Post by Radrook Admin on Jun 6, 2020 22:01:28 GMT -5
Burning Mouth Syndrome
Burning Mouth Syndrome
Lichen Planus Burning Mouth
Causes
Theories
In about 50% of cases of burning mouth sensation no identifiable cause is apparent; these cases are termed (primary) BMS. Several theories of what causes BMS have been proposed, and these are supported by varying degrees of evidence, but none is proven. As most people with BMS are postmenopausal women, one theory of the cause of BMS is of estrogen or progesterone deficit, but a strong statistical correlation has not been demonstrated. Another theory is that BMS is related to autoimmunity, as abnormal antinuclear antibody and rheumatoid factor can be found in the serum of more than 50% of persons with BMS, but these levels may also be seen in elderly people who do not have any of the symptoms of this condition Whilst salivary flow rates are normal and there are no clinical signs of a dry mouth to explain a complaint of dry mouth, levels of salivary proteins and phosphate may be elevated and salivary pH or buffering capacity may be reduced.
Depression and anxiety are strongly associated with BMS. It is not known if depression is a cause or result of BMS, as depression may develop in any setting of constant unrelieved irritation, pain, and sleep disturbance. It is estimated that about 20% of BMS cases involve psychogenic factors, and some consider BMS a psychosomatic illness, caused by cancerophobia, concern about sexually transmitted infections, or hypochondriasis.
Chronic low-grade trauma due to parafunctional habits (e.g. rubbing the tongue against the teeth or pressing it against the palate), may be involved. BMS is more common in persons with Parkinson's disease, so it has been suggested that it is a disorder of reduced pain threshold and increased sensitivity. Often people with BMS have unusually raised taste sensitivity, termed hypergeusia ("super tasters"). Dysgeusia (usually a bitter or metallic taste) is present in about 60% of people with BMS, a factor which led to the concept of a defect in sensory peripheral neural mechanisms. Changes in the oral environment, such as changes in the composition of saliva, may induce neuropathy or interruption of nerve transduction The onset of BMS is often spontaneous, although it may be gradual. There is sometimes a correlation with a major life event or stressful period in life. In women, the onset of BMS is most likely three to twelve years following menopause.
Other causes of an oral burning sensation
Substances capable of causing an oral burning sensation.
Foods and additives
Benzoic acid
Chestnuts
Cinnamaldehyde
Instant coffee
Nicotinic acid
Peanuts
Sodium metabisulphite
Sorbic acid
Metals
Cadmium
Cobalt chloride
Mercury
Nickel
Palladium
Plastics
Benzoyl peroxide
Bisphenol A
Epoxy resins
Methyl methacrylate
Octyl gallate
Propylene glycol
: Glossitis
Several local and systemic factors can give a burning sensation in the mouth without any clinical signs, and therefore may be misdiagnosed as BMS. Some sources state that where there is an identifiable cause for a burning sensation, this can be termed "secondary BMS" to distinguish it from primary BMS. However, the accepted definitions of BMS hold that there are no identifiable causes for BMS, and where there are identifiable causes, the term BMS should not be used.
Some causes of a burning mouth sensation may be accompanied by clinical signs in the mouth or elsewhere on the body. For example, burning mouth pain may be a symptom of allergic contact stomatitis. This is a contact sensitivity (type IV hypersensitivity reaction) in the oral tissues to common substances such as sodium lauryl sulfate, cinnamaldehyde or dental materials. However, allergic contact stomatitis is accompanied by visible lesions and gives positive response with patch testing.
Acute (short term) exposure to the allergen (the substance triggering the allergic response) causes non-specific inflammation and possibly mucosal ulceration. Chronic (long term) exposure to the allergen may appear as chronic inflammatory, lichenoid (lesions resembling oral lichen planus), or plasma cell gingivitis, which may be accompanied by glossitis and cheilitis. Apart from BMS itself, a full list of causes of an oral burning sensation is given below:
Deficiency of iron, folic acid or various B vitamins (glossitis e.g. due to anemia), or zinc[16]
Neuropathy, e.g. following damage to the chorda tympani nerve.
Hypothyroidism.
Medications ("scalded mouth syndrome", unrelated to BMS) - protease inhibitors and angiotensin-converting-enzyme inhibitors (e.g. captopril).
Type 2 diabetes
True xerostomia, caused by hyposalivation e.g. Sjögren's syndrome
Parafunctional activity, e.g. nocturnal bruxism or a tongue thrusting habit.
Restriction of the tongue by poorly constructed dentures.
Geographic tongue.
Oral candidiasis.
Herpetic infection (herpes simplex virus).
Fissured tongue.
Lichen planus.
Allergies and contact sensitivities to foods, metals, and other substances (see table).
Hiatal hernia.
Human immunodeficiency virus.
Multiple myeloma
en.wikipedia.org/wiki/Burning_mouth_syndrome
Theories
In about 50% of cases of burning mouth sensation no identifiable cause is apparent; these cases are termed (primary) BMS. Several theories of what causes BMS have been proposed, and these are supported by varying degrees of evidence, but none is proven. As most people with BMS are postmenopausal women, one theory of the cause of BMS is of estrogen or progesterone deficit, but a strong statistical correlation has not been demonstrated. Another theory is that BMS is related to autoimmunity, as abnormal antinuclear antibody and rheumatoid factor can be found in the serum of more than 50% of persons with BMS, but these levels may also be seen in elderly people who do not have any of the symptoms of this condition Whilst salivary flow rates are normal and there are no clinical signs of a dry mouth to explain a complaint of dry mouth, levels of salivary proteins and phosphate may be elevated and salivary pH or buffering capacity may be reduced.
Depression and anxiety are strongly associated with BMS. It is not known if depression is a cause or result of BMS, as depression may develop in any setting of constant unrelieved irritation, pain, and sleep disturbance. It is estimated that about 20% of BMS cases involve psychogenic factors, and some consider BMS a psychosomatic illness, caused by cancerophobia, concern about sexually transmitted infections, or hypochondriasis.
Chronic low-grade trauma due to parafunctional habits (e.g. rubbing the tongue against the teeth or pressing it against the palate), may be involved. BMS is more common in persons with Parkinson's disease, so it has been suggested that it is a disorder of reduced pain threshold and increased sensitivity. Often people with BMS have unusually raised taste sensitivity, termed hypergeusia ("super tasters"). Dysgeusia (usually a bitter or metallic taste) is present in about 60% of people with BMS, a factor which led to the concept of a defect in sensory peripheral neural mechanisms. Changes in the oral environment, such as changes in the composition of saliva, may induce neuropathy or interruption of nerve transduction The onset of BMS is often spontaneous, although it may be gradual. There is sometimes a correlation with a major life event or stressful period in life. In women, the onset of BMS is most likely three to twelve years following menopause.
Other causes of an oral burning sensation
Substances capable of causing an oral burning sensation.
Foods and additives
Benzoic acid
Chestnuts
Cinnamaldehyde
Instant coffee
Nicotinic acid
Peanuts
Sodium metabisulphite
Sorbic acid
Metals
Cadmium
Cobalt chloride
Mercury
Nickel
Palladium
Plastics
Benzoyl peroxide
Bisphenol A
Epoxy resins
Methyl methacrylate
Octyl gallate
Propylene glycol
: Glossitis
Several local and systemic factors can give a burning sensation in the mouth without any clinical signs, and therefore may be misdiagnosed as BMS. Some sources state that where there is an identifiable cause for a burning sensation, this can be termed "secondary BMS" to distinguish it from primary BMS. However, the accepted definitions of BMS hold that there are no identifiable causes for BMS, and where there are identifiable causes, the term BMS should not be used.
Some causes of a burning mouth sensation may be accompanied by clinical signs in the mouth or elsewhere on the body. For example, burning mouth pain may be a symptom of allergic contact stomatitis. This is a contact sensitivity (type IV hypersensitivity reaction) in the oral tissues to common substances such as sodium lauryl sulfate, cinnamaldehyde or dental materials. However, allergic contact stomatitis is accompanied by visible lesions and gives positive response with patch testing.
Acute (short term) exposure to the allergen (the substance triggering the allergic response) causes non-specific inflammation and possibly mucosal ulceration. Chronic (long term) exposure to the allergen may appear as chronic inflammatory, lichenoid (lesions resembling oral lichen planus), or plasma cell gingivitis, which may be accompanied by glossitis and cheilitis. Apart from BMS itself, a full list of causes of an oral burning sensation is given below:
Deficiency of iron, folic acid or various B vitamins (glossitis e.g. due to anemia), or zinc[16]
Neuropathy, e.g. following damage to the chorda tympani nerve.
Hypothyroidism.
Medications ("scalded mouth syndrome", unrelated to BMS) - protease inhibitors and angiotensin-converting-enzyme inhibitors (e.g. captopril).
Type 2 diabetes
True xerostomia, caused by hyposalivation e.g. Sjögren's syndrome
Parafunctional activity, e.g. nocturnal bruxism or a tongue thrusting habit.
Restriction of the tongue by poorly constructed dentures.
Geographic tongue.
Oral candidiasis.
Herpetic infection (herpes simplex virus).
Fissured tongue.
Lichen planus.
Allergies and contact sensitivities to foods, metals, and other substances (see table).
Hiatal hernia.
Human immunodeficiency virus.
Multiple myeloma
en.wikipedia.org/wiki/Burning_mouth_syndrome