain and dysesthesia is recurrent intraoral herpes.17 The clinical presentation of primary herpes stomatitis and the secondary recurrent lip lesion that typically follows the initial infection are familiar. Burning mouth syndrome. Journal of Pharmacy and BioAllied Sciences.
2015;7:S194. Kohorst JJ, et al. A population-based study of the incidence of burning mouth syndrome. When compared to other chronic pain populations, using a different psychological screening tool (Irritability, Depression and Anxiety Scale), BMS subjects appeared to have psychological illness more often than other subjects with chronic pain, except those attending a psychiatric clinic. 2014;89:1545. Miziara I, et al. It is appreciably relieved, but generally not eliminated, by indomethacin.
International Archives of Otorhinolaryngology. 2015;19:86. Coping with chronic pain. American Psychological Association. http://www.apa.org/helpcenter/chronic-pain.aspx. In a study supporting this non-causal relationship, Carlson et al.81 used standardized psychological assessment instruments (Revised Symptom Checklist and the Multidimensional Pain Inventory) on 33 BMS cases and compared the data to population samples which included both non-BMS chronic pain patients and a normal non-clinical sample. 17, 2015.
Torgerson RR (expert opinion). Other conditions that may cause salivary gland abnormalities and dry mouth include Sjögren syndrome, scleroderma, systemic lupus erythematosus, hypothyroidism, and infection (eg, with HIV or hepatitis C virus). Dec. 22, 2015.