Burning mouth syndrome

Burning pain in tongue or oral mucous membranes without accompanying clinical or laboratory findings.

Chronic burning pain of the oral mucosal with no associated clinical signs or a parent extraneous cause.

Also known as orodynia, glossodynia, stomatodynia, oral dysesthesia and persistent idiopathic orofacial pain.

Most common among postmenopausal women.

Typically bilateral and can localize to any area of the oral cavity, but most commonly affects the tongue.

It is associated with xerostomia, dysguesia, diabetes, chronic pain, anxiety, and depression.

Prevalence rate 0.7-2.6%.

Spontaneous recovery within 6-7 years after onset reported in up to two thirds of patients.

Two thirds of patients have altered taste.

Can be caused by ACE inhibitors.

It’s pathogenesis is poorly understood and include psychological, hormonal, neurological, and allergic features.

Diagnosis requires the presence of superficial burning oral pain that recurs for more than two hours per day for more than three months with normal appearing oral mucosa and no more appropriate diagnosis.

Differential diagnosis includes salivary hypofunction, oral candidiasis, nutritional deficiencies, menopause, endocrinopathies, bruxism, medication adverse effects, dental trauma, mucosal irritation from dentures, and allergic contact stomatitis.

Associated with tongue thrusting, lip sucking, depression, and smoking.

Mean time from onset of symptoms to diagnosis is more than one year.

Misdiagnosed by an average of more than three physicians before a correct diagnosis is made.

Treatment as for neuropathic conditions.

Treatment includes clonazepan, tricyclic antidepressants, capsaicin, and other medications that treat neuropathic pain.

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