By definition,<unk>  has no signs. Sometimes affected persons will attribute the symptoms to sores in the<unk> , but these are in fact normal anatomic structures (e.g. lingual papillae, varices). Symptoms of<unk>  are variable, but the typical clinical picture is given below, considered according to the Socrates pain assessment method (see table). If clinical signs are visible, then another explanation for the<unk>  sensation may be present. Erythema (redness) and edema (swelling) of papillae on the tip of the tongue may be a sign that the tongue is being habitually pressed against the teeth. The number and size of filiform papillae may be reduced. If the tongue is very red and smooth, then there is likely a local or systemic cause (e.g. eythematous candidiasis, anemia). Parameter Usual findings in<unk> . Site Usually bilaterally located on the tongue or less commonly the palate, lips or lower alveolar mucosa Onset Pain is chronic, and rarely spontaneously remits Character<unk> , scalded or tingling. Sometimes the sensation is described as 'discomfort', 'tender', 'raw' and 'annoying' rather than pain or<unk> . Radiation Associations Possibly subjective xerostomia, dysgeusia (altered taste), thirst, headaches, chronic back pain, irritable bowel<unk> , dysmenorrhea, globus pharyngis, anxiety, decreased appetite, depression and personality disorders Time course Type 2 (most common) pain upon waking and throughout day, less commonly other patterns. Exacerbating/Relieving factors Possible exacerbating factors (make the pain worse) include tension, fatigue, speaking, and hot, acidic or spicy foods. Possible relieving factors include sleeping, cold, distraction, and alcohol. The pain is often relieved by eating and drinking (unlike pain caused by organic lesions or neuralgia) or when the person's attention is occupied. Temporary relief while eating is described as "almost pathognomonic" by the IASP. Pain is not often relieved by systemic analgesics, but can sometimes be relieved by topical anesthetics. Severity Moderate to severe, rated 5-8 out of 10, similar in intensity to toothache Effect on sleep May not disturb sleep, or may change sleep patterns, e.g. insomnia. Previous treatment Often multiple consultations and unsuccessful attempts at dental and/or medical treatment
Burning mouth syndrome
Oral allergy syndrome
Dermatophagia
Nonallergic rhinitis
Honeymoon rhinitis
Aerosinusitis
Rhinosinusitis
Adenoiditis