Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
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A Review of Etiopathogenesis of Burning Mouth Syndrome

구강작열감증후군의 병인론과 병태생리에 대한 고찰

  • Lim, Hyun-Dae (Department of Oral medicine, School of Dentistry, Wonkwang University Wonkwang Dental Research Institute) ;
  • Kang, Jin-Kyu (Department of Oral medicine, School of Dentistry, Wonkwang University Wonkwang Dental Research Institute) ;
  • Lee, You-Mee (Department of Oral medicine, School of Dentistry, Wonkwang University Wonkwang Dental Research Institute)
  • 임현대 (원광대학교 치과대학 구강내과학 교실 및 원광치의학 연구소) ;
  • 강진규 (원광대학교 치과대학 구강내과학 교실 및 원광치의학 연구소) ;
  • 이유미 (원광대학교 치과대학 구강내과학 교실 및 원광치의학 연구소)
  • Received : 2010.01.12
  • Accepted : 2010.02.17
  • Published : 2010.03.30
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Abstract

Burning mouth syndrome(BMS) is a chronic oral pain and a symptom complex disorder usually unaccomplished by mucosal lesion or other clinical and laboratory signs of organic disease. BMS is characterized by a spontaneous burning sensation that mainly affects middle-aged and postmenopausal women. The etiology of BMS is poorly understood even though evidence for a possible neuropathic pathogenesis. BMS cause from various local or systemic factor, including nutritional deficiencies, hormonal change, local infection, dental procedure, dry mouth, medication and systemic disease including diabetes mellitus. Many studies suggest peripheral alteration in sensory of trigeminal nerve system. BMS patients with supertaster indicates pathologies of central and peripheral nerve system induced by an alteration in the taste system at the level of chorda tympani and glossopharyngeal nerve. The author discuss our current understanding of etiology and pathogenesis of BMS that refered chronic oral pain.

구강작열감증후군은 임상적 증상이나 검사실 소견없이 구강점막에 나타나는 작열감을 말하며 중년이후 폐경기 여성에게 높은 발생율을 보인다. 구강작열감증후군에서 보여지는 통증은 자발적이며 뚜렷한 악화요인을 보이고 있지 않다. 통증 유발과 관련해서 치과적 술식, 최근의 질환, 투약(항생제 요법)등을 포함하고 있으며, 작열감이 한 번 시작되면 수년간 지속된다. 대부분의 구강작열감 환자는 국소적 또는 전신적 요인을 가지고 있으며, 구강작열감증후군은 신경병리학적 활성화에서 기원되는 만성구강증상으로 고려할 수 있으며, 정신학적 원인에 대한 역할은 아직은 명확하지 않다. 구강작열감의 신경학적 측면에 대하여 연구가 증가하고 있고 이런 연구는 구강작열감에 중추신경계, 말초신경계가 관여함을 제시하고 있다. 그 중에 하나로 대두 되고 있는 것이 미각에서의 이상이 존재한다는 것이다. 구강작열감증후군에서 supertaster의 존재에 대해 언급하고 있으며, 이는 미각과 유해수용성 기전에 상호작용함을 제시하고 있다. 즉 중추신경계에서 미각과 구강 통증 감각이 연결되어 있고 이것은 구강작열감증후군에서 고삭신경, 설인신경수준에서 미각체계 변형에 의한 말초신경계와 중추신경계가 같이 상호 작용하여 구강작열감증후군을 발생시킴을 보여준다. 이에 본 저자는 만성구강통증으로 여겨지는 구강작열감증후군을 유발하는 요인과 병태 생리를 고찰하여 환자의 진단과 원인 지향적인 치료에 도움을 주고자 한다.

Keywords

References

  1. Drage LA, Rogers RS 3rd. Burning mouth syndrome. Dermatol Clin 2003;21(1):135-145. https://doi.org/10.1016/S0733-8635(02)00063-3
  2. Danhauer SC, Miller CS, Rhodus NL, Carlson CR. Impact of criteria-based diagnosis of burning mouth syndrome on treatment outcome. J Orofac Pain 2002;16(4):305-311.
  3. Browning S, Hislop S, Scully C, Shirlaw P. The association between burning mouth syndrome and psychosocial disorders. Oral Surg Oral Med Oral Pathol 1987;64(2):171-174. https://doi.org/10.1016/0030-4220(87)90085-5
  4. Lopez-Jornet P, Camacho-Alonso F, Andujar-Mateos P, Sanchez-Siles M, Gomez-Garcia F. Burning mouth syndrome : An update. Med Oral Patol Oral Cir Bucal 2009 Dec 29 [Epub ahead of print].
  5. Klasser GD, Fischer DJ, Epstein JB. Burning mouth syndrome : recognition, understanding, and management. Oral Maxillofac Surg Clin North Am 2008;20(2):255-271. https://doi.org/10.1016/j.coms.2007.12.012
  6. Abetz LM, Savage NW. Burning mouth syndrome and psychological disorders. Aust Dent J 2009;54(2):84-93. https://doi.org/10.1111/j.1834-7819.2009.01099.x
  7. Scala A, Checchi L, Montevecchi M, Marini I, Giamberardino MA. Update on burning mouth syndrome : overview and patient management. Crit Rev Oral Biol Med 2003;14(4):275-291. https://doi.org/10.1177/154411130301400405
  8. 고명연, 장용석, 허준영, 안용우. 구강작열감증후군 환자의 미각에 대한 연구. 대한구강내과학회지 2006;31(4):275-281.
  9. Grushka M, Epstein JB, Gorsky M. Burning mouth syndrome. Am Fam Physician 2002:65(4);615-20.
  10. Patton LL, Siegel MA, Benoliel R, De Laat A. Management of burning mouth syndrome : systematic review and management recommendations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103:S39.e1-13. https://doi.org/10.1016/S1079-2104(07)00358-7
  11. Maltsman-Tseikhin A, Moricca P, Niv D. Burning mouth syndrome : will better Understanding yield better management?. Pain Pract 2007;7(2):151-162. https://doi.org/10.1111/j.1533-2500.2007.00124.x
  12. Marino R, Capaccio P, Pignataro L, Spadari F. Burning mouth syndrome : the role of contact hypersensitivity. Oral Dis 2009;15(4):255-258. https://doi.org/10.1111/j.1601-0825.2009.01515.x
  13. Pinto A, Sollecito TP, DeRossi SS. Burning mouth syndrome - A retrospective analysis of clinical characteristics and treatment outcomes. N Y State Dent J 2003;69(3):18-24.
  14. Granot M, Nagler RM. Association between regional idiopathic neuropathy and salivary involvement as the possible mechanism for oral sensory complaints. J Pain 2005;6(9):581-587. https://doi.org/10.1016/j.jpain.2005.03.010
  15. Hershkovich O, Nagler RM. Biochemical analysis of saliva and taste acuity evaluation in patients with burning mouth syndrome, xerostomia and/or gustatory disturbances. Arch Oral Biol 2004;49(7):515-522. https://doi.org/10.1016/j.archoralbio.2004.01.012
  16. Ito M, Kurita K, Ito T, Arao M. Pain threshold and pain recovery after experimental stimulation in patients with burning mouth syndrome. Psychiatry Clin Neurosci 2002;56(2):161-168. https://doi.org/10.1046/j.1440-1819.2002.00950.x
  17. Salort-Llorca C, Minguez-Serra MP, Silvestre FJ. Drug-induced burning mouth syndrome : a new etiological diagnosis. Med Oral Patol Oral Cir Bucal 2008;13(3):E167-170.
  18. Savage NW, Boras VV, Barker K. Burning mouth syndrome : clinical presentation, diagnosis and treatment. Australas J Dermatol 2006;47(2):77-81. https://doi.org/10.1111/j.1440-0960.2006.00236.x
  19. Lamey PJ, Freeman R, Eddie SA, Pankhurst C, Rees T. Vulnerability and presenting symptoms in burning mouth syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;99(1):48-54. https://doi.org/10.1016/j.tripleo.2004.01.021
  20. Woda A, Dao T, Christelle Gremeau-Richard. Steroid dysregulation and stomatodynia (burning mouth syndrome). J Orofac Pain 2009;23(3):202-210.
  21. Heckmann SM, Heckmann JG, Hilz MJ et al. Oral mucosal blood flow in patients with burning mouth syndrome. Pain 2001;90(3):281-286. https://doi.org/10.1016/S0304-3959(00)00410-3
  22. Lauria G, Majorana A, Borgna M et al. Trigeminal small-fiber sensory neuropathy causes burning mouth syndrome. Pain 2005;115(3):332-337. https://doi.org/10.1016/j.pain.2005.03.028
  23. Femiano F. Damage to taste system and oral pain : burning mouth syndrome. Minerva Stomatol 2004;53(9):471-8.
  24. Forssel H, Jaaskelainen S, Tenovuo O, Hinkka S. Sensory dysfunction in burning mouth syndrome. Pain 2002;99:41-47. https://doi.org/10.1016/S0304-3959(02)00052-0
  25. Svensson P, Bjerring P, Arendt-Nielsen L, Kaaber S. Sensory and pain thresholds to orofacial argon laser stimulation in patients with chronic burning mouth syndrome. Clin J Pain 1993;9(3):207-215. https://doi.org/10.1097/00002508-199309000-00009
  26. Gao S, Wang Y, Wang Z. Assessment of trigeminal somatosensory evoked potentials in burning mouth syndrome. Chin J Dent Res 2000;3(1):40-46.
  27. Jaaskelainen SK, Rinne JO, Forssell H et al. Role of the dopaminergic system in chronic pain - a fluorodopa-PET study. Pain 2001;90(3):257-260. https://doi.org/10.1016/S0304-3959(00)00409-7
  28. Femiano F, Scully C. Burning mouth syndrome(BMS) : double blind controlled study of alpha-lipoic acid(thioctic acid) therapy. J Oral Pathol Med 2002;31(5):267-269. https://doi.org/10.1034/j.1600-0714.2002.310503.x
  29. Llewellyn CD, Warnakulasuriya S. The impact of stomatological disease on oral health-related quality of life. Eur J Oral Sci 2003;111(4):297-304. https://doi.org/10.1034/j.1600-0722.2003.00057.x
  30. Trombelli L, Zangari F, Calura G. The psychological aspects of patients with the burning mouth syndrome. Minerva Stomatol 1994;43(5):215-221.
  31. Formaker BK, Frank ME. Taste function in patients with oral burning. Chem Senses 2000;25(5):575-581. https://doi.org/10.1093/chemse/25.5.575
  32. Albuquerque RJ, de Leeuw R, Carlson CR, Okeson JP, Miller CS, Andersen AH. Cerebral activation during thermal stimulation of patient who have burning mouth disorder : and MRI study. Pain 2006;122(3): 223-234. https://doi.org/10.1016/j.pain.2006.01.020