Burning Mouth Syndrome

To the Editor.— In regard to Dr Grushka's letter (1983;249:1151), she makes a suggestive argument for the presence of collagen vascular disease in about 50% of patients with the "burning mouth syndrome." A more comprehensive patient history is needed to help substantiate her claims: how many patients have signs or symptoms of arthritis, serositis, nephritis, cutaneous involvement, Raynaud's phenomenon, and muscle or CNS disorders? More specifically, with a female-to-male ratio of 2.4:1, all patients having intraoral burning, and 44% of patients having dry mouth, we would like to know what percentage of the patients had dry eyes, dry skin, and parotid enlargement. Sjogren's syndrome is the second most common of the autoimmune diseases, following only rheumatoid arthritis. 1 It should be considered in all patients with symptoms of dry mouth. A more complete history and an examination by an ophthalmologist including a Schirmer tear test and a rose bengal dye