Burning mouth syndrome: an update on recent findings

Burning mouth syndrome (BMS) is characterized by a burning sensation of the oral mucosa in the absence of mucosal abnormality Various local, systemic and psychological factors are associated with BMS, but its aetiology is not fully understood. Recently, significant inroads have been made, producing a better understanding of this complex condition. The aim of the current paper is to explore the condition of BMS in an educational context with the specific outcome of increasing awareness of the condition.

Burning mouth syndrome: A discussion about possible etiological factors and treatment modalities

Although several studies discuss the contributing factors associated with the burning mouth syndrome (BMS), there is still controversy with regard to its etiology. Therefore, in the majority of cases, the establishment of an adequate diagnosis and consequently the best treatment modality is complicated. In order to assist the clinician in the establishment of the correct diagnosis and management of BMS, this article reviews the literature, providing a discussion on the various etiologic factors involved in BMS, as well as the best treatment modalities for this condition that have showed to be the most effective ones in randomized clinical trials. In addition, the authors discuss some clinical characteristics in the differential diagnosis of BMS and other oral diseases. It is important for the clinician to understand that BMS should be diagnosed only after all other possible causes for the symptoms have been ruled out.

Burning mouth syndrome: clinical presentation, diagnosis and treatment

Burning mouth syndrome is an oral dysaesthesia presenting as a burning sensation of the tongue and less frequently other oral and peri-oral sites. There may be other coincident symptoms and signs, but the defining feature is the absence of any obvious organic cause. Because of this the condition frequently remains unrecognized for extended periods with a variable progression of symptoms. The current paper describes the complex presentation of burning mouth syndrome with the major aim of increasing recognition.

Síndrome da boca ardente

Resumo: O presente trabalho trata-se de uma revisão da literatura existente acerca da Síndrome da Boca Ardente e é colmatado com a apresentação de um caso clínico. Nele são apresentados e discutidos todos os parâmetros da doença com o objectivo final de apresentar e confrontar a informação já existente. O trabalho foi elaborado sempre visando a aplicação da informação na prática clínica do médico dentista generalista. Introdução: A Síndrome da Boca Ardente é uma doença identificada pela International Association for the Study of Pain como “uma entidade nosológica distinta” caracterizada por “sensação de dor ou ardor incessante acompanhada pela ausência de alterações objectivas na mucosa oral”. Objectivo: Apresentar as características da doença e organizar a informação com o intuito da sua aplicação prática. Materiais e métodos: Foi realizada uma pesquisa em duas bases de dados Pubmed e Scielo. Foram utilizados apenas artigos em inglês e preferivelmente com data de publicação a partir de 2000, embora não tenham sido usados limites temporais. O critério de inclusão foi o acesso ao texto integral. Conclusão: Foi possível concluir que é ainda necessário aprofundar a investigação no que diz respeito à fisiopatologia da doença, para que se avance para conclusões acerca da manutenção e tratamento de um paciente com Síndrome da Boca Ardente. Por outro lado, depois da organização das evidências relativas à história médica e exame clínico, a questão que se prende com o atraso de diagnóstico é uma que é merece atenção e para a qual a transmissão de informação parece ser a solução.

Diabetes mellitus: avaliação do conhecimento de cirurgiões-dentistas em municípios de três estados brasileiros

Introduction: Pathological changes in the bucal cavity associated with Diabetes mellitus (DM) may include gingivitis, periodontal disease, salivary gland dysfunction and xerostomia (dry mouth), susceptibility to bucal infections, burning mouth syndrome, and altered taste. Objective: This study assessed the technical and scientific knowledge of dentists working in primary care in the National Health System (SUS) on the DM. Material and method: The study was conducted in the municipalities of Birigui-SP, Maringá-PR and TrêsLagoas-MS, with the participation of 76 dentists working in the SUS primary care system.These professionals agreed to answer to a questionnaire developed for this study and the results of the questions were submitted to a quantitative analysis. Result: Showed that 94.7% were in contact with diabetic patients; 97.4% know what is DM; about other types of DM, 77.6% said they know, the most mentioned (by 55.9%) was the gestational DM. The DM2 was indicated as the most prevalent by 59.2%; the normal range of fasting blood glucose level was quoted correctly by 2.6% of the participants; obesity was reported by 98.7% of participants as a risk factor for DM; 96.0% stated correctly what are the main signs and symptoms related to Diabetes; periodontal disease was reported by 92.1% as an bucal manifestation in diabetic patients. Conclusion: The dentist needs to develop specific knowledge about DM, being able to identify normal levels of blood glucose and ready to identify and meet the bearer of DM.

Tracking the Links to Social Functioning: Asperger Syndrome and Gaze Patterns

The application of Eye Tracking (ET) to the study of social functioning in Asperger Syndrome (AS) provides a unique perspective into social attention and cognition in this atypical neurodevelopmental group. Research in this area has shown how ET can capture social attention atypicalities within this group, such as diminished fixations to the eye region when viewing still images and movie clips; increased fixation to the mouth region; reduced face gaze. Issues exist, however, within the literature, where the type (static/dynamic) and the content (ecological validity) of stimuli used appear to affect the nature of the gaze patterns reported. Objectives: Our research aims were: using the same group of adolescents with AS, to compare their viewing patterns to age and IQ matched typically developing (TD) adolescents using stimuli considered to represent a hierarchy of ecological validity, building from static facial images; through a non-verbal movie clip; through verbal footage from real-life conversation; to eye tracking during real-life conversation. Methods: Eleven participants with AS were compared to 11 TD adolescents, matched for age and IQ. In Study 1, participants were shown 2 sets of static facial images (emotion faces, still images taken from the dynamic clips). In Study 2, three dynamic clips were presented (1 non-verbal movie clip, 2 verbal footage from real-life conversation). Study 3 was an exploratory study of eye tracking during a real-life conversation. Eye movements were recorded via a HiSpeeed (240Hz) SMI eye tracker fitted with chin and forehead rests. Various methods of analysis were used, including a paradigm for temporal analysis of the eye movement data. Results: Results from these studies confirmed that the atypical nature of social attention in AS was successfully captured by this paradigm. While results differed across stimulus sets,
collectively they demonstrated how individuals with AS failed to focus on the most socially relevant aspects of the various stimuli presented. There was also evidence that the eye movements of the AS group were atypically affected by the presence of motion and verbal information. Discriminant Function Analysis demonstrated that the ecological validity of stimuli was an important factor in identifying atypicalities associated with AS, with more accurate classifications of AS and TD groups occurring for more naturalistic stimuli (dynamic rather than static). Graphical analysis of temporal sequences of eye movements revealed the atypical manner in which AS participants followed interactions within the dynamic stimuli. Taken together with data on the order of gaze patterns, more subtle atypicalities were detected in the gaze behaviour of AS individuals towards more socially pertinent regions of the dynamic stimuli. Conclusions: These results have potentially important implications for our understanding of deficits in Asperger Syndrome, as they show that, with more naturalistic stimuli, subtle differences in social attention can be detected that

Assessing the impact of menopause on salivary flow and xerostomia

Background: The aim of this study was to evaluate the symptoms of dry mouth and salivary flow in menarche and menopausal women. Methods: Objective and subjective assessment of salivary function were analysed by Xerostomia Inventory and Visual Analogue Scale questionnaire in menopausal and menarche women (control group). Salivary flow was evaluated by a chemical absorption stimulation test. Each subject provided three saliva samples: S1, non-stimulated saliva; S2, saliva initially stimulated with two drops of citric acid 2.5%; and S3, saliva super-stimulated with two drops of citric acid 2.5% every 30 seconds for two minutes. Results: No intergroup association was observed between Xerostomia Inventory and Visual Analogue Scale questionnaire. In both groups, the salivary flow was greatest at S3, followed by S2 and finally S1. Salivary flow was lower in the menopausal group compared to the control group only in S2 and S3. Conclusions: In the menopausal group, the salivary flow showed reduction but without clinical symptoms of dry mouth. It is important to normalize salivary flow to prevent oral abnormalities and maintain oral health. © 2013 Australian Dental Association.

Síndrome da ardência bucal: avaliação e tratamento

The burning mouth syndrome (BMS) is a relevant pathology that has been defined as a chronic pain with difficult diagnosis and treatment. The prevalence of BMS is estimate to be 15% of the general population, being more common in the elderly and middle-aged. Characterized by a burning sensation in more than one area, more frequently on the two thirds of the tongue, on the anterior half of the hard palate and on the mucosa of the upper lip, the BMS is associated with clinical signs of normality and normal laboratory findings. For several studies the BMS etiology is controversial because it is multifactorial since it can be caused by local, neuropathic, psychological and/or systemic factors. These controversies make the diagnosis more difficult, especially if the dentist does not have knowledge about the syndrome. Thus, the aim of this paper is to present, by means of a literature review, the main features of BMS, indicating the procedures that may be useful for diagnosis, and also the available therapeutic modalities in order to increasing the knowledge of health professionals so that patients with BMS may benefit from appropriate treatment, support and professional confidence, always aiming to better quality of life.

Taste alteration, mouth dryness and teeth staining as side effects of medications taken by elderly

Elderly patients generally use several types of medication, some of which may cause oral side effects. Aim: To investigate the oral side effects caused by medication in an elderly sample. Methods: Three hundred patients were interviewed about their use of medication and were divided in two groups: institutionalized (n=150) and community-dwelling (n=150) elderly. Results: The most used drugs were antihypertensives (53%) for community-dwelling elders and antiulceratives (76%) for the institutionalized ones. The more prevalent side effects were taste alterations that occurred in 19%, dry mouth in 17% and teeth staining in 2%. Conclusions: A high prevalence of oral side effects from medications used by the elderly was found in this study. The health professionals should be aware of the possible side effects caused by prescribed medications.

Reacções adversas a fármacos com manifestações na mucosa oral

Existe uma grande quantidade de fármacos que provocam reacções adversas na mucosa oral. Os efeitos que causam são variados, nomeadamente angioedema, língua pilosa nigra, bruxismo, síndrome da boca ardente, candidose, queilite, xerostomia, eritema multiforme, hiperplasia gengival, glossite, halitose, hiperpigmentação das mucosas, hipersalivação, reações liquenóides, lupóides, penfigóides e tipo pênfigo, osteonecrose, tumefação das glandulas salivares, alterações do paladar, ulcerações, mucosite e lesões potencialmente malignas, entre outras. Com o presente trabalho pretende-se criar uma base de dados que facilite a pesquisa dos diferentes efeitos adversos e relação com a terapêutica prescrita ao paciente, de modo a auxiliar a vida ao Médico Dentista no contexto da prestação de serviços aos seus Utentes.