Burning mouth syndrome: A selective review
The present review article was carried out to include a selective literature review of BMS (Burning Mouth Syndrome) with respect to its etiology and management. The etiological factors included drug related (antidepressants and all drugs acting on the parasympathetic systems); diabetes related (impaired tolerance to glucose); peripherical nervous system related; stress and emotional factors related (cancerphobia); and major psychiatric disorders. It has been suggested that BMS may be regarded also as a variant of atypical facial pain; iron, folic acid, and cobalamine deficiencies have been linked to BMS. Vitamins B1, B2, and B6 also seem to be associated with BMS. In some studies, replacement of the deficient vitamins in the diet led to resolution of the symptomatology. Other factors involved in the etiology of BMS seem to be denture resin materials, substances like sorbic and benzoic acid, propylene glycol, cinnamon, smoking, and hormonal changes (female menopause).
Some authors believe there is an association between BMS and connective tissue disorders. However, in a recent study Gorsky found that in 50% of the cases no specific disease or contributory factor could be identified. BMS is difficult to diagnose and it is difficult to eliminate the etiological cause. Patients should be advised that it is very unlikely there will be a complete resolution of the disturbances. Complete examination, hematological examination, medication review, and a pain questionnaire are suggested. Conclusions are that all nonresponding cases should be reexamined regularly, even if only for their own psychological support. [M.O.]
Maresky, L.S., I. Gird, and P. van der Bijl, Ann Dent, 52:21,1995