Burning Mouth Syndrome: Medical History

Medical history (history of illness) represents an important component in the diagnosis of burning mouth syndrome. Family history

Social history

• Is there any evidence of psychosocial stress or strain due to your family situation?

Current medical history/systemic history (somatic and psychological complaints).

• What symptoms (e.g., burning tongue (glossodynia) have you noticed?
• How long have these symptoms existed?
• In addition to burning tongue, have you noticed after other complaints, such as itching, tingling or stabbing pain on the tongue, dry mouth, disturbances in the sense of taste, white coating, etc.?

Vegetative anamnesis including nutritional anamnesis.

• If you wear dentures, do they fit well? Do you tolerate the denture material well?
• Have you noticed tongue habit, i.e., habits in which the tongue abuts the anterior teeth?
• Has there been any change in your appetite?
• Do you smoke? If so, how many cigarettes, cigars, or pipes per day?
• Do you drink alcohol? If yes, what drink(s) and how many glasses per day?
• Do you use drugs? If yes, what drugs and how often per day or per week?

Self history including medication history.

• Pre-existing conditions (allergies, metabolic diseases (eg diabetes mellitus), skin diseases (eg fungal infections – also elsewhere: eg vaginal fungus, athlete’s foot, etc.), food intolerances).
• Dental status including tongue habit
  • Electrogalvanic voltage differences of dental fillings (amalgam, dentures, plastics).
  • Poorly fitting / unmaintained dentures.
  • Incompatibility of the denture material
  • Tongue habit, unspecified (see below vegetative history).
• Operations
• Allergies
• Menopause? (onset of menopause)
• Radiation therapy to the head?

Medication history

Medications that may lead to xerostomia (dry mouth).

• ACE inhibitors (benazepril, captopril, cilazapril, enalapril, fosinopril, imidapril, lisinopril, moexipril, perindopril, quinapril, ramipril, spirapril, trandolapril, zofenopril).
• Alpha-2 agonists (apraclonidine, brimonidine, clonidine).
• Alpha-1 receptor blockers (bunazosin, doxazosin, prazosin, terazosin).
• Anorectic (sibutramine).
• Anti-allergic (H1 antihistamines)
• Anticholinergics (ipratropium bromide) [via peripheral receptor blockade]; aclidinium, biperiden, darifenacin, glycopyrronium, metixene, methanthelinium bromide, oxybutynin, phenoxybenzamine, propiverine, scopolamine, solifenacin, tiotropium, tolterodine, trihexyphenidyl, trospium chloride, umeclidinium
  • Methanthelinium bromide
  • See also under “Anticholinergic effects due to drugs” if applicable.
• Antidepressants [via central receptor blockade].
  • Noradrenergic and specific serotonergic antidepressants (NaSSA) – mirtazapine.
  • Selective norepinephrine reuptake inhibitors (NARI) – reboxetine, viloxazine.
  • Selective serotonin–norepinephrine reuptake inhibitors (SSNRI) – duloxetine, venlafaxine.
  • Selective serotonin reuptake inhibitors (SSRI) – trazodone
  • Tricyclic antidepressants (TCAs) – amitriptyline, butriptyline, cianopramine, clomipramine, desipramine, doxepin, imipramine, iprindole, melitrace, nortriptyline, opipramol, protriptyline, trimipramine).
• Antiemetics (dimenhydrinate, scopolamine).
• Antiepileptic drugs (gabapentin)
• Antihistamines (clemastine, dimetindene, ketotifen).
• Antiparkinsonian drugs
  • Anticholinergics (belladonna whole extract, benzatropine, biperiden, bornaprin, metixen, pridinol, procyclidine, scopolamine, trihexyphenidyl).
  • Dopaminergic substances (amantadine, apomorphine, bromocriptine, cabergoline, alpha-dihydroergocryptine, levodopa, lisuride, memantine, pergolide, pramipexole, ropinirole).
• Antipsychotics (neuroleptics).
  • Conventional (Classical) antipsychotics (neuroleptics).
    • Phenothiazine-type drugs (levomepromazine, triflupromazine).
• Antisympathotonics (α-methyldopa).
• Anxiolytics (azapirone, hydroxyzine).
• SS-3-mimetic (mirabegron)
• Beta-blocker (metoprolol)
• Bronchodilators (β2-mimetics) – salbutamol, terbutaline).
• Carboanhydrase inhibitors, local (brinzolamide, dorzolamide).
• Diuretics
  • Loop diuretics (azosemide, bumetanide, etacrynic acid, etozolin, furosemide, piretanide, torasemide).
  • Thiazide diuretics (benzthiazide, chlorothiazide, hydrochlorothiazide (HCT), hydroflumethiazide, methyclothiazide, polythiazide, trichloromethiazide).
• Dopamine agonists (bromocriptine, cabergoline, lisuride).
• Dopamine antagonists (butyrophenones: haloperidol).
• Drugs (amphetamines, tetrahydrocannabinol).
• Hypnotics
• Magnesium sulfate
• Narcotics, centrally acting analgesics.
• Opioid antagonists (nalmefene, naltrexone).
• Parasympatholytics (atropine).
• Perchlorates (perchlorate)
• Psychotropic substances such as modafinil
• Sedatives
• Spasmolytics (butylscopolamine)
• Sympathomimetics
  • Indirect sympathomimetics (amphetamines).
• Cytostatics

Drugs that can cause burning of the mouth

• Mouthwashes
• Reserpine

Drugs that can lead to mycosis of the oral cavity

• Antibiotics
• Asthma sprays containing cortisone