PubMed · 4535941
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J C Colli. 1974. [Lingual pain].. https://pubmed.ncbi.nlm.nih.gov/4535941/
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Glossodynia (synonym: burning mouth syndrome) is thought to be a disorder with a wide range of possible causes. Aetiologies may include haematological diseases, vitamin deficiencies, dental work, hormonal factors, or infections. In addition, psychological disorders such as neuroses, depression, or phobias have been reported as playing a significant role in the initiation of burning mouth syndrome. Typically, the oral mucosa is found to be normal in most burning mouth syndrome patients. A multidisciplinary approach appears to be essential for appropriate assessment of this disorder, i.e. the diagnostic procedure should involve dentistry, neurology, and internal medicine. If possible, careful treatment of underlying causes must be undertaken. However, the replacement of suspected but unproven hormonal/nutritional deficiencies should be avoided.
Severe xerostomia may be a primary cause of glossodynia. If radiation therapy and systemic disease are ruled out as causes of xerostomia, the wide variety of pharmacologic agents found in prescription medications, over-the-counter medications, common dietary components, and recreational drugs must be considered. The xerostomic side effect of a medication may be unavoidable; however, it may be minimized by alterations in diet, environment, or elimination of optional concurrent medications. When evaluating the patient with glossodynia, the practitioner must be aware of the many types of offending agents that contribute to a decrease in salivary flow. A clinical referral to a dentist to manage the oral complications of xerostomia is appropriate, although the patient's physician is the one who may make any changes in prescribed medications.
Oral inflammation occurs during puberty, pregnancy, menses, and therapy with hormones (especially oral contraceptive agents), and other medications such as phenytoin. Alterations of the oral environment result from fluctuations of plasma and salivary sex steroids. The ratio of the sex steroids to one another, and their absolute concentration, determine the amount of prostanoid and peroxidase production and salivary flow. These relationships are complex and are not readily predictable; however, they are reproducible in both humans and animals. The sex steroids exert profound effects on the function of many nonsexual organs; particularly the skin, bone, liver, salivary glands, and oral tissues. We reviewed the currently available information concerning sex steroid action on salivary glands and oral epithelium. In light of the dramatic drop in sex steroid levels at menopause, the purely psychogenic nature of glossodynia or burning mouth (stomatopyrosis), first manifested at menopause, requires further consideration and study.