Síndrome de la boca ardiente: revisión de la literatura / Burning mouth syndrome: literature review

Resumen El síndrome de la boca ardiente (SBA) es una condición de dolor crónico en la cavidad oral, que se presenta mayoritariamente en mujeres de edad media. Diversas causas locales y sistémicas pueden producirlo en forma secundaria, o bien, puede representar un cuadro primario, sin etiología específica identificable. Su etiopatogenia y evolución clínica es poco comprendida. Las opciones terapéuticas son variadas y en general es necesario un tratamiento multidisciplinario. A continuación, se presenta una revisión de la literatura respecto a esta patología para difusión en nuestro medio.

Abstract Burning mouth syndrome (BMS) is a chronic pain condition of the oral cavity, which occurs more frequently in middle-aged women. It can be secondary to different local and systemic causes, or represent a primary condition, with no specific identifiable etiology. Its etiopathogenesis and clinical evolution are poorly understood. Therapeutic options are multiple and a multidisciplinary treatment is necessary. We present a review of the literature regarding BMS, to provide information relevant to our area of expertise.

Current advances in research of burning mouth syndrome: biological nerve and social psychology patterns / 中华口腔医学杂志

Burning mouth syndrome (BMS) is a complex chronic disorder characterized symptomatically by burning sensation mainly localized in the tongue with no specific lesions. Its etiology is not fully understood. Due to the persistent pain and unsatisfactory outcome of treatment, patients with high expectation when seeking medical advice easily feel discontent after treatment, which might cause medical dispute. This review introduces the epidemiology, manifestations, etiology, diagnosis, classification and treatment of BMS. The authors hope the current advances about BMS, mainly focus on the etiology of biological nerve and social psychology, may help the clinicians in treatment of BMS.

Necrosis lingual como forma de presentación de arteritis temporal / Lingual necrosis as a form of presentation of temporary arteritis

La arteritis de células gigantes es una vasculitis sistémica que compromete arterias de mediano y gran calibre, principalmente la arteria aorta y sus ramas. Su prevalencia es mayor en mujeres a partir de los 50 años, típicamente se manifiesta con fiebre, claudicación mandibular, cefalea, hiperestesia del cuero cabelludo y pérdida de la visión con neuropatía óptica isquémica anterior, en una minoría de casos aparecen síntomas menos frecuentes que dificultan y retrasan el diagnóstico. Se presenta el caso de una mujer de 76 años que consultó por dolor en la cavidad bucal con edema lingual y en cuello de 48 horas de evolución asociado a cefalea el mes previo. En el examen físico presentaba signos clínicos de isquemia lingual, por lo que se consideró como diagnóstico presuntivo compromiso isquémico por arteritis de células gigantes, e inició tratamiento con corticoides sistémicos realizándose una biopsia de arteria temporal que evidenció infiltrado linfocitario panparietal con engrosamiento de la túnica íntima y hallazgos compatibles con panarteritis. La arteritis de células gigantes debe ser sospechada en pacientes con manifestaciones de isquemia lingual, iniciándose en forma precoz el tratamiento para evitar complicaciones irreversibles.

Giant cell arteritis is a systemic vasculitis that affects arteries of medium and large caliber, mainly the aorta artery and its main branches. It is more frequent in women older than 50 years. The most common symptoms are fever, jaw claudication, headache, hyperesthesia of the scalp and loss of vision with anterior ischemic optic nerve disease. But, in a minority of cases, less frequent symptoms are observed that delay and make more difficult the diagnosis. Here, we present the case of a 76-year-old woman who came to our consultation having pain in the oral cavity and presenting tongue and neck edema for 48 hours. She had also suffered from headaches during the previous month. Because the physical examination showed clinical signs of lingual ischemia, a presumptive diagnosis of ischemic involvement due to giant cell arteritis was considered. She started a treatment with systemic corticosteroids and a temporal artery biopsy was performed. We conclude, that giant cell arteritis should be suspected in patients presenting lingual ischemia symptoms in order to start the specific treatment early enough to avoid irreversible complications.

Presencia de lesiones orales en pacientes con afecciones psicológicas, atendidos en una institución de salud / Presence of oral lesions in a group of patients with psychological disorders attending a health institution

Introducción: El liquen plano oral, la estomatitis aftosa recurrente y el síndrome boca urente constituyen entidades patológicas bucales que presentan relación con afecciones psicológicas. Objetivo: Describir la presencia de liquen plano oral, estomatitis aftosa recurrente y síndrome de boca urente en pacientes con afecciones psicológicas atendidos en una institución de salud. Métodos: Se realizó un estudio descriptivo de corte transversal, obteniéndose una población de 35 pacientes seleccionados mediante un muestreo no probabilístico por criterio de 26 pacientes aquellos que fueron remitidos del área de psicología (bajo un test de diagnóstico psicológico) al servicio de estomatología, con lesiones orales antes descritas. Bajo la firma de un consentimiento informado fueron tratadas y evolucionadas en un periodo de 16 meses. Se tuvieron en cuenta las consideraciones éticas basadas en la resolución 008430 de 1993, tratado de Helsinki. Resultados: En cuanto a la frecuencia, la lesión bucal que más se presentó fue la estomatitis aftosa recurrente en un 65,3 por ciento, las aftas mayores en un 38,4 por ciento, seguido de un tipo aftas menores en un 26,9 por ciento, entre otras lesiones en menor frecuencia. Los diagnósticos psicológicos evidenciados fueron estrés, depresión y ansiedad, en diferentes proporciones, mostrándose como lesión más frecuente dentro de estas entidades psicológicas, la estomatitis aftosa recurrente. No existió asociación estadística entre las variables orales y las psicológicas por mostrar valores de p >0,005. Conclusiones: Existió la presencia de liquen plano oral, la estomatitis aftosa recurrente y el síndrome boca urente en alteraciones psicológicas como estrés, ansiedad y depresión, con mayor frecuencia la estomatitis aftosa recurrente(AU)

Introduction: Oral lichen planus, recurrent aphthous stomatitis and burning mouth syndrome are oral conditions related to psychological disorders. Objective: Describe the presence of oral lichen planus, recurrent aphthous stomatitis and burning mouth syndrome in patients with psychological disorders attending a health institution. Methods: A descriptive cross-sectional study was conducted of a population of 35 patients, of whom 26 were selected by criterion nonprobability sampling and referred from the psychology service (based on a psychological diagnosis test) to the dental care service due to the presence of the aforementioned oral lesions. Upon granting their informed consent, the patients were treated and followed up for 16 months. Ethical provisions from Resolution 008430 of 1993, the Helsinki Declaration, were complied with. Results: In terms of frequency, the most common oral lesion was recurrent aphthous stomatitis with 65.3 percent. Major aphthas represented 38.4 percent. and aphthas of a minor type 26.9 percent.; other lesions had a lower frequency. The psychological diagnoses achieved were stress, depression and anxiety to various degrees, and the most common lesion for these psychological disorders was recurrent aphthous stomatitis. No statistical association was found between oral and psychological variables, for they showed values of p >0.005. Conclusions: The presence of oral lichen planus, recurrent aphthous stomatitis and burning mouth syndrome was determined in psychological disorders such as stress, anxiety and depression. Of these oral lesions, recurrent aphthous stomatitis was the most common(AU)

Enfoque terapéutico para el síndrome de boca urente / Therapeutic approach for burning mouth syndrome

INTRODUCCIÓN: el síndrome de boca urente (SBU), también conocido como estomatodinia o glosodinia, es una situación de dolor crónico que varía en su intensidad de moderado a severo y que se manifiesta como una disestesia ardiente relacionada a la lengua, pero también afecta frecuentemente la cara interna de los labios y la porción anterior del paladar duro. corresponde a una sensación de ardor continua, con una mucosa oral normal y de la cual no se puede encontrar ninguna causa dental o médica evidente. el SBU se divide en dos tipos: uno primario o idiopático, el cual no se puede asociar a ninguna otra patología, siendo un diagnóstico de exclusión; y uno secundario, el cual puede relacionarse a factores locales o generales, que puedan estar generándolo y que el tratamiento de esta causa conlleva a la resolución del problema. en esta revisión nos enfocaremos al tratamiento del SBU primario, del cual su fisiopatología aún no está clara, y la cual podría estar relacionada a factores periféricos como centrales, teniendo también un rol los problemas psicológicos. al no tener clara en su totalidad la fisiopatología de esta enfermedad, se hace muy difícil el poder tratarla. el objetivo de esta revisión es poder entregar herramientas actuales para su correcto diagnóstico y cuáles son los enfoques terapéuticos actuales que se están utilizando hoy para poder tratar esta enfermedad.

INTRODUCTION: burning mouth syndrome (BMS), also known as stomatodynia or glossodynia, is a chronic pain condition that ranges from moderate to severe, manifesting as a burning dysesthesia usually related to the tongue, but also frequently affects the inner face of the lips and the anterior portion of the hard palate. it corresponds to a continuous burning sensation, derived from a normal oral mucosa and from which no dental or medical cause can be found. the SBU is divided into two types: a primary or idiopathic one that cannot be associated with any other pathology, being a diagnosis of exclusion and a secondary one, which can be related to local or general factors that may be generating it and that the treatment of this cause leads to the resolution of the problem. in this review we will focus on the treatment of the primary SBU, of which its pathophysiology is still unclear, could be related to peripheral or central factors, with psychological problems also related. not being fully aware of the pathophysiology of this disease, it is very difficult to treat it. the objective of this review is to be able to deliver current tools that are being done to treat this disease

<b>Efficacy of Jiinshihoto in Patients with Glossodynia and Abnormal </b><b>Sensation in the Throat : Three Case Reports</b> / 日本東洋医学雑誌

Jiinshihoto, a Kampo formulation described in the textbook, <i>Wanbinhuichun</i>, is well known as a suitable formulation for patients troubled by chronic cough with qi obstruction. The components of jiinshihoto have several effects including nourishing yin, clearing empty heat, replenishing qi, and improving digestive function. We report three cases with glossodynia and abnormal sensation in the throat which were treated successfully with jiinshihoto. We therefore recommend jiinshihoto for the treatment of glossodynia and abnormal sensation in the throat associated with signs of yin deficiency including thirst, dry mouth, and viscous sputum,and signs of qi obstruction such as a tympanic sound on the right side of the abdomen.

Síndrome de boca ardiente y saliva / Burning mouth syndrome and saliva

El síndrome de Boca Ardiente (SBA) se caracteriza por ardor, picor, escozor y dolor bucal sin causa orgánica que lo justifique. La boca ardiente aún es un desafío en el campo de la medicina. Su etiología es desconocida, a pesar de que diversos estudios indican que intervienen una serie de factores locales, sistémicos y psicológicos que se consideran como posibles agentes causales. La saliva puede desempeñar un papel importante en la sintomatología del ardor bucal, presenta propiedades físicas y químicas (reológicas) que determinan funciones imprescindibles para el equilibrio de la cavidad bucal. En pacientes con boca ardiente hay cambios en la composición y tasa del flujo salival relacionados con boca seca, viscosidad, ardor bucal, humedad entre otros. En esta revisión se trata de actualizar varios aspectos que relacionan las distintas causas del síndrome de boca ardiente con la saliva y sus alteraciones como uno de los factores más importantes en la etiología del ardor bucal. Estudios recientes sugieren que el ácido alfa lipoico combinado con gabapentina es un tratamiento efectivo para este síndrome

Burning mouth syndrome is characterized by burning, smarting and oral pain without any organic cause justifying it. Burning mouth is still a challenge in medical field. It has an unknown aetiology; despite many studies indicate the involvement of local, systemic and psychological factors that can be considered possible causal agents. Saliva can perform an important role in oral smarting symptomatology, shows physico-chemical properties (rheological) determining vital functions for oral cavity equilibrium. There are changes in composition and salivary flow rate of burning mouth patients, related with dry mouth, viscosity, oral smarting, and humidity, among others. This review pretends to update many aspects that relate different causes of burning mouth syndrome with saliva and its alterations as one of the most important factors in the aetiology of oral smarting. Recent studies suggest that alpha lipoic acid combined with gabapentin is an effective treatment for this syndrome

An Overview of Burning Mouth Syndrome.

Burning mouth syndrome (BMS) is an idiopathic condition characterized by a chronic continuous burning sensation of intraoral soft tissues, typically involving the tongue, with or without extension to the lips and oral mucosa. It is classically accompanied by gustatory disturbances like dysgeusia and parageusia and subjective xerostomia. This syndrome commonly affects people all over the world without racial or socioeconomic predilection. Some patients may develop a single episode of burning sensation while some may show recurrent episodes that last for months or years. It commonly affects perimenopausal and postmenopausal women. The etiology remains obscure and multifactorial, hence the treatment is complicated with multiple approaches involving drugs, psychotherapy along with latest techniques like acupuncture and low level laser therapy being used to treat BMS effectively.

Burning mouth syndrome: an enigma / Síndrome de boca urente: un enigma

El síndrome de boca urente (SBU) es una condición enigmática porque la intensidad de los síntomas rara vez se corresponde con los signos clínicos de la enfermedad. Los síntomas incluyen ardor bucal, boca seca, dolor, cambios en los hábitos alimenticios, graves síntomas de la menopausia, y problemas no específicos de salud, entre otros. SBU es más frecuente en las mujeres posmenopáusicas con relación mujer/hombre de 7:1. La etiología del SBU es multifactorial, como los cambios hormonales (menopausia), las carencias nutricionales y alteraciones del gusto por nombrar algunos. SBU es un reto con respecto al diagnóstico y al manejo. El presente artículo analiza algunos de los acuerdos recientes de la etiopatogenia de SBU, así como el papel de la gestión farmacoterapeutica en este trastorno.

Burning mouth syndrome (BMS) is an enigmatic condition because the intensity of symptoms rarely corresponds to the clinical signs of the disease. Symptoms include oral burning, dry mouth, pain, changes in eating habits, severe menopausal symptoms, and non specific health problems etc. BMS is most prevalent in postmenopausal women with female: male ratio of 7:1. The etiology of BMS is multifactorial such as hormonal changes (menopause), nutritional deficiencies and taste disturbances to name a few. BMS is a challenge to diagnose and manage. The present article discusses some of the recent understanding of etiopathogenesis of BMS as well as the role of pharmacotherapeutic management in this disorder.

Glossodynia as an Unusual Manifestation of Vitamin B12 Deficiency: A case report / 대한통증학회지

A 58-year old male patient, with a history of gastrectomy, came to our department for recently aggravated glossodynia. A delicate physical examination revealed gait ataxia and a positive Rhomberg test. He was diagnosed as having vitamin B12 deficiency using a combination of the laboratory results, such as macrocytic anemia. It was thought that the tongue pain might have been a main clinical manifestation of vitamin B12 deficiency.

The Use of Traditional Chinese Medicine(Kampo Medicines) for Glossodynia / 日本東洋医学雑誌

A study of 16 cases of glossodynia based on the Kampo diagnosis “Sho”, treated by the department of Oral Surgery, Gifu University School of Medicine was performed between February 1995 and February 1998.<br>There were three males and 13 females with glossodynia. The patients ranged in age from 44 to 75. The total number of Chinese medicine (Kampo medicines) which we used were Kami-shoyo-san for 8 cases, Ninjin-yoei-to for 6 cases, Rikko-san for 5 cases, Ninjin-to and Kihi-to for 4 cases, and Oren-gedoku-to for 3 cases; Hange-byakujutsu-temma-to, Gorei-san, Kambaku-taiso-to, Juzen-taiho-to and Sansonin-to for 2 cases respectively; Sho-kenchu-to, Koso-san, Ryutan-shakan-to, Sairei-to, Chorei-to, San'o-shashin-to, Gosha-jinki-gan, and Seishin-renshi-in for 1 case respectively. The administration period was between 16 and 396 days.<br>Glossodynia is still not well understood. However, the treatment based on Sho was effective.