Pathophysiology of primary burning mouth syndrome with special focus on taste dysfunction: a review

Abstract

Primary burning mouth syndrome (BMS) is a chronic oral condition characterized by burning pain often accompanied with taste dysfunction and xerostomia. The most compelling evidence concerning BMS pathophysiology comes from studies on the somatosensory system using neurophysiologic or psychophysical methods such as blink reflex, thermal quantitative sensory testing, as well as functional brain imaging. They have provided convincing evidence for neuropathic involvement at several levels of the somatosensory system in BMS pain pathophysiology. The number of taste function studies trying to substantiate the subjective taste disturbances or studies on salivary factors in BMS is much more limited, and most of them suffer from definitional and methodological problems. This review aims to critically evaluate the existing literature on the pathophysiology of BMS, paying special attention to the correctness of case selection and the methodology used in published studies, and to summarize the current state of knowledge. Based on the recognition of several gaps in the current understanding of the pathophysiology of BMS especially as regards taste and pain system interactions, the review ends with future scenarios for research in this area.

Taste function assessed by electrogustometry in burning mouth syndrome: a case–control study

“…Although the multifactorial aspect of iBMS is supported by studies on psychogenic, gustatory, salivary, hormonal, autonomic and neuropathic features (Jääskeläinen, ), gustatory/nociceptive interactions need to be considered (Kolkka‐Palomaa et al , ). Pain sensation may be modulated by food intake as more than 50% of iBMS patients report a relief in iBMS symptoms when eating meals or cold foods, whereas 38% of iBMS patients feel increased pain with hot foods (Grushka, ).…”

Role of vitamin B6 in idiopathic burning mouth syndrome: some clinical observations

“…As PLP is an efficient blocker of the P2X ATP receptors [25], changes in vitB6 levels might impact nociceptive processing. How elevated vitB6 can translate to pain sensation is difficult to determine, but it should be kept in mind that inhibitory inputs can lead to increases in pain sensations [7,26]. It should also be mentioned that, besides their role in pain transmission, ATP receptors are present on taste bud cells and play a role in the genesis of taste messages [27], alterations of vitB6 levels may then participate in dysgeusia, often accompanying iBMS.…”

“…Some histological, psychophysical, pharmacological, electrophysiological, and imaging data suggest neuropathic mechanisms, including both peripheral and central changes and autonomic system alterations. The main clinical characteristics [1,2], pathophysiological mechanisms [4][5][6][7] and therapeutic options [8] of BMS have been reviewed [7].…”

Burning Mouth Syndrome –Latest update

“…1). Therefore, it has been alleged that taste could be affected by BMS, in conjunction with the activation of the chronic trigeminal neuralgia pathway 11,12,14,24,[27][28][29][30][31] . BMS may be caused by the hyperactivity of somatosensory fibers of the trigeminal nerve, followed by the loss of central inhibition due to the damage to the sensory of the chorda tympani nerve or of the glossopharyngeal nerve.…”

“…It has been argued that future research on BMS should include clinical trials that look into pain, taste dysfunction, and xerostomia as well as psychological evaluations to assess the effect of the disease on quality of life 30 .…”