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PubMed1978

[Psychological aspects of glossodynia (author's transl)].

The term glossodynia refers to all conditions with pain and dysaesthesia of the tongue and entire oral mucosa manifesting themselves in burning, prickling, itching, stinging, and other frequently bizarre sensations as well as subjective xerostomia and bad taste. In most cases psychiatric diseases are the cause of the complex of complaints whereas local and general disorders are of only minor importance. Menopausal women with atypical depression are most often affected. Schizophrenia and abnormal personality development are far less frequent in glossodynia. After exclusion or therapy of organic disorders antidepressants are the treatment of choice in glossodynia. Thereapeutic difficulties may arise in patients suffering from marked xerostomia whose complaints may intensify during therapy because of the anticholinergic effect of most antidepressants, and in neurotic persons.

Adult↗
PubMedDate not supplied

[Are patients with glossodynia unremarkable? A hard-to-grasp psychodiagnostic disease].

INTRODUCTION: Idiopathic glossodynia is generally considered a disease with profound psychical involvement. Nevertheless, psychodiagnostic studies on this disease have been rare. The patients usually have low emotional self-reference, are focused on their physical complaints and refuse a psychosomatic attribute. Therefore, the doctor-patient relationship is often complicated, which impedes the initiation of an adequate therapy. PATIENTS AND METHODS: Seventeen patients diagnosed to have glossodynia or orofascial pain syndrome were examined within the psychosomatic consultation-liaison service of two dermatological hospitals. The Coping with Skin Disease Questionnaire (CSD) and the Symptom Check List (SCL-90R) were used as test inventory. Patients with glossodynia were compared with other dermatological patients in the consultation-liaison service (n = 356) and with the standard random sample of the SCL-90R. RESULTS: By comparing the test inventories it was found that glossodynia patients appeared particularly "inconspicious" on nearly all dimensions. Compared with the standard random sample of the SCL-90R (n = 1006) higher values were only observed for the scores "somatization" and "anxiety". CONCLUSION: Based on the two psychological test inventories, no indication of depression was found, which is often suspected in glossodynia patients. It appears that psychosomatic (accompanying) symptoms in these individuals are not sufficiently assessed by many psychological test instruments.

Adaptation, Psychological↗
PubMed2004

[Glossopyrosis--diagnosis and therapy].

Glossopyrosis (Glossodynie, Burning mouth syndrome) is not a independent diagnosis it is only a symptom of a lot clinical pictures. Local diseases like glossitis, allergies and tumors of the tongue are best known from ENT-doctors. But there are also gastrointestinal, immunologic, neurologic, psychiatric and dermatologic diseases cause glossopyrosis. Glossopyrosis may be the first symptom of HIV infection, Diabetes or a depression long before manifestation of the full clinical picture. Also dental materials and drugs are iatrogenic factors for glossopyrosis. The multifarious differential diagnosis were described and discussed.

Comorbidity↗
PubMed1996

The dynias.

The "dynias" are a group of chronic, focal pain syndromes with a predilection for the orocervical and urogenital regions. They include glossodynia, carotidynia, vulvodynia, orchidynia, prostatodynia, coccygodynia, and proctodynia. In some cases, the dynias occur secondarily, but more often, despite an exhaustive evaluation, no etiology is found and in these remaining cases, the cause of the pain remains enigmatic. The controversy that surrounds this group of disorders, which ranges from questioning their existence to suggesting that they are purely psychosomatic, is counterbalanced by an extensive literature attesting to their organicity. The approach to the patient begins with acknowledging that the symptom is well described, searching for a secondary cause, and performing a careful psychologic assessment. Treatment is empirical and patients can often be helped with medications used to treat neuropathic pain, all the while providing psychologic support and exercising caution toward invasive and irreversible therapeutic procedures.

Adult↗
PubMed2002

Incidence and treatment of dysgeusia in patients with glossodynia.

In 96 patients who visited our hospital with glossodynia, we conducted gustatory tests, measured serum zinc and copper levels, examined lingual papillae using biomicroscopy, conducted psychological tests and investigated the effectiveness of treatments directed at the cause of dysgeusia. Gustatory test results showed that 43 (44.8%) of the patients had dysgeusia, which was mild in 62.8%, moderate in 30.2% and severe in 7.0%. By giving higher priority to treatment of dysgeusia than to glossodynia, pain disappeared or was relieved and gustatory sensation improved in 27 (62.8%) of these 43 patients. Overall, pain disappeared or was improved in 65 (67.7%) cases. When treating glossodynia, it is important to diagnose the cause of pain and to give higher priority to treating that cause. The clinical efficacy of treatment for glossodynia will be improved when the presence or absence of dysgeusia is diagnosed early in the course of treatment.

Adult↗
PubMed2000

Candidiasis may induce glossodynia without objective manifestation.

BACKGROUND: The causes of glossodynia in the absence of objective abnormalities range widely and differential diagnosis of glossodynia is very difficult. METHODS: Based on the examination results of peripheral blood, stimulated and nonstimulated salivary flow rate (SFR), glossal pain threshold, and C. albicans cell culture and the response to treatment, we identified the cause of vague pain of the tongue in 98 patients who lacked objective findings and identified candidiasis as the cause of glossodynia in 26 patients. RESULTS: These patients revealed hyposalivation and decreased glossal pain thresholds and C. albicans cell overgrowth. Pain thresholds in the painful portion (54.6+/-2.9 degrees C) were significantly decreased compared with those in the painless portion (57.7+/-3.4 degrees C) (P < 0.05) and the pain thresholds were largely increased after treatment (57.2+/-1.6 degrees C). Nonstimulated SFR before treatment was lower than that of age- and gender-matched healthy people, although stimulated SFR was decreased only slightly. C. albicans cell overgrowth was detected by the number of C. albicans colonies that formed in Sabouraud's agar plate (539.3+/-198.4/dish). After the subsidence of glossal pain by mouth washing with a 3% amphotericin B solution, the C. albicans colonies were decreased to 31.5+/-19.3/dish, which was almost same as the control level, 14.1+/-8.4/dish. CONCLUSION: These results indicate that candidiasis in conjunction with hyposalivation may induce pain in the tongue without manifestation of objective abnormalities.

Adult↗
PubMedDate not supplied

Detection of psychopathologic trends in glossodynia patients.

Glossodynia affects primarily middle-aged women. Although many possible etiologies have been proposed for the syndrome, most have not been substantiated. In the present study 56 glossodynia patients were evaluated for their psychopathologic profile as reflected by the SCL-90 questionnaire. The data show that glossodynia patients present a relatively high psychopathologic profile, especially on the scales of somatization and depression. Significant correlations were found between the intensity of pain experienced by the patients and some of the SCL-90 scales (somatization, depression, anxiety, GSI and PSDI). No correlations were found between SCL-90 scores and duration of symptoms, prevalence of symptoms per day and patient's condition during the past year. Patients living alone were found to differ significantly from those living with a significant other (overall group effect significant at the 0.01 level). The data suggest that psychopathologic trends may be associated with glossodynia.

Aged↗
PubMed1990

Clinical oral test for the assessment of oral symptoms of glossodynia and glossopyrosis.

Subjective oral symptoms of a burning sensation and pain in the tongue may exist in the absence of any pathological changes in the oral mucosa. Owing to different treatment approaches and the lack of any specific therapy, it appeared potentially useful to identify these subjective symptoms by means of a test for an improved therapy evaluation. In this study, we have attempted to develop a method for the objective assessment of oral symptoms of glossodynia and glossopyrosis, by recording the local temperature. The temperature of the tongue was determined using a DT-1 electron thermoesthesiometer, that was highly sensitive to temperatures between 36 degrees C and 38 degrees C. Measurements were performed in topographic areas recommended by the World Health Organization in 1980. The study sample consisted of a group of 50 patients with glossopyrosis and glossodynia, without any clinically manifest pathological changes in the oral cavity, who were compared with a group of 50 age- and sex-matched subjects free of these oral symptoms and with normal oral mucosa. Statistically significant temperature differences were observed between the patients and the controls, as measured in seven different areas. The lowest temperatures (33 degrees C) were measured in the apex linguae area. The minimum temperature was significantly lower in the study group. Significant differences in temperature were also observed between the sexes. It was concluded that glossodynia and glossopyrosis, both inflammation and diminished circulation without any visible clinical signs, can be diagnosed using the thermoesthesiometry test. Such an objective test allows appropriate therapeutic treatment to be selected for patients with the above-mentioned symptoms.

Age Factors↗
PubMed1992

Long-term follow-up of patients with orofacial discomfort complaints.

To a group of 113 patients who exhibited wide variation in orofacial and general complaints, which they related to the effects of dental material, a new questionnaire was sent 8-10 years after the first examination. Eight patients had died, and 23 individuals could not be contacted. Of the remaining 82 patients, 62 (76%) individuals completed the questionnaire. Almost two-thirds (29%) of the responding patients reported that they were now free from the previous symptoms, or that these symptoms were alleviated (35%). Dryness of the mouth and smarting tongue were the most frequent symptoms at the follow-up. Half of the patients (52%) thought they still needed treatment for their complaints, and several of them had visited many other therapists after the end of the treatment period at the Department. The treatment outcome and symptom development may be regarded as acceptable with regard to the severity and long duration of the original complaints. However, the prognosis was poor in a substantial proportion of the patients, and this group continued to be a high consumer of health-care resources.

Burning Mouth Syndrome↗
PubMed1993

Subjective reports of oral dryness in an older adult population.

In this study of an older adult population almost one-fifth reported oral dryness. It was the most common of 22 oral symptoms and complaints. In a logistic regression analysis of predictors of oral dryness three variables had significant independent effects: income, taking prescribed medications and experiencing a stressful life change within the previous 6 months. Subjects with oral dryness had more decayed crown surfaces than those without but there was no association with decayed root surfaces. Nor were there any significant associations between reports of oral dryness and a number of indicators of periodontal health. Those with dryness were more likely to report other oral symptoms such as unpleasant taste, a burning sensation in the tongue and other parts of the mouth and pain from dentures. They were also more likely to report problems chewing food, problems with eating and communication and were more likely to be dissatisfied with their oral health. Given its prevalence and effects, oral dryness constitutes an important health issue among older adults.

Aged↗
PubMed1995

Oral signs and symptoms in patients with undiagnosed vitamin B12 deficiency.

The oral manifestations of glossitis, stomatitis and mucosal ulceration in vitamin B12 deficiency have long been recognised. These oral changes may occur in the absence of symptomatic anaemia or of macrocytosis. The aim of this paper is to describe a retrospective study of the wide range of oral signs and symptoms reported by 14 patients found to have a previously undiagnosed vitamin B12 deficiency. None of the patients described in this study had generalised symptoms sufficiently advanced to arouse suspicions of vitamin B12 deficiency. The essential criteria for the diagnosis of pernicious anaemia are also discussed.

Anemia↗
PubMed1999

Defensin-1, an antimicrobial peptide present in the saliva of patients with oral diseases.

OBJECTIVES AND DESIGN: A preceding paper has noted a detection of defensin-1 (HNP-1), a peptide with antimicrobial and cytotoxic properties, in the saliva of patients with oral squamous cell carcinoma. The present study deals with the presence of HNP-1 in the saliva of patients with various oral diseases. METHODS: Whole saliva samples were obtained from the patients. HNP-1 in the saliva was isolated and purified by HPLC and the amino acid sequence of the peptide was determined. The molecular weight of HNP-1 was measured by mass spectrometry. The concentration of HNP-1 in saliva was determined by comparing the height of eluted HNP-1 with that of a synthetic HNP-1 standard. RESULTS: The concentrations of HNP-1 in the saliva of patients with oral lichen planus (n = 5), leukoplakia (n = 4), and glossitis associated with iron deficiency (n = 4) were 8.3 +/- 4.3 micrograms ml-1, 13.2 +/- 7.9 micrograms ml-1, and 11.4 +/- 4.9 micrograms ml-1, (mean +/- s.d.), respectively. These concentrations were significantly higher than those in healthy subjects (0.8 microgram ml-1) (P < 0.01). In contrast, salivary HNP-1 concentrations in patients with glossodynia (n = 4) and oral discomfort (n = 4) were similar to those in healthy subjects. CONCLUSIONS: Since HNP-1 is a non-specific defensive peptide present in neutrophils, it may play an important role in the protection against diseases such as oral lichen planus, leukoplakia, and glossitis associated with iron deficiency.

Adult↗
PubMed2004

Effects of near-infrared irradiation to stellate ganglion in glossodynia.

OBJECTIVE: This study was designed to assess the effect of stellate ganglion near-infrared irradiation (SGR) on glossodynia and the mechanism of action. STUDY DESIGN: Thirty-seven patients with glossodynia received SGR once weekly for 4 weeks. The response to treatment was evaluated on the basis of the change in pain intensity, assessed with a visual analogue scale (VAS) before and after 4 weeks of treatment. The temperature and blood flow of the tongue were also measured before and after first SGR. As control, eight healthy subjects were studied. RESULTS: Tongue pain as assessed by the VAS decreased in 28 of the 37 patients (75.7%). Mean pain intensity decreased significantly from 5.1 +/- 2.2 to 1.9 +/- 2.1 (P < 0.05). Tongue blood flow at rest in the patients with glossodynia [7.2 +/- 1.6 ml min(-1) (100 g)(-1)] was significantly lower than that in the healthy subjects [7.8 +/- 0.23 ml min(-1) (100 g)(-1)]. Five minutes after SGR, the temperature of the tongue rose 1.5 +/- 0.21 degrees C, and blood flow increased to 8.5 +/- 1.2 ml min(-1) (100 g)(-1). Tongue blood flow (at rest) after 4 weeks of SGR had increased to 7.7 +/- 1.1 ml min(-1) (100 g)(-1). CONCLUSION: SGR is an effective treatment for glossodynia. The mechanism by which SGR improves symptoms associated with glossodynia is thought to be as follows: SGR inhibits abnormally increased sympathetic activity associated with glossodynia. This is followed by normalization of decreased tongue blood flow, thereby alleviating pain.

Aged↗
PubMed1996

Glossodynia: personality characteristics and psychopathology.

BACKGROUND: Glossodynia or burning mouth syndrome has been suggested to be a multifunctional disorder. Etiologic factors that have been reported include hematologic or vitamin deficiencies, denture factors, the climacteric, infections or endocrinological disorders. On the other hand psychological factors, such as anxiety, depression and phobias have been reported to play a significant role at the beginning of this nosological entity. It seems therefore that there are two main categories of glossodynia, one with a detectable organic etiology and another with a psychologic origin. The purpose of this study was to provide further information concerning the personality characteristics and the incidence of psychopathology in patients suffering from glossodynia without an organic etiology. METHODS: Twenty-five patients suffering from glossodynia and 25 control subjects, matched for sex and age, participated in the study. Patients and controls were assessed concerning their psychosomatic morbidity. Both groups were given psychometric instruments (SRSD, STAI, EPQ, HDHQ, SSPS) for the assessment of personality characteristics and psychopathological symptoms. RESULTS: Patients were significantly differentiated from controls with respect to all factors of HDHQ; they exhibited more hostility, either introverted or extroverted, than control subjects. The patients also had significantly higher values in the N (neuroticism) and the L (lie) factors of the EPQ. Concerning the other psychometric measurements there were no significant differences. Patients also had significantly higher rates of psychosomatic morbidity than controls. CONCLUSIONS: Our findings indicate that hostility-especially introverted hostility-neuroticism and possibly depression are important components of the psychological profile of patients suffering from glossodynia.

Adult↗