A nationwide register-based study of the prevalence of burning mouth syndrome in Taiwan from 2004 to 2013

Oral dysaesthesia: a special focus on aetiopathogenesis, clinical diagnostics and treatment modalities

Oral dysaesthesia is a condition characterised by persistent alteration to oral sensation, perceived by the patient to be abnormal and/or unpleasant, in the absence of any mucosal pathology. The condition can be difficult to detect and diagnose. A possible peripheral or central neuropathic aetiology has been proposed. Burning mouth syndrome (BMS) is the most common idiopathic oral dysesthesia in which long-term suffering is often reported by patients. Recent efforts from professional organisations and study groups have provided a consensus on BMS disease definition and diagnostic criteria. Large-scale epidemiological studies are required to provide an accurate estimate for prevalence and incidence of the condition. Meticulous diagnostic investigations which may require interdisciplinary teamwork are often warranted to reach an accurate diagnosis. A combination of interventional modalities, with a holistic approach, is key for successful management and improvement in patients' quality of life.

Pain sensitivity and quality of life of patients with burning mouth syndrome: a preliminary study in a Chinese population

BACKGROUND

Burning mouth syndrome (BMS) is an oral-facial pain disorder involving the central and peripheral nervous systems, but the evidence for altered pain sensitivity remains inconclusive. The aim of this study was to investigate pain sensitivity and oral health-related quality of life (OHRQoL) in patients with BMS and to assess the relationship between them.

METHODS

Fifty Chinese patients with BMS (57.82 ± 11.2 years) and fifty age- and gender-matched healthy subjects (55.64 ± 10.1 years) participated in the study. The Pain Sensitivity Questionnaire (PSQ) was used to assess participants' pain sensitivity. The Oral Health Impact Profile (OHIP-14) was used to evaluate participants' OHRQoL.

RESULTS

The PSQ total score (p = 0.009), the PSQ minor score (p = 0.003) and the OHIP-14 score (p<0.05) of patients with BMS were significantly higher than those of the healthy subjects. Simple linear regression showed that the PSQ minor score was significantly associated with the OHIP-14 score in patients with BMS (β = 0.338, p = 0.016).

CONCLUSION

Patients with BMS have higher pain sensitivity than healthy subjects. Reducing pain sensitivity might help to improve the quality of life of patients with BMS.

Relationship of Depression, Anxiety, and Bipolar Disease with Burning Mouth Syndrome: A Nationwide Cohort Study

Burning mouth syndrome (BMS) is a chronic, painful condition of the oral mucosa. Although the pathogenesis remains unclear, psychological and neuroendocrine factors are considered the major contributors. Few longitudinal studies have investigated the effects of psychological factors on the occurrence of BMS. Therefore, we evaluated the risk of BMS in patients with affective disorders using a nationwide population-based cohort dataset. We identified patients with depression, anxiety, and bipolar disorder and then selected comparison participants using the 1:4 propensity score-matching method. We investigated the incidence of BMS events during the follow-up period using survival analysis, the log-rank test, and Cox proportional hazards regression models. After adjusting for other contributing conditions, the adjusted hazard ratio (HR) for developing BMS was 3.37 (95% confidence interval [CI]: 1.67-6.80) for depression and 5.09 (95% CI: 2.19-11.80) for anxiety; however, bipolar disorder showed no significant risk. Specifically, female patients with depression and anxiety had an increased risk of BMS. Moreover, patients with anxiety showed an increased adjusted HR of BMS events during the first 4 years after diagnosis, whereas patients with depression did not. In conclusion, depression and anxiety disorders are significantly associated with the risk of BMS. Additionally, female patients showed a significantly higher risk of BMS than male patients, and anxiety showed increased BMS events earlier than depression. Therefore, clinicians should consider the risk of BMS when treating patients with depression or anxiety.

Decreased trends of using dental amalgam filling for decayed teeth in Taiwan from 1997 to 2013

Background/purpose

Mercury within dental amalgam has been criticized for the potential toxicity and environmental hazard. Phasing down the use of dental amalgam is the transition for amalgam free dentistry. However, little is known about dental amalgam filling (AMF) in Taiwan. In this study, time trends of AMF were measured by using National Health Insurance Research Database (NHIRD).

Materials and methods

A retrospective study was conducted to analyze the AMF data in registered database compiled by Taiwanese NHIRD from 1997 to 2013. The AMF data were further analyzed according to sex, age, and geographic location, respectively. Time trends of dental visits for AMF and medical expenses for AMF were also evaluated.

Results

The average annual AMF ratio was 8.965% of nationwide population in Taiwan. The prevalence of AMF was significantly decreased both in male and female from 1997 to 2013 (P for trend <0.0001). The decreased pattern of AMF was found by the age stratification (P for trend <0.0001). The significant fall of AMF was also displayed in six districts (P for trend <0.0001). The number of dental visits were ranged from 821,749 in 1997 to 1,313,734 in 2013. However, time trends of dental visits for AMF were significantly decreased (P for trend <0.0001). The medical expenses for AMF were simultaneous significantly decreased from 1997 to 2013 (P for trend <0.0001).

Conclusion

Form the results of this nationwide population-based database, a significant decrease of AMF in Taiwan was observed during past 17 years.