{"id":7428,"date":"2020-04-24T11:22:18","date_gmt":"2020-04-24T14:22:18","guid":{"rendered":"https:\/\/doctorhoogstra.com\/es\/sindrome-de-boca-ardiente\/"},"modified":"2020-04-27T16:22:57","modified_gmt":"2020-04-27T19:22:57","slug":"burning-mouth-syndrome","status":"publish","type":"wiki","link":"https:\/\/doctorhoogstra.com\/en\/wiki\/sindrome-de-boca-ardiente\/","title":{"rendered":"Burning mouth syndrome"},"content":{"rendered":"<p><\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_88 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/sindrome-de-boca-ardiente\/#%C2%BFQue-esta-quemando-la-boca-sindrome\" >What is burning your mouth? syndrome?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/sindrome-de-boca-ardiente\/#%C2%BFQuien-contrae-el-sindrome-de-boca-ardiente\" >Who gets Burning Mouth Syndrome?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/sindrome-de-boca-ardiente\/#%C2%BFCuales-son-las-caracteristicas-clinicas-o-el-sindrome-de-boca-ardiente\" >What are the clinical features or burning mouth syndrome?<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/sindrome-de-boca-ardiente\/#Historia-y-sintomas\" >History and symptoms<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/sindrome-de-boca-ardiente\/#El-examen-de-la-boca\" >Examination of the mouth<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/sindrome-de-boca-ardiente\/#%C2%BFComo-se-diagnostica-el-sindrome-de-boca-ardiente\" >How is burning mouth syndrome diagnosed?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/sindrome-de-boca-ardiente\/#%C2%BFCual-es-el-tratamiento-del-sindrome-de-boca-ardiente\" >What is the treatment of burning mouth syndrome?<\/a><\/li><\/ul><\/nav><\/div>\n\n<section class=\"textBlock\">\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFQue-esta-quemando-la-boca-sindrome\"><\/span>What is burning your mouth? <span class=\"term\" data-term-id=\"350\">syndrome<\/span>?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Burning mouth syndrome is a <span class=\"term\" data-term-id=\"319\">chronic<\/span> pain syndrome strictly defined as a burning sensation and pain in the mouth (oral <span class=\"term\" data-term-id=\"843\">dysesthesia<\/span>) with normal clinical examination and without obvious organic cause. Therefore, it is a diagnosis made only after excluding the recognized organic causes of oral pain.<\/p>\n<p>Currently thought to be <span class=\"term\" data-term-id=\"402\">neurological <\/span>originally, and not psychogenic as previously believed. Many other names have been given for this condition, including orodynia (burning in the mouth) and glossodynia (burning on the tongue).<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFQuien-contrae-el-sindrome-de-boca-ardiente\"><\/span>Who gets Burning Mouth Syndrome?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Burning mouth syndrome is seen predominantly, but not exclusively, in peri and postmenopausal women. Males can be affected. the <span class=\"term\" data-term-id=\"578\">incidence<\/span> increases with advancing age. It is rarely seen before the age of 30. No racial or ethnic differences have been reported. It probably affects approximately 1% in the general population, increasing to 30% in selected populations, such as postmenopausal women.<\/p>\n<p>Burning mouth syndrome can be associated with personality or mood disorders, particularly anxiety and depression. It is not clear if they are due to oral symptoms or if they contribute to the development of the problem. Teeth grinding, tongue thrusting, and jaw clenching are also commonly associated and can only be identified by asking family members.<\/p>\n<div id=\"square-placement-country-holder\" class=\"country-dependent advert\">\n<div class=\"box-placement square-placement\">\n<div class=\"advert__frame\">\n<div id=\"dermnet-dermnet-mobbox\">\n<\/div><\/div><\/div><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCuales-son-las-caracteristicas-clinicas-o-el-sindrome-de-boca-ardiente\"><\/span>What are the clinical features or burning mouth syndrome?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<h3><span class=\"ez-toc-section\" id=\"Historia-y-sintomas\"><\/span>History and symptoms<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>A careful history is important, as the underlying organic causes must be sought and excluded to make this diagnosis. The questions should cover the following points.<\/p>\n<ul>\n<li>Medications: some dry the mouth<\/li>\n<li>Dental care - dental hygiene<\/li>\n<li>General health, especially diabetes risk<\/li>\n<li>Skin conditions: can affect the mouth<\/li>\n<li>Diet: iron and vitamins are required for good oral health<\/li>\n<li>Hormonal state: Burning mouth may start around menopause<\/li>\n<\/ul>\n<p>The three key symptoms of burning mouth syndrome are:<\/p>\n<ol>\n<li>Oral pain<\/li>\n<li>Abnormal taste<\/li>\n<li>Dry mouth<\/li>\n<\/ol>\n<table class=\"borders\">\n<tbody>\n<tr>\n<td>Oral pain<\/td>\n<td>Oral pain is the greatest <span class=\"term\" data-term-id=\"902\">symptom<\/span> and is most commonly described as a burning sensation in the mouth as a scalding of a hot drink, or as tingling or numbness. The tongue is the most common site involved, followed by the inside of the lower lip and the hard palate. Pain rarely causes waking up from sleep. <br \/> Three patterns of oral pain have been identified:<\/p>\n<ul>\n<li>Type 1: absent pain upon awakening and developing during the day<\/li>\n<li>Type 2: pain present day and night<\/li>\n<li>Type 3: intermittent pain, with days without pain.<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr>\n<td>Abnormal taste<\/td>\n<td>Abnormal taste (dysgeusia, parageusia) is a metallic or bitter taste in the mouth or an altered perception of taste, particularly of salty or sweet \/ sour foods.<\/td>\n<\/tr>\n<tr>\n<td>Dry mouth<\/td>\n<td>Although the patient may perceive a dry mouth, reduced saliva production is not confirmed in tests.<\/td>\n<\/tr>\n<\/tbody>\n<caption>Burning symptoms in the mouth<\/caption>\n<\/table>\n<p>In burning mouth syndrome, symptoms persist for many months and often years. Not all people with this condition describe the three key symptoms, and the absence of any one of these does not exclude the diagnosis.<\/p>\n<p>Many other symptoms can also be described and can include:<\/p>\n<ul>\n<li>Complaint that dentures do not fit properly even if the dentist finds them right<\/li>\n<li>Aggravation or relief of symptoms with specific foods.<\/li>\n<li>Bad breath (halitosis): must be confirmed by questioning family members, as this can be socially disabling for the patient<\/li>\n<li>Difficulty to swallow (<span class=\"term\" data-term-id=\"514\">dysphagia<\/span>)<\/li>\n<li>A feeling of having a lump in the throat when there is nothing there.<\/li>\n<li>Symptoms of clenching the jaw or grinding the teeth can present as headache, earache, pain in the muscles or joints around the jaw, face, and neck.<\/li>\n<li>Language <span class=\"term\" data-term-id=\"1279\">ulcers<\/span> usually related to the inflamed tongue <span class=\"term\" data-term-id=\"374\">papillae<\/span>.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"El-examen-de-la-boca\"><\/span>Examination of the mouth<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>A comprehensive clinical examination should be performed, including the oral cavity, where local organic causes, such as oral and thrush <span class=\"term\" data-term-id=\"30\">Cancer<\/span>, must be excluded. The upper part of the tongue must have a complex architecture (that is, it must not be smooth as seen in <span class=\"term\" data-term-id=\"598\">anemia<\/span>) All surfaces in the mouth must be checked <span class=\"term\" data-term-id=\"1278\">ulceration<\/span> which can represent a spectrum of causes of <span class=\"term\" data-term-id=\"1365\">trauma<\/span>, <span class=\"term\" data-term-id=\"862\">idiopathic<\/span> <span class=\"term\" data-term-id=\"805\">recurrent<\/span> aphthous <span class=\"term\" data-term-id=\"272\">stomatitis<\/span>, <span class=\"term\" data-term-id=\"691\">autoimmune<\/span> diseases such as pemphigus to oral cancer.<\/p>\n<p>Skin examination and <span class=\"term\" data-term-id=\"193\">nail<\/span> must search <span class=\"term\" data-term-id=\"380\">systemic<\/span> causes of oral pain, including nutritional deficiencies, lichen planus, and hormonal disorders (eg, diabetes mellitus, thyroid disease).<\/p>\n<p>Oral <span class=\"term\" data-term-id=\"189\">mucous membrane<\/span> it looks normal in burning mouth syndrome. Clues may be seen on the exam that may help confirm the diagnosis.<\/p>\n<ul>\n<li>Worn teeth or damaged tooth enamel may indicate grinding and clenching of teeth<\/li>\n<li>Scallops along the sides of the tongue caused by the thrust of the tongue<\/li>\n<li>Protruding teeth or malocclusion may indicate thrusting of the tongue<\/li>\n<li>Sensitive muscles around the jaw and neck due to clenched jaw<\/li>\n<li>Foamy saliva accumulates on the floor of the mouth indicating excessive mucous submandibular saliva that is not easily cleared by swallowing<\/li>\n<li>Mild redness in symptomatic areas such as the tongue, hard palate, inside the lower lip near the incisors.<\/li>\n<li>Exhibition of the <span class=\"term\" data-term-id=\"103\">filiform<\/span> papillae (taste buds) on the tongue due to <span class=\"term\" data-term-id=\"1367\">traumatic<\/span> abrasion on teeth<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFComo-se-diagnostica-el-sindrome-de-boca-ardiente\"><\/span>How is burning mouth syndrome diagnosed?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Burning mouth syndrome is a diagnosis of exclusion, therefore history taking, clinical examination, and testing aim to find an organic explanation for the symptoms.<\/p>\n<p>Exams based on history and exam findings may be required. However, in burning mouth syndrome all of these are normal \/ negative.<\/p>\n<p>Investigations may include:<\/p>\n<ul>\n<li>Detection of nutritional deficiencies (folic acid, iron, vitamin B12, zinc)<\/li>\n<li>Hormonal levels (especially for thyroid and menopause), autoimmune conditions<\/li>\n<li>Blood sugar - diabetes mellitus<\/li>\n<li>\n<span class=\"term\" data-term-id=\"1018\">Mucous membrane<\/span> scraping for candida\n<\/li>\n<li>\n<span class=\"term\" data-term-id=\"224\">Patch<\/span> contact tests <span class=\"term\" data-term-id=\"1136\">allergy<\/span>\n<\/li>\n<li>Sialometry for the production of saliva.<\/li>\n<li>Mucous membrane <span class=\"term\" data-term-id=\"24\">biopsy<\/span>, but this is rarely indicated.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCual-es-el-tratamiento-del-sindrome-de-boca-ardiente\"><\/span>What is the treatment of burning mouth syndrome?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>In a small number of patients (3%) the condition resolves spontaneously. Over 6-7 years, half or two thirds of patients experience some improvement. There is no definitive cure.<\/p>\n<p>A list of symptoms and signs of burning mouth syndrome can help the patient accept the diagnosis, as this is an important step to progress. For some, only recognition and explanation is required.<\/p>\n<p>For many, the condition is disabling and active treatment is required. Realistic expectations of response to treatment are important. Often the first <span class=\"term\" data-term-id=\"899\">sign<\/span> response is an improvement in altered taste. However, the improvement is unpredictable: it can be incomplete and slow, which can take several years. The feeling of dryness (xerostomia) is often resistant to therapy. Referral to a specialized multidisciplinary oral medicine unit may offer the best opportunity for relief in the medium and long term.<\/p>\n<p>Few studies have been done on treatment and only cognitive behavioral therapy, <span class=\"term\" data-term-id=\"1330\">current<\/span> Clonazepam, oral capsaicin, and alpha lipoic acid (+\/- cognitive behavioral therapy) have been shown to have a positive impact in properly conducted trials. Oral capsaicin causes significant abdominal pain that can outweigh any benefits. Cognitive behavioral therapy can exert its effect through better mechanisms for dealing with pain.<\/p>\n<p><span class=\"term\" data-term-id=\"1103\">Placebo<\/span>Controlled studies have failed to show any benefit from using topical steroids, benzydamine hydrochloride oral rinses, or trazodone (serotonergic antidepressant), causing most patients to withdraw from the trial due to side effects, particularly dizziness.<\/p>\n<p>The reported treatments include:<\/p>\n<ul>\n<li>Other medications\n<ul>\n<li>Antidepressants, particularly tricyclics, are the most widely used treatment and should be started at low doses, since dry mouth is a common side effect, e.g. amitriptyline starting with 10 mg before bed, slowly increasing to a maximum of 150 mg as tolerated or required.<\/li>\n<li>Anxiolytic medications such as benzodiazepines, in low doses, may be helpful in confirming the diagnosis, as there is generally a perceived slight improvement, for example, clonazepam starting with 0.25 mg before bedtime, increasing to a maximum of 2 mg as prescribed. tolerated or required<\/li>\n<li>Anticonvulsants, for example gabapentin, which begins with 100 mg before bedtime and increases as tolerated or required.<\/li>\n<li>Hormone replacement therapy<\/li>\n<li>Topical local anesthetics\n<\/li>\n<li>Capsaicin topical<\/li>\n<\/ul>\n<\/li>\n<li>Behavioral therapies, including relaxation and exercise therapies.<\/li>\n<li>Physical therapies including massage, acupuncture, and <span class=\"term\" data-term-id=\"1617\">To be<\/span>\n<\/li>\n<li>Empirical treatment for known causes of oral pain, such as nystatin for candidiasis.<\/li>\n<\/ul>\n<p>These treatments can be used alone or in combination, particularly with cognitive behavioral therapy.<\/p>\n<\/section>","protected":false},"excerpt":{"rendered":"<p>\u00bfQu\u00e9 est\u00e1 quemando la boca? s\u00edndrome? El s\u00edndrome de boca ardiente es un cr\u00f3nico s\u00edndrome de dolor estrictamente definido como una sensaci\u00f3n de ardor y dolor en la boca (oral&#8230;<\/p>","protected":false},"author":8,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"categories":[204],"tags":[],"class_list":["post-7428","wiki","type-wiki","status-publish","format-standard","category-glosario-definiciones"],"_links":{"self":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/7428","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/comments?post=7428"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/7428\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/media?parent=7428"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/categories?post=7428"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/tags?post=7428"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}