BMS Flashcards
Signs, symptoms, haematological, microbiological, psychological investigations, cancer phobia, social history, tx,
What is BMS
Burning mouth syndrome(BMS) is a burning sensation in the mouth with no underlying known dental or medical cause.[3]No relatedsigns of diseaseare found in the mouth.[3]People with burning mouth syndrome may also have a subjectivexerostomia(dry mouth sensation where no cause can be found such as reduced salivary flow),paraesthesia(altered sensation such as tingling in the mouth), or an altered taste or smell
What are other names for BMS
glossodynia,[1]orodynia,[2]oral dysaesthesia,[3]glossopyrosis,[3]stomatodynia,[1]burning tongue,[4]stomatopyrosis,[3]sore tongue,[3]burning tongue syndrome,[5]burning mouth,[3]or sore mouth
What is BMS associated with
Possibly subjectivexerostomia,dysgeusia(altered taste), thirst,headaches, chronic back pain,irritable bowel syndrome,dysmenorrhea,globus pharyngis,anxiety, decreased appetite,depressionandpersonality disorders
What are possible exacerbating and relieving factors of bms
Possible exacerbating factors (make the pain worse) include tension, fatigue, speaking, and hot, acidic or spicy foods. Possible relieving factors include sleeping, cold, distraction, and alcohol. The pain is often relieved by eating and drinking (unlike pain caused by organic lesions orneuralgia) or when the person’s attention is occupied. Temporary relief while eating is described as “almostpathognomonic” by the IASP. Pain is not often relieved by systemic analgesics, but can sometimes be relieved by topical anesthetics
What theories are associated with BMS
In about 50% of cases of burning mouth sensation no identifiable cause is apparent;[1]these cases are termed (primary) BMS.[9]Several theories of what causes BMS have been proposed, and these are supported by varying degrees of evidence, but none is proven.[5][9]As most people with BMS are postmenopausal women, one theory of the cause of BMS is ofestrogenorprogesteronedeficit, but a strong statistical correlation has not been demonstrated.[5]Another theory is that BMS is related toautoimmunity, 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.[5]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.[5]
Depression andanxietyare strongly associated with BMS.[5][11][12]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.[5][10][13]It is estimated that about 20% of BMS cases involvepsychogenic factors,[12]and some consider BMS apsychosomatic illness,[5][11]caused bycancerophobia,[11][12]concern aboutsexually transmitted infections,[12]orhypochondriasis.[11]
Chronic low-grade trauma due toparafunctional habits(e.g. rubbing the tongue against the teeth or pressing it against the palate), may be involved.[10]BMS is more common in persons withParkinson’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, termedhypergeusia(“super tasters”).[1]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.[10]Changes in the oral environment, such as changes in the composition of saliva, may induce neuropathy or interruption of nerve transduction.[1][9]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.[8]In women, the onset of BMS is most likely three to twelve years following menopause.[5
Where does BMS occur
Usually bilaterally located on the tongue or less commonly the palate, lips or loweralveolar mucosa
What is the character of BMS
Burning, scalded or tingling. Sometimes the sensation is described as ‘discomfort’, ‘tender’, ‘raw’ and ‘annoying’ rather than pain or burning.
What substances are associated with BMS
Substances capable of causing an oral burning sensation.[1]Foods and additives
Benzoic acid
Chestnuts
Cinnamaldehyde
Instantcoffee
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
What is bowens disease
a precancerous orin situform of cSCC is known
