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Burning Mouth Syndrome (BMS) is poorly known to health professionals, with a prevalence in the general population of between 0.1% and 16.9%. It leads to medical wandering of patients and delayed diagnosis. This problem, combined with the lack of literature on the subject, leads to increased patient suffering. Between 11 February 2019 and 28 February 2020, we conducted a monocentric retrospective clinical study within the Medical Activity Unit of mucous membrane pathologies and chronic orofacial pain at Bordeaux University Hospital. 100 patients with BMS were included in the study. Analysis of the results showed an average wait of 25.3 months before diagnosis, a significant number of false diagnoses as well as the implementation of unsuitable treatments and complementary examinations. The vagrancy of which patients are victims leads to moral and financial damage. Our work has the longer-term aim of raising awareness among ENT practitioners and general practitioners and optimising the care of patients with BMS in order to reduce the waiting time before their diagnosis., La stomatodynie primaire est un syndrome peu connu des professionnels de santé, dont la prévalence au sein de la population générale se situe entre 0,1% et 16,9%. Cela entraine une errance médicale des patients et un retard diagnostic. Cette problématique associée au manque de littérature sur le sujet crée un allongement de la souffrance des patients. Entre le 11 février 2019 et le 28 février 2020, nous avons mené une étude clinique rétrospective monocentrique au sein de l’Unité d’Activité Médicale de pathologies des muqueuses et douleurs orofaciales chroniques du CHU de Bordeaux. 100 patients atteints de stomatodynie primaire ont été inclus dans l’étude. L’analyse des résultats a permis de démontrer une attente moyenne de 25,3 mois avant le diagnostic, un nombre conséquent de faux diagnostics ainsi que la mise en place de traitements et d’examens complémentaires inadaptés. L’errance dont les patients sont victimes mène à des préjudices moraux et financiers. Notre travail a pour but à plus long terme de sensibiliser les praticiens de la sphère ORL et les médecins généralistes ainsi que d’optimiser la prise en charge des patients atteints de stomatodynie primaire afin de réduire le temps d’attente avant leur diagnostic.

Les stomatodynies sont des douleurs chroniques donnant des sensations de brûlures des muqueuses buccales sans lésion biologique/ clinique ou radiologique. Elles concernent majoritairement les femmes ménopausées. Ces douleurs sont sous-tendues par un mécanisme neuropathique, non élucidé encore, altérant les fonctions sensorielles centrales et/ ou périphériques. Afin de soulager les patients, de nombreuses thérapeutiques sont tentées (antidépresseurs tricycliques, gabapentinoïdes, dérivés morphiniques, anesthésiques locaux) mais les résultats sont souvent décevants et les rémissions rares. Motivé par le cas d’une patiente stomatodynique chez qui l’inhalation de cannabis a provoqué la disparition des symptômes douloureux, nous décrivons, dans ce travail, les mécanismes d’action des cannabinoïdes. En se liant, notamment, aux récepteurs cannabinoïdes CB1 et CB2 mais aussi au récepteur vanilloïde TRPV1, les cannabinoïdes et les endocannabinoïdes (produits par notre organisme) sont capables d’atténuer l’hyperalgésie et l’allodynie thermiques dans le cadre de douleurs chroniques orofaciales. Ces résultats constituent un espoir thérapeutique pour les patients atteints de stomatodynie chez qui une altération du système endocannabinoïde est observée. Ainsi, l’augmentation des taux d’endocannabinoïdes ou l’administration des cannabinoïdes exogènes font partie des pistes thérapeutiques potentielles.

Medically unexplained oral paresthesia, or burning mouth syndrome, is a condition that primarily affects female patients, and often leads them to consult their dentist, who may feel helpless concerning the repeated complaints of these patients. Therefore, they tend to increase visits to various health professionals in an attempt to find a relief. Since 1996, a joint stomato-psychological consultation has been established in Geneva University Hospitals, in order to offer adequate care to these patients. This article describes this type of treatment, and the referral issues.

Among the degenerative diseases of the nervous system, Lewy body disease has the most psychiatric symptoms especially hallucinations, delusion and identification disorders.We report a case of Lewy body disease that started with a burning mouth syndrome for three year as the only symptom before the development of a pseudo-psychiatric syndrome (melancholy and Capgras). None of the usual cardinal criteria were present. MRI, cerebrospinal fluid, and DAT scan findings enabled the diagnosis.The dopaminergic hypothesis put forward in some cases of burning mouth syndrome might explain this symptom in Lewy body disease.

By definition, stomatodynia or burning-mouth syndrome involves oral pain with no causes being found on history taking or examination. An allergic origin is often suspected by doctors and patients alike. In this study, we attempted to assess the value of epicutaneous tests in demonstrating allergic causes for patients presenting stomatodynia.This was a single-centre retrospective study of patients undergoing epicutaneous tests between 1996 and 2003 to screen for allergic causes of mouth pain not accounted for by any abnormalities seen during examination performed at consultations for mouth disease.Forty patients were included (11 male, 29 female; mean age: 58 years), and 39 were excluded. Sixteen patients presented at least one positive test, with a total of 35 positive tests in all. In decreasing order of frequency, the causes were metals, mercury derivatives (nickel salts: n=5; chrome salts: n=3; palladium salts: n=2; phenylmercuric acetate: n=2; thiomersal: n=2; cobalt salts: n=1; gold salts: n=1; mercury: n=1) and resins (acrylates: n=4). The relevance of these test results was considered probable in three cases and possible in five cases, associated with the existence of metals or resins in patients' mouths. The Peru balm test was positive in four cases but was not relevant. Tests for personal products were negative in all cases, with the exception of one case of resin from a prosthesis and one case of tixocortol pivalate.Type I stomatodynia (daily occurrence with gradually increase in discomfort throughout the day) and type II stomatodynia (permanent) are not normally attributable to allergies. However, for type III stomatodynia (non-permanent, with acute episodes followed by remission), an allergy survey guided by questioning may be undertaken to determine the cause, primarily prostheses or diet. The relevance of positive test results must be interpreted with caution in view of the incidence of positive epicutaneous tests for metals and Peru balm among the general population studied.

The aim of this study is to present a new approach of burning mouth syndrome treatment by cognitive and behavioral therapy.Cognitive and behavioral therapy in a patient with severe and resistant burning mouth syndrome.Disappearing of the oral pain of the burning mouth syndrome.After a review of the literature, we propose the treatment of burning mouth syndrome by cognitive and behavioral therapy.

Burning mouth is a symptom typical for the oral mucosa. In contrast, pruritus is absent at this site. The situation which is the reverse on the skin can be explained by microanatomical differences in the sensorial innervation and by a different balance between neuromediators. Burning mouth sensation calls for the search of a series of diseases. However, it is most often a monosymptomatic expression of a minimal lichenoid stomatitis.

1. Analytical approaches to Burning Mouth Syndrome permit the suggestion that it is a symptom of hidden depression, where the depressive process and its two major indicators (vital sadness and psycho-motor slowing down) are totally or partially concealed by a somatic symptomatology which can strike down any system: vaso-vegetative, cardio-vascular, gastro-intestinal, genito-urinary, muscles and skeleton. 2. Depression is a mental process, part of normal psychic development, which must be overcome at least once in a lifetime in order to reach the status of an autonomous being. Hidden depression is one form of pathological depression, which expresses an inability to (i) mentalize depression, separation, and (ii) become an autonomous being. 3. Burning mouth is a symptom resulting from complex dynamics, from hysterical conversion to the inability to mentalize separation, both with underlying fault in the "narcissistic nucleus" (a term meaning the sense of identity originating in the motherly holding, in the skin to skin touch). 4. Treatment will be a combination of anti-depressive drugs and psychotherapy, drugs being prescribed by the practitioner, and psychotherapy conducted by a therapist with an analytical background.

Stomatodynia is pain localised to the buccal cavity which cannot be explained on an organic basis and where the etiological diagnosis is depression. The particular way in which the patient describes his pain may suggest the diagnosis. Treatment involves prescription of anti-depressants.