Burning mouth syndrome

Synonym(s)

None

Definition

Sensation of burning or pain in the mouth without an identifiable visible pathologic process responsible for the symptom

Pathogenesis

Possible etiologic factors: nutritional deficiency (e.g. B vitamin deficiency), major depression; increased taste sensation; menopause (90% of affected women postmeno-pausal); trigeminal nerve neuropathy

Clinical manifestation

Burning pain affecting oropharynx; onset in the morning; peak symptoms in the late afternoon; lower lip mucosa, anterior tongue, anterior hard palate affected; pain relief with eating; associated with dry mouth and taste disturbance; no evident lesions

Differential diagnosis

Tobacco abuse; atrophic glossitis; menopau-sal glossitis; heavy metal poisoning; vitamin deficiency; leukemia; lichen planus; uremia; medication reaction

Therapy

Capsaicin: starting with hot pepper diluted 1:2 with water; rinsing of mouth with 1 teaspoon; decreasing dilution to 1:1 as tolerated; amitriptyline; gabapentin: starting with 300 mg PO at bedtime, titrating up to a maximum of 1800 mg per day; serotonin reuptake inhibitor

References

Muzyka BC, De Rossi SS (1999) A review of burning mouth syndrome. Cutis 64(1^29-35

Busse-Buschke disease 109

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