Distinguishing patients with glossopyrosis from those with oropyrosis based upon clinical differences and differences in saliva and erythrocyte magnesium.

OBJECTIVE

Burning mouth syndrome (BMS) is a complex of clinical symptoms defined by burning sensations in the oral cavity without observed oral pathology. Clinically two patient groups within BMS were distinguished, one with burning limited to the anterior tongue (glossopyrosis) and the other with burning in multiple mouth regions, including tongue, lips, palate, gums and cheeks (oropyrosis). Biochemical differences between these two groups could assist in distinguishing them.

DESIGN

Eighty-three patients with BMS, 47 with oropyrosis and 31 with glossopyrosis were studied. Measurements of zinc, copper, magnesium and calcium in blood plasma, erythrocytes and parotid saliva were obtained in patients and in normal subjects and mean levels were compared.

RESULTS

Clinical history differentiated patients into categories of oropyrosis and glossopyrosis. Erythrocyte and saliva levels of magnesium were significantly lower in patients with glossopyrosis than in patients with oropyrosis or in normal volunteers whereas levels of zinc and calcium were similar.

CONCLUSIONS

These data suggest that patients with glossopyrosis not only differ clinically from those with oropyrosis but also exhibit magnesium deficiency as manifested by lower than normal magnesium levels in saliva and erythrocytes. Lingual burning in patients with glossopyrosis is consistent with hyperalgesia and neurogenic inflammation observed in patients and animals with magnesium deficiency and in magnesium deficient tissues. These results suggest a possible biochemical mechanism for pyrosis in patients with glossopyrosis.