1
|
Gunendran T, Bai P, Subhedar R, Mansuri U, Jain S. An Unusual Case of Burning Mouth Syndrome in an Adult Male: A Case Report. Cureus 2023; 15:e44847. [PMID: 37692186 PMCID: PMC10484243 DOI: 10.7759/cureus.44847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 09/12/2023] Open
Abstract
Burning mouth syndrome (BMS) is a rare disorder primarily affecting the oral mucosa and characterized by a chronic burning sensation without specific oral mucosal lesions. This paper presents a case of a 54-year-old adult male patient who complained of chronic burning mouth pain. The clinical diagnosis was made after excluding various differentials, including oral candidiasis, hairy oral leukoplakia, gastroesophageal reflux disease, oral lichen planus, local infective processes, and nutritional deficiencies. Physical examination did not reveal specific signs or lesions related to BMS; however, considering the patient's signs, symptoms, and the exclusion of other possibilities, a possible diagnosis of BMS was considered. The patient was evaluated in an outpatient setting, and management was conducted in this setting to reduce patient costs. This presentation is considered rare, as the disorder predominantly affects postmenopausal females, and most proposed theories behind its pathophysiology revolve around estrogen-mediated modulation of pain receptors. Currently, diagnostic and management criteria for BMS may vary and continue to evolve. The management of this patient focuses on patient education and routine follow-up. This case report presents the management of this particular case, along with a review of other proposed management options.
Collapse
Affiliation(s)
| | - Payal Bai
- Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Rashmi Subhedar
- Psychiatry, Seth Gordhandas Sunderdas Medical College (GSMC) and the King Edward Memorial (KEM) Hospital, Mumbai, IND
| | - Uvesh Mansuri
- Medicine, MedStar Union Memorial Hospital, Baltimore, USA
| | - Sakshi Jain
- Geriatrics, Hackensack University Medical Center, New Jersey, USA
| |
Collapse
|
2
|
Dugan C, Parlatescu I, Popescu BO, Pop CS, Marin M, Dinculescu A, Nistorescu AI, Vizitiu C, Varlas VN. Applications for oral research in microgravity - lessons learned from burning mouth syndrome and ageing studies. J Med Life 2023; 16:381-386. [PMID: 37168310 PMCID: PMC10165527 DOI: 10.25122/jml-2022-0285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 02/07/2023] [Indexed: 05/13/2023] Open
Abstract
The negative consequences of microgravity for the human body are central aspects of space travel that raise health problems. Altered functions of the same systems and treatment options are common points of spaceflight physiology, age-related diseases, and oral medicine. This work emphasizes the convergence of knowledge between pathophysiological changes brought on by aging, physiological reactions to microgravity exposure, and non-pharmacological and non-invasive treatment methods that can be used in spaceflight. Sarcopenia, peripheral nerves alterations, neuromotor plaque in the masticatory muscles, lingual, labial, and buccal weakness, nociplastic pain in oral mucosal diseases, and microgravity, as well as soft tissue changes and pathologies related to chewing and swallowing, corticomotor neuroplasticity of tongue, and swallowing biomechanics, are of particular interest to us. Neurologic disease and other pathologies such as recovery from post-stroke dysphagia, nociplastic pain in glossodynia, sleep bruxism, and obstructive sleep apnea have been studied and, in some cases, successfully treated with non-invasive direct and transcranial magnetic stimulation (TMS) methods in recent decades. An interdisciplinary team from medical specialties, engineering, and biophysics propose an exploratory study based on the parallelism of ageing and space physiology, along with experiment scenarios considering TMS and non-invasive direct methods.
Collapse
Affiliation(s)
- Cosmin Dugan
- Internal Medicine Department, Bucharest University Emergency Hospital, Bucharest, Romania
- Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Ioanina Parlatescu
- Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Corresponding Author: Ioanina Parlatescu, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. E-mail:
| | - Bogdan Ovidiu Popescu
- Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Corina Silvia Pop
- Internal Medicine Department, Bucharest University Emergency Hospital, Bucharest, Romania
- Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Mihaela Marin
- Space Applications for Health and Safety Laboratory, Institute of Space Science, Magurele, Romania
| | - Adrian Dinculescu
- Space Applications for Health and Safety Laboratory, Institute of Space Science, Magurele, Romania
| | - Alexandru Ion Nistorescu
- Space Applications for Health and Safety Laboratory, Institute of Space Science, Magurele, Romania
| | - Cristian Vizitiu
- Space Applications for Health and Safety Laboratory, Institute of Space Science, Magurele, Romania
- Department of Automatics and Information Technology, Faculty of Electrical Engineering and Computer Science, Transilvania University of Brasov, Brasov, Romania
| | - Valentin Nicolae Varlas
- Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of Obstetrics and Gynaecology, Clinical Hospital of Obstetrics and Gynecology Filantropia, Bucharest, Romania
| |
Collapse
|
3
|
Seeman MV. Use of metaphors when treating unexplained medical symptoms. World J Clin Cases 2023; 11:332-341. [PMID: 36686355 PMCID: PMC9850979 DOI: 10.12998/wjcc.v11.i2.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/02/2022] [Accepted: 01/03/2023] [Indexed: 01/12/2023] Open
Abstract
The words one chooses to describe personal pain mirror current usage, but may also hold echoes of an individual’s lived experience. They may provide clues to the origin of physical symptoms that are medically hard to explain. The aim of this commentary is to propose, on the basis of the available literature, that verbal metaphors can prove effective in the psychotherapy of such conditions. I provide a case history of a 45 year old woman referred to psychiatry because of extreme ‘burning’ pain in her mouth and tongue. She had been to numerous doctors, had undergone a variety of tests, had tried many medical treatments, and had been prescribed a number of different pharmaceutical agents. She had changed her diet, done her daily dental mouth exercises, drunk a lot of water, but the burning continued and interfered, with her job (she was a teacher), her friendships, and her everyday life. This made her angry and recalcitrant to therapy, but the metaphor ‘burning with rage,’ as applicable to her pain, worked to establish a good alliance that led to a decrease of symptoms. Burning Mouth Syndrome is a medically unexplained condition of complex etiology that psychotherapy alone cannot reverse. The literature bears out, however, that the use of metaphors can help to open avenues of psychological exploration that accelerate adaptation to pain and improve quality life.
Collapse
Affiliation(s)
- Mary V Seeman
- Department of Psychiatry, University of Toronto, Toronto M5S 1A1, Ontario, Canada
| |
Collapse
|
4
|
Adamo D, Spagnuolo G. Burning Mouth Syndrome: An Overview and Future Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010682. [PMID: 36613002 PMCID: PMC9819290 DOI: 10.3390/ijerph20010682] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 12/27/2022] [Indexed: 06/02/2023]
Abstract
Burning Mouth Syndrome (BMS) is a complex chronic neuropathic orofacial pain disorder characterized by a generalized or localized intraoral burning, dysesthetic sensation or pain of the oral mucosa, recurring daily for more than 2 h per day for more than 3 months, without any evidence of specific mucosal lesions and/or laboratory findings [...].
Collapse
|
5
|
Canfora F, Calabria E, Pecoraro G, D'Aniello L, Aria M, Gaetano M, Sammartino P, Mignogna MD, Adamo D. The use of self-report questionnaires in an analysis of the multidimensional aspects of pain and a correlation with the psychological profile and quality of life in patients with Burning Mouth Syndrome: a case control study. J Oral Rehabil 2022; 49:890-914. [PMID: 35611463 PMCID: PMC9544557 DOI: 10.1111/joor.13343] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/29/2022] [Accepted: 05/19/2022] [Indexed: 11/27/2022]
Abstract
Background The symptomatology in Burning Mouth Syndrome (BMS) is complex and it should be considered in accordance with a biopsychosocial model. Objectives To evaluate the multidimensional aspects of pain with a complete battery of tests and to analyse its relationship with potential predictors such as mood disorders, sleep and quality of life. Methods Forty patients with BMS versus an equal number of age and sex‐matched healthy controls were enrolled. The VAS, SF‐MPQ, BPI, PD‐Q, BDI‐II, STAI, PSQI, ESS, SF‐36 and OHIP‐14 were administered. Results The scores of the VAS, SF‐MPQ, BPI, PD‐Q, BDI‐II, STAI, PSQI, SF‐36 and OHIP‐14 were statistically significantly higher in the BMS patients than the controls (p < .001**). A strongly linear correlation between pain (VAS, SF‐MPQ, BPI and PD‐Q) and disease onset (STAI, BDI‐II, PSQI and sub‐items of SF‐36 and OHIP‐14) was found. In the multiple regression analysis, the contributions of the BDI‐II and OHIP‐14 were found to be statistically significant with the SF‐MPQ, PD‐Q and BPI in terms of severity and interference, while the contributions of the STAI and sleep were found to be statistically significant with the SF‐MPQ and BPI in terms of severity and interference, respectively. Conclusions Pain tests are differently correlated with mood and quality of life. Therefore, a complete analysis of the patient requires several tools to better understand the multidimensional aspects of pain in BMS.
Collapse
Affiliation(s)
- Federica Canfora
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Elena Calabria
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Giuseppe Pecoraro
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Luca D'Aniello
- Department of Social Sciences, University Federico II of Naples, Italy
| | - Massimo Aria
- Department of Economics and Statistics, University Federico II of Naples, Italy
| | - Marenzi Gaetano
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Pasquale Sammartino
- Head and Neck Clinical Department, AOU San Giovanni di Dio e Ruggi di Aragona, Salerno, Italy
| | - Michele Davide Mignogna
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Daniela Adamo
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| |
Collapse
|
6
|
Rossella I, Alessandro V, Naman R, Gary K, Hervé SY. Topical clonazepam for burning mouth syndrome: Is it efficacious in patients with anxiety or depression? J Oral Rehabil 2021; 49:54-61. [PMID: 34716948 DOI: 10.1111/joor.13275] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/11/2021] [Accepted: 10/25/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Burning mouth syndrome (BMS) is a chronic disorder characterised by pain in the oral cavity without clinically evident causative lesions. The aetiology of this condition is poorly understood, and treatment can be challenging. METHOD A retrospective review of the medical records of 82 patients with BMS was performed. Data on demographics, BMS associated symptoms, symptoms' intensity score (NRS: 0-10) and response to treatment with topical clonazepam were extracted from clinical notes based on a standardised clinical questionnaire. Differences in the symptoms' intensity score between patients with or without concomitant anxiety/depression or systemic psychogenic medication use were analysed using the Wilcoxon signed rank test. RESULTS Among the entire cohort, the median symptoms' intensity score at baseline was 4.5 and 3.0 at first follow-up, a statistically significant improvement (p < .001; 95% CI). Among the subjects with anxiety/depression and those who were prescribed systemic psychogenic medications, the median symptoms' intensity score at baseline was 5.0 and 3.0 at first follow-up, a statistically significant improvement (p < .001; 95% CI). Among those without anxiety/depression, the symptoms' intensity score at baseline was 4.0 and 2.0 at first follow-up, a statistically significant improvement (p < .05; 95% CI). The median symptoms' intensity score for those who were not on any psychogenic medications at baseline was 4.0 and 2.0 at first follow-up, a statistically significant improvement (p < .001; 95% CI). CONCLUSIONS Clinicians are encouraged to prescribe topical clonazepam for BMS regardless of concomitant use of systemic psychogenic medications or comorbid mood disorders as it is an efficacious management approach in the presence or absence of these potentially complicating factors.
Collapse
Affiliation(s)
- Intini Rossella
- Department of Oral Medicine and Dentistry, Harvard School of Dental Medicine and Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Villa Alessandro
- Department of Orofacial Sciences, University of California, San Francisco, California, USA
| | - Rao Naman
- Henry M. Goldman School of Dental Medicine, Boston University, Boston, Massachusetts, USA
| | - Klasser Gary
- Department of Diagnostic Sciences, Louisiana State University Health Sciences Center School of Dentistry, New Orleans, Louisiana, USA
| | - Sroussi Y Hervé
- Department of Oral Medicine and Dentistry, Harvard School of Dental Medicine and Brigham and Women's Hospital, Boston, Massachusetts, USA
| |
Collapse
|