Oral burning: local and systemic connection for a patient-centric approach

Abstract

Burning symptoms in the oral cavity are caused by a range of systemic and local factors, in addition to the neuropathic pain disorder burning mouth syndrome (BMS). Patients may state oral burning as a standalone symptom or may report as a secondary symptom in association with other factors, most commonly with oral dryness, oral mucosal lesions, or certain systemic conditions. There is a level of uncertainty in the presentation of this condition which creates a diagnostic challenge from both the patient's perspective and the practitioner evaluating these individuals. The diagnoses are complicated due to the lack of a clear definition of BMS and clinical guidelines to distinguish BMS from other conditions that are responsible for oral burning symptoms. A clinician should be able to differentiate oral burning from burning mouth syndrome. This integrative review discusses on local and systemic etiologies of oral burning based on current evidence that needs to be excluded for a diagnosis of BMS. It also provides an algorithm for diagnostic workup and therapeutic management to medical providers for patients experiencing oral burning symptoms. This comprehensive system provides a systematic stepwise workup in diagnosing and managing patients presenting with a complaint of oral burning that optimally meets a predictive, preventive, and personalized medicine (PPPM) approach.

Periodontal health related–inflammatory and metabolic profiles of patients with end-stage renal disease: potential strategy for predictive, preventive, and personalized medicine

“…ESRD patients are more susceptible to periodontal disease due to general debilitation and depression of the immunological system. The altered saliva composition and persistent low-grade inflammation in patients with CKD also mechanistically influence the onset and/or progression of periodontal disease [ 8 , 9 ]. In the progression of CKD, more cytokines were secreted by inflammatory cells to the inflammation sites, which aggravates the periodontal disease [ 10 , 11 ].…”

Undetected Jawbone Marrow Defects as Inflammatory and Degenerative Signaling Pathways: Chemokine RANTES/CCL5 as a Possible Link Between the Jawbone and Systemic Interactions?

“…Our earlier investigations showed that R/C expression is highly appropriate as an index of chronic inflammation when investigating the jawbone. 6 , 7 , 12 , 17 As an example, we compared a group of 21 patients with chronic fatigue syndrome (CFS) to explore their inflammatory profile, 20 as well as a group of 48 tumor cases to identify the extent of BMDJ. 19 The tumor cases were divided as follows: 62% breast cancer, 15% ovarian cancer, 13% prostate cancer, and 10% melanoma.…”

“…In the last few years, osteopathias of the jawbone are subject to different definitions and classifications. Concerning the conspicuous morphology of BMDJ we proposed the term “fatty–degenerative osteonecrosis/osteolysis of jawbone” (FDOJ) for this cavitational osteonecrosis, 6 , 7 , 17–20 reflecting the clinical state of focal bone marrow defects ( Figure 3 ). A total of 301 samples of fatty-degenerative osteonecrosis of the jawbone (FDOJ), as determined by the morphological analysis of the intraoperatively exposed bone marrow defects (BMDJ) ( Figure 3 ), were examined.…”

“…In the search for potential cytokine mechanisms and chronic inflammatory connections between so-called “bone marrow defects” in the jawbone and other organs, we were able to determine the local overexpression of the chemokine RANTES/CCL5 (R/C) in old wound areas of the jawbone. 6 , 7 An alternate consideration for R/C expression is indicated, as each cytokine binds to a specific receptor and triggers an intracellular cascade. What, then, explains the many and varied properties of a single cytokine?…”

Intestinal alkaline phosphatase modulation by food components: predictive, preventive, and personalized strategies for novel treatment options in chronic kidney disease

“…Suboptimal health conditions reduce the quality of life, can cause and contribute to several diseases, and inflammatory processes [18][19][20]. iALP can be extremely useful as an indicator for an in-depth diagnosis of coexisting and healththreatening conditions.…”