Burning Mouth Syndrome-A Report of 3 Cases
Burning Mouth Syndrome-A Report of 3 Cases
Mingi Chan-Liao
Dept. of Anesthesia, Jen-Ai Hospital, Tali, Taichung, Taiwan
The burning mouth syndrome(BMS) is a relatively common intraoral disorder affecting women seven times more frequently than men. It is characterized by burning and painful sensations of the mouth in the absence of significant mucosal abnormalities.
The pain is typically reported at the anterior part of the tongue, the anterior hard palate and the lip. We report our recent experience in treating 3 cases of BMS. All were post-menopausal women and treated mainly with a series of stellate ganglion blocks plus antiderpressants except for Case 2 who in addition received low-level laser therapy but in vain.
Typically they had different manifestations and different outcomes after treatment. Case 1 and 2 could be classified(Tab.2) as type 2 (continuous) BMS and Case 3 as type 3 (intermittent) BMS based on diurnal fluctuations of symptoms according to Lamey and Lewis. Following basically similar treatment for 2 weeks~2months, Case 1 had total relief of pain, Case 2 had only partial improvement but Case 3 experienced no improvement at all. BMS with many other confusing synonyms(Tab.1) is a difficult disease for both patients and pain clinicians. Because its etiology and pathophysiology are still unknown, evaluation should be followed in a stepwise fashion and management(Fig.1) focused on correcting suspected causative factors(local, systemic or psychologic). Generally it is believed that psychologic factors predominate in the etiology of BMS. It is unclear whether psychologic factors predispose patients to BMS or whether BMS predisposes them to psychologic disorders but treatment with low-dose antidepressants is always indicated.
Tab.1 Synonyms of Burning Mouth Syndrome
Glossalgian Syndorme
Glossodynia
Glossopyrosis
Stomatodynia
Stomatopyrosis
Oral dysesthesia
Denture sore mouth
Tab.2 Classification of 3 Subtypes of BMS
Type Other Linked Etiology Burning Sensation
1 Nutritional deficiencies Symptom-free on waking
2 Chronic anxiety Continuous
3 50% emotional instability 50% food allergies, Intermittent
(Lamey and Lewis 1989)
Tab3. Summary of 3 cases with intraoral burning
Fig1 A Clinical Protocol for Evaluation and Management of Burning Mouth Syndrome
Medical, dental, psychological history
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Physical exam of oral mucosa and dentition Exam of denture design and occlusion
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