Other Contributing Factor for BMS

Subclinical Candida infection has been suggested as one of the etiological factors in patients with BMS. In order to investigate the possible factors that contribute to the relatively high isolation rate of Candida in people with BMS, a study analyzing parotid saliva sam-ples from clients with this condition were collected, and the growth of Candida in each sample was observed.13 The results showed no significant growth disparity within the test and control saliva samples with Candida albicans and Candida tropicalis. However, a single isolate of Candida glabrata tende to grow better in the saliva from BMS patients than in saliva from the controls. The results indicate that the composition of saliva may be a contributing factor for the high isolation rate of Candida in saliva of patients with BMS.12

Salivary gland hypofunction (xerostomia), caused by salivary gland disease, medication, or radiation, may predispose a person for secondary oral mucosal diseases, and has been thought to be a cause of BMS.12 In clients with salivary hypofunction the protective coating of saliva is reduced or absent, leaving the oral mucosa more vulnerable to opportunistic infections. Candidiasis, BMS, and white lesions of the oral mucosa increase in frequency in these clients.13 However, if treating the underlying causes of pain alleviates the burning mouth symptoms, it is not classified as true BMS. The goal of management in clients with xerostomia is to prevent oral pathological changes. Dental hygiene interventions will be reviewed in the treatment section.

Clients may be misdiagnosed with BMS when other conditions actually exist. There is a report of a female denture wearer who presented with burning of the lips and tongue, with no visible oral lesions. She appeared to be suffering from BMS. Her biochemical data, complete blood cell count, sedimentation rate, thyroid, and sex hormones were assessed as normal, and a tongue culture produced negative results. Patch tests were then performed with a panel of 20 potential denture allergens and yielded positive results only to a 2% petrolatum cadmium sulfate that was present in the denture material. Removal of the denture led to resolution of her oral symptoms in three days. The study by Purello-D’Ambrosio highlights the need for careful diagnosis and for performing tests for the possible allergens present in denture materials.14 In this case, what appeared to be BMS was identified as a metal allergy after differential diagnosis, and a new denture was indicated.