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Burning mouth syndrome

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Abstract

Bruning mouth syndrome is a burning sensation of one or several oral soft tissues with the tongue being affected the most, and may be associated with some other symptoms outside the oral structures. The oral symptoms may appear suddenly or gradually within a time course, may be persistent throughout the day or get more intense as the day progresses in a complaint-free patient in the morning. The syndrome affects mostly women and those over 50 years old, and usually caused by multiple factors. Local factors including allergy, high residual monomer level in dentures, trauma, fungal and bacterial infections; systemic factors including menopause, vitamin deficiency, iron deficiency, anemia, and xerostomia, finally psychogenic factors are thought to be responsible in the etiology of burning mouth syndrome. The treatment of burning mouth syndrome is complicated, related with the difficulty in isolating the causative factors. Thorough patient examination along with detailed anamnesis, some laboratory tests, and in some cases salivary analysis, radiographic examination and biopsy are mandatory for eliminating the causes and providing the relief of symptoms. Also, characterization of psychology disorders that are thought to have an impact on this syndrome is of utmost importance for a successful treatment. The etiology, clinical features and suggested treatment modalities of burning mouth syndrome are reviewed in this article.

Burning Mouth Syndrome (BMS)は1か所ないし数カ所の口腔粘膜に灼熱感をきたす症候群で,舌がもっとも侵されやすく, 口腔以外にも何らかの症状を呈することがある。口腔症状は突然出現することもあれば,一定の期間を経て段々強くなることもある。また,その症状は一日中続くものもあれば,午前中は無症状で午後になって次第に症状が強くなるものもある。患者は50才以上の女性に多く,その発生にはいろいろな因子が関与しているとされている。BMSの病因としては,アレルギー,義歯に残留する高濃度のモノマー,外傷,カビあるいは細菌感染などの局所的因子や閉経,ビタミン欠乏症,鉄欠乏症,貧血,口腔乾燥症,精神的要因などの全身的因子があげられている。BMSの治療は,その原因を特定出来にくいことから,難しいことが多い。既往歴,現病歴をよく聞き,必要に応じて臨床検査を行ない,症例によっては唾液検査,レントゲン検査,生検なども含めた十分な患者の診察が原因の鑑別と症状の緩解には欠かせない。また,治療を成功に持っていくためには,本症の発生に強く関与しているといわれている精神的要因を十分に分析,解明することがもっとも重要である。この論文はBMSの病因,臨床症状および治療法について綜説したものである。

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