Burning mouth syndrome

1. Burning mouth syndrome
MADE BY – RIYA GUPTA
FINAL
YEAR
MADE BY – RIYA GUPTA
FINAL YEAR
ROLL NO. - 38

3. DEFINITION
• BURNING MOUTH SYNDROME IS A
BURNING OR STINGING OF MUCOSA, LIPS
AND / OR TONGUE ,IN THE ABSENCE OF
CLINICAL OR LABORATORY FINDINGS TO
JUSTIFY THESE SYPMTOMS.

4. SYNONYMS
• GLOSSDYNIA
• STOMATODYNIA
• GLOSSOPYRSIS
• STOMATOYROSIS

5. CLASSIFICATION
PRIMARY OR IDIOPATHIC
BMS
•CAUSE -
UNKNOWN
SECONDARY BMS
•CAUSED BY
UNDERLYING
MEDICAL
CONDITION

6. SUBTYPES
TYPES CLINICAL FINDINGS ASSOCIATION
TYPE 1 PRORESSIVE PAIN, NOT
PRESENT UPON AWAKENING,
WORSENS AS THE DAY
PROGRESSES.
NON- PSYCHIATRIC
TYPE 2 CONSTANT PAIN PSYCHIATRIC, CHRONIC
ANXIETY.
TYPE 3 INTERMITTENT PAIN AT
UNUSUAL SITES (FLOOR OF
MOUTH)
ALLERGIC CONTACT
STOMATITIS DUE TO
PRESERVING AGENTS AND
ADDITIVES.

8. ETIOLOGY
LOCAL CAUSES
1. ILL- FITTING DENTURES
2. DRY MOUTH (XEROSTOMIA)
3. GASTROESOPHAGEAL REFLUX DISEASE
4. MUCOSAL DISORDERS- GEOGRAPHIC TONGUE , LICHEN PLANUS
ETC
5. PARAFUNCTIONAL HABITS( TONGUE THRUSTING)
6. SENSORY NERVE DAMAGE ( DUE TO TRAUMA )

9. SYSTEMIC FACTORS
• DIABETES
• SJOGREN SYNDROME
• HORMONAL CHANGES (MENOPAUSE)
• ANXIETY AND DEPRESSION
• NUTRITIONAL DEFICIENCY(VIT B12 , FOLATE,IRON )
• MEDICATIONS

10. EPIDEMIOLOGY
• 0.7% -15 %
PREVALENCE
• FEMALE PREDILECTION
SEX
• 5th -7th DECADE
AGE

11. SYMPTOMATIC TRIAD
ORAL
MUCOSAL
PAIN
DYSGUESIA XEROSTOMIA

12. SYMPTOMS
PAIN TYPE PAIN ONSET PAIN PATTEN
BURNING
INTENSITY
VARIES FROM
MILD TO SEVERE.
SPONTANEOUS
LASTS FROM
MONTHS TO
SEVERAL YEARS.
 MAY BE IRREGULAR
( INCREASES
TOWARDS THE END
OF THE DAY)
 CHRONIC
UNREMMITING
PATTERN IS USUAL.

14. • DRY MOUTH AND THIRST ( NO EVIDENCE OF DECREASED
SALIVARY FLOW IN SOME PATIENTS).
• RESLESSNESS , IRRITABILITY ,ANXIETY AND DEPRESSION ,
DECREASED APETITE.
• FACIAL PAIN AND PAIN AT OTHER SITES.
• DYSGUESIA(USUALLY METALLIC TASTE).
• TMJ SYMPTOMS.

15. DIAGNOSIS
• ORAL EXAMINATION.
• SALIVARY PARAMETERS .
• HAEMATOLOGIC PARAMETERS .
• HORMONAL PARAMETERS.
• MEDICATIONS.
• PARAFUNCTIONAL HABITS .
• CONTACT ALLERGIES .
• PSYCHOLOGICAL / PSYCHOSOCCIAL EVALUATION .

16. TREATMENT
• REPLACING OR ADDJUSTING POORLY FITTING DENTURES.
• NUTRITIONAL SUPPLEMENTS - VIT B COMPLEX REPLACEMENT
THERAPY..
• XEROSTOMIA – ACTIVE STIMULATION OF SALIVA BY CHEWING
GUMS , OR DRUGS LIKE CEVIMELINE , PILOCARPINE ).
• FOR IRON DEFICIENCY ANAEMIA – SERUM IRON ,SERUM FOLATE
• AVOIDING TOBACCO & ALCOHOL
• AVOIDING SPICY FOODS

17. TOPICAL MEDICATIONS
• CLONAZEPAM – BD FOR 1 MONTH
• 5% LIDOCAINE APPLIED TO AFFECTED AREAS 3- 5 TIMES.
• CAPSAICIN CREAM – 3 TO 5 TIMES FOR 2 MONTHS
• NON STEROIDAL ANTI- INFLAMMATORY DRUGS
(NSAIDS) – 5 ML OF BENZYDAMINE HYDROCHLORIDE
O.15% AS A RINSE .

18. SYSTEMIC MEDICATIONS
• BENZODIAZEPINES ( CLONAZEPAM OR
ALPRAZOLAM)
• ANTICONVULSANTS – GABAPENTIN
• ANTIDEPRESSANTS –(AMITRIPTYLINE ,
NORTRIPTYLINE )
• ALPHA LIPOIC ACID – 600 MG/ DAY FOR 8 WEEKS .