1
|
Tan HL, Smith JG, Hoffmann J, Renton T. A systematic review of treatment for patients with burning mouth syndrome. Cephalalgia 2022; 42:128-161. [PMID: 34404247 PMCID: PMC8793318 DOI: 10.1177/03331024211036152] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/29/2021] [Accepted: 07/13/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Burning mouth syndrome is a chronic idiopathic intractable intraoral dysaesthesia that remains a challenge to clinicians due to its poorly understood pathogenesis and inconsistent response to various treatments. AIM This review aimed to study the short- (≤3 months) and long-term (>3 months) effectiveness and sustainable benefit of different burning mouth syndrome treatment strategies and the associated side effects. MATERIALS AND METHODS Randomised controlled trials of burning mouth syndrome treatment compared with placebo or other interventions with a minimum follow up of 2 months were searched from the PubMed, Embase and Cochrane database (published to July 2020). RESULTS Twenty-two studies were selected based on the inclusion and exclusion criteria and analysed. Nine categories of burning mouth syndrome treatment were identified: Anticonvulsant and antidepressant agents, phytomedicine and alpha lipoic acid supplements, low-level laser therapy, saliva substitute, transcranial magnetic stimulation, and cognitive behaviour therapy. Cognitive behaviour therapy, topical capsaicin and clonazepam, and laser therapy demonstrated favourable outcome in both short- and long-term assessment. Phytomedicines reported a short-term benefit in pain score reduction. The pooled effect of alpha lipoic acid (ALA) pain score improvement was low, but its positive effects increased in long term assessment. CONCLUSION A more significant volume in terms of sample size, multi-centres, and multi-arm comparison of therapeutic agents with placebo and longitudinal follow-up studies is recommended to establish a standardised burning mouth syndrome treatment protocol. Further studies are required to assess the analgesic benefits of topical clonazepam and capsaicin, alternative medicines with neurodegenerative prevention capability and psychology support in treating burning mouth syndrome and reducing systemic adverse drug reactions.Registration International Prospective Register of Systematic Reviews (PROSPERO):Protocol ID - CRD42020160892.
Collapse
Affiliation(s)
- Huann Lan Tan
- Faculty of Dentistry, Oral & Craniofacial Science, King’s College London, London, UK
- Faculty of Dentistry, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Jared G Smith
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Jan Hoffmann
- Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- NIHR-Wellcome Trust King’s Clinical Research Facility/SLaM Biomedical Research Centre, King’s College Hospital, London, UK
| | - Tara Renton
- Faculty of Dentistry, Oral & Craniofacial Science, King’s College London, London, UK
| |
Collapse
|
2
|
Nosratzehi T. Burning mouth syndrome: a review of therapeutic approach. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 19:83-90. [PMID: 34881535 DOI: 10.1515/jcim-2021-0434] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 11/15/2021] [Indexed: 01/03/2023]
Abstract
Burning mouth syndrome (BMS) is described by an intense burning sensation of the tongue or other oral areas without a clear etiopathology. The diagnosis of BMS is challenging due to variations of manifestations. The management of BMS is complicated due to the complex etiology of the disease. Many medications and treatment methods have been recommended for BMS management, but no one confirmed as the standard method. In this study, the therapeutic approaches of BMS were evaluated. The data of the article was obtained from PubMed/MEDLINE, Cochrane Library, and Web of Science. The following terms including "burning mouth syndrome", "therapy", and "treatment" were used for search in the databases. A wide range of articles about the therapeutic approach of BMS was searched and reviewed. Pharmacological and non-pharmacological approaches have been used for BMS management. Pharmacological treatments are including Capsaicin, Clonazepam, Low-dose aripiprazole, Alpha-lipoic acid, Duloxetine, Amitriptyline, Gabapentin, and Pregabalin, and ultra-micronized palmitoylethanolamide. Non-pharmacological therapies for BMS are cognitive therapy, Electroconvulsive therapy, Laser therapy, Acupuncture and auriculotherapy, Transcranial Magnetic Stimulation (rTMS), Salivary Mechanical Stimulation, and Botulinum Toxin. A detailed assessment of the etiology and pathophysiology of BMS, and having information about novel therapeutic interventions are essential for the management of BMS.
Collapse
Affiliation(s)
- Tahereh Nosratzehi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Oral and Dental Disease Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| |
Collapse
|
3
|
Jin JQ, Cui HM, Han Y, Su S, Liu HW. Multifactor analysis of patients with oral sensory complaints in a case-control study. Chin Med J (Engl) 2020; 133:2822-2828. [PMID: 33273331 PMCID: PMC10631587 DOI: 10.1097/cm9.0000000000001190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND There are an increasing number of patients with oral sensory complaints (OSCs) presenting to our dental clinic. For most dentists, it is difficult to distinguish burning mouth syndrome (BMS) from other oral mucosal diseases that may cause symptoms such as burning mouth. It is beneficial to effectively distinguish OSC patients to reduce misdiagnosis and eliminate burning symptoms as much as possible. METHODS Patients with oral burning sensations in the oral mucosal disease clinic were collected from the Peking University Hospital of Stomatology between September 1, 2014 and December 31, 2018. After excluding oral candidiasis, anemic stomatitis, dental material allergy, and other diseases from patients with oral sensory complaints, basic conditions such as gender, age, education level, job status, hyperglycemia, hypertension, hyperlipidemia, history of brain abnormalities, history of cervical spondylitis, history of thyroid disease, history of thyroid disease and insomnia were obtained. The BMS patients were compared with the control group. The t test and Chi-square test were used for statistical analysis to compare the clinical symptoms of these diseases and explore the risk factors for BMS. RESULTS In this case-control study, 395 patients (321 females and 74 males, mean age 55.26 ± 10.51 years) with oral sensory complaints and 391 healthy controls (281 females and 110 males, mean age 47.11 ± 13.10 years) were enrolled, among which, 8.4% (33/395) had oral candidiasis, 1.3% (5/395) had dental material allergy, 0.8% (3/395) had anemic stomatitis and 0.5% (2/395) had lichen planus. A total of 352 patients were eventually diagnosed with BMS. Anxiety and depression were more severe in BMS patients, as were the incidences of sleep disorders and brain abnormalities. Logistic regression analysis showed that age (odds ratio [OR] = 2.79, 95% confidence interval [CI]: 1.61-4.83, P < 0.001), total cholesterol level (OR = 2.92, 95% CI: 1.32-6.50, P = 0.009) and anxiety score (OR = 1.75, 95% CI: 1.01-2.77, P = 0.017) significantly increased the incidence of BMS. Patients with hyperglycemia (OR = 0.46, 95% CI: 0.23-0.89, P = 0.022), low body mass index (BMI: OR = 0.57, 95% CI: 0.34-0.93, P = 0.026) and low education level (OR = 3.43, 95% CI: 1.91-6.15, P < 0.001) were more likely to suffer from BMS. CONCLUSIONS Oral candidiasis, anemic stomatitis, and dental material allergy with burning symptoms should be excluded from patients with BMS. It is recommended to conduct a questionnaire survey (including anxiety and depression), blood cell analysis, and salivary fungus culture for all patients with an oral burning sensation. It is necessary to conduct a patch test on patients with oral burning sensations and metal restorations.
Collapse
Affiliation(s)
- Jian-Qiu Jin
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing 100081, China
- Department of Stomatology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Hong-Mei Cui
- Department of Stomatology, Suzhou Vocational Health College, Suzhou, Jangsu 215009, China
| | - Ying Han
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Sha Su
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing 100069, China
| | - Hong-Wei Liu
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing 100081, China
| |
Collapse
|
4
|
Scardina GA, Casella S, Bilello G, Messina P. Photobiomodulation Therapy in the Management of Burning Mouth Syndrome: Morphological Variations in the Capillary Bed. Dent J (Basel) 2020; 8:dj8030099. [PMID: 32882863 PMCID: PMC7559391 DOI: 10.3390/dj8030099] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/10/2020] [Accepted: 08/26/2020] [Indexed: 01/25/2023] Open
Abstract
Burning mouth syndrome (BMS) is an idiopathic condition that manifests itself primarily with the onset of a burning sensation. The aim of this research was to perform photobiomodulation therapy (PBM) using a diode laser on the oral mucosa of BMS patients, followed by an objective evaluation of the morphological changes in the vascular bed underlying the mucosa using polarized light videocapillaroscopy. A group of 40 patients were included in the study. The patients were randomly divided into two groups (using simple randomization) as follows: 20 patients were assigned to the laser group and 20 patients were assigned to the placebo group. Each patient of the laser group received eight irradiations (with 4 Watt of power, wavelength 800 nm, energy 1200 Joules, irradiation time of 300 s, energy density 50 J/cm2, 60 mW continuous wave laser, and irradiance 180 mW/cm2), twice a week, blinded to the type of irradiation administered, for four consecutive weeks. The patients in the placebo group underwent the same sessions as the other patients, the only difference was the non-emission of the laser. An initial check of the vascular bed was performed with a polarized light videocapillaroscope. This was followed by treatment with a therapeutic diode laser and a subsequent check with a videocapillaroscope. We observed that in the group of patients who underwent laser therapy, there was a lasting improvement in symptoms. The capillary oral bed of patients in the placebo group did not show any statistically significant difference (p > 0.05). In the laser group we observed the following: in the buccal mucosa the diameter of the capillary had a reduction of 3 μm; in the upper lip mucosa, there was a reduction of 3 μm; in the lower lip mucosa, there was a reduction of 3 μm; and in the dorsal lingual surface, there was a reduction of 2 μm. An increase in capillary length was also obtained in all irradiated regions in the laser group patients (p < 0.05). PBM induces microcirculatory changes that are still present over a long period of time, such as an improvement in the clinical picture. The improvement in the symptoms has been correlated to the reduction of the capillary diameter. The placebo effect only led to a temporary improvement in symptoms that were unrelated to changes in the microcirculatory pattern.
Collapse
|
5
|
How Do You Treat Burning Mouth Syndrome in Your Practice? Med Acupunct 2019; 31:49-56. [DOI: 10.1089/acu.2019.29107.cpl] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
6
|
Jurisic Kvesic A, Zavoreo I, Basic Kes V, Vucicevic Boras V, Ciliga D, Gabric D, Vrdoljak DV. The Effectiveness of Acupuncture versus Clonazepam in Patients with Burning Mouth Syndrome. Acupunct Med 2018; 33:289-92. [DOI: 10.1136/acupmed-2015-010759] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2015] [Indexed: 11/04/2022]
Abstract
Objective Burning mouth syndrome (BMS) is a chronic oral condition, characterised by burning symptoms, which mainly affects perimenopausal and postmenopausal women. Neuropathy might be the underlying cause of the condition. There are still insufficient data regarding successful therapy. The aim of this study was to compare the effectiveness of acupuncture and clonazepam. Methods Forty-two patients with BMS (38 women, 4 men) aged 66.7±12.0 years were randomly divided into two groups. Acupuncture was performed on 20 participants over 4 weeks, 3 times per week, on points ST8, GB2, TE21, SI19, SI18 and LI4 bilaterally as well as GV20 in the midline, each session lasting half an hour. Twenty-two patients took clonazepam once a day (0.5 mg in the morning) for 2 weeks and, after 2 weeks, two tablets (0.5 mg in the morning and in the evening) were taken for the next 2 weeks. Prior to and 1 month after either therapy, participants completed questionnaires: visual analogue scale, Beck Depression Inventory, Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) pain scale, 36-item Short Form Health Survey (SF-36) and Montreal Cognitive Assessment (MoCA). Results There were significant improvements in the scores of all outcome measures after treatment with both acupuncture and clonazepam, except for MoCA. There were no significant differences between the two therapeutic regimens regarding the scores of the performed tests. Conclusions Acupuncture and clonazepam are similarly effective for patients with BMS.
Collapse
Affiliation(s)
| | - I Zavoreo
- Clinic for Neurology, Clinical Hospital Centre Sisters of Mercy, Zagreb, Croatia
| | - V Basic Kes
- Clinic for Neurology, Clinical Hospital Centre Sisters of Mercy, Zagreb, Croatia
| | - V Vucicevic Boras
- Department of Oral Medicine, School of Dental Medicine and Clinical Hospital Centre, Zagreb, Croatia
| | - D Ciliga
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - D Gabric
- Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - D V Vrdoljak
- Clinic for Tumours, Clinical Hospital Centre Sisters of Mercy, Zagreb, Croatia
| |
Collapse
|
7
|
Abstract
Primary burning mouth syndrome (BMS) is an oral mucosal disorder that is characterized by a chronic and often debilitating intraoral burning sensation for which no localized or systemic cause can be found. BMS most commonly affects postmenopausal women. The pathophysiology of primary BMS is not well understood. Diagnosing BMS can prove to be challenging. BMS patients can also pose a therapeutic challenge to clinicians who are consulted to evaluate these patients. Most commonly used therapies include tricyclic antidepressants, α-lipoic acid, clonazepam, and cognitive-behavioral therapy. Clinical judgment, patient counseling, and monitoring of pain are important. Further research is required to assess the effectiveness of serotonin and newer serotonin-noradrenalin reuptake inhibitors.
Collapse
Affiliation(s)
- Siamak Moghadam-Kia
- Department of Rheumatology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Nasim Fazel
- Department of Dermatology, University of California, Davis School of Medicine, Sacramento, CA.
| |
Collapse
|
8
|
Affiliation(s)
- Maria João Susano
- Department of Anesthesiology, Intensive and Emergency Care, Centro Hospitalar do Porto, Portugal
| | - Ana Maria Araújo
- Department of Anesthesiology, Intensive and Emergency Care, Centro Hospitalar do Porto, Portugal
| | - Asdrúbal Pinto
- Department of Oral and Maxillofacial Surgery Porto, Centro Hospitalar do Porto, Portugal
| | - Dalila Veiga
- Department of Anesthesiology, Intensive and Emergency Care, Centro Hospitalar do Porto, Portugal
| |
Collapse
|
9
|
Franco FRV, Castro LA, Borsatto MC, Silveira EA, Ribeiro-Rotta RF. Combined Acupuncture and Auriculotherapy in Burning Mouth Syndrome Treatment: A Preliminary Single-Arm Clinical Trial. J Altern Complement Med 2017; 23:126-134. [DOI: 10.1089/acm.2016.0179] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
10
|
Abstract
Dermatologists face a wide range of pain control challenges in daily practice, from the transient pain of dermatologic surgery to the persistent pain that plagues some chronic dermatologic conditions. Although the pathophysiology of pain is well described and the profound impact of dermatological pain on patients' quality of life is well appreciated, there is an identified need for clear therapeutic plans for providing symptomatic pain relief of common painful dermatoses. In this paper, we will review and clearly outline approaches to pain management of a number of common painful dermatoses such as herpes zoster and post-herpetic neuralgia, ulcers, oral dermatoses, dysesthesias, and many others.
Collapse
|
11
|
Cheung D, Trudgill N. Managing a patient with burning mouth syndrome. Frontline Gastroenterol 2015; 6:218-222. [PMID: 28839812 PMCID: PMC5369598 DOI: 10.1136/flgastro-2014-100431] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Revised: 05/23/2014] [Accepted: 05/26/2014] [Indexed: 02/04/2023] Open
Abstract
A 64-year-old woman presented with an increasing frequency of symptoms of heartburn and retrosternal pain over the last few months, and a constant and intense burning pain affecting her tongue tip, mouth and lips for the past 5 years. She found consuming hot drinks exacerbated the burning oral pain and chewing gum seemed to alleviate some of her symptoms. She thought these oral sensations were caused by frequently licking her finger tips to separate prints in her work in publishing. She had been previously diagnosed with gastro-oesophageal reflux disease (GORD), and her heartburn symptoms had been controlled until recently with lansoprazole 15 mg daily. Her past medical history included irritable bowel syndrome and depression, for which she had been treated with mebeverine and paroxetine for a number of years. She was a non-smoker and did not consume alcohol. Clinical examination was unremarkable with no oral lesions on examination. Her routine laboratory tests, including autoimmune serology, haematinics and thyroid function tests were all within normal limits. She underwent a gastroscopy, which revealed moderate reflux oesophagitis, and following commencing omeprazole 20 mg twice daily, her heartburn resolved. However, her oral burning symptoms were not affected and a diagnosis of burning mouth syndrome (BMS) was made. Following explanation and reassurance concerning the cause of her BMS symptoms, she chose not to receive treatment for this but to access cognitive behavioural therapy in the future if her symptoms worsened.
Collapse
Affiliation(s)
- Danny Cheung
- Department of Gastroenterology, Sandwell General Hospital, West Bromwich, UK
| | - Nigel Trudgill
- Department of Gastroenterology, Sandwell General Hospital, West Bromwich, UK
| |
Collapse
|
12
|
Brailo V, Bosnjak A, Boras VV, Jurisic AK, Pelivan I, Kraljevic-Simunkovic S. Laser Acupuncture in the Treatment of Burning Mouth Syndrome: A Pilot Study. Acupunct Med 2013; 31:453-4. [DOI: 10.1136/acupmed-2013-010419] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- V Brailo
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - A Bosnjak
- Department of Periodontology, School of Medicine, Croatia
| | - V Vucicevic Boras
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
- Clinical Hospital Center Zagreb, Croatia
| | - A Kvesic Jurisic
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Croatia
| | - I Pelivan
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Croatia
| | - S Kraljevic-Simunkovic
- Clinical Hospital Center Zagreb, Croatia
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Croatia
| |
Collapse
|
13
|
|
14
|
Sardella A, Lodi G, Tarozzi M, Varoni E, Franchini R, Carrassi A. Acupuncture and Burning Mouth Syndrome: A Pilot Study. Pain Pract 2013; 13:627-32. [DOI: 10.1111/papr.12031] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Accepted: 11/12/2012] [Indexed: 12/21/2022]
Affiliation(s)
- Andrea Sardella
- Dipartimento di Scienze Biomediche; Chirurgiche e Odontoiatriche Unità di Medicina Orale; Patologia Orale e Odontoiatria Geriatrica; Università di Milano; Milan Italy
| | - Giovanni Lodi
- Dipartimento di Scienze Biomediche; Chirurgiche e Odontoiatriche Unità di Medicina Orale; Patologia Orale e Odontoiatria Geriatrica; Università di Milano; Milan Italy
| | - Marco Tarozzi
- Dipartimento di Scienze Biomediche; Chirurgiche e Odontoiatriche Unità di Medicina Orale; Patologia Orale e Odontoiatria Geriatrica; Università di Milano; Milan Italy
| | - Elena Varoni
- Dipartimento di Scienze Biomediche; Chirurgiche e Odontoiatriche Unità di Medicina Orale; Patologia Orale e Odontoiatria Geriatrica; Università di Milano; Milan Italy
- Dipartimento di Scienze Mediche; Università del Piemonte Orientale; Novara Italy
| | - Roberto Franchini
- Dipartimento di Scienze Biomediche; Chirurgiche e Odontoiatriche Unità di Medicina Orale; Patologia Orale e Odontoiatria Geriatrica; Università di Milano; Milan Italy
- Dipartimento di Scienze Mediche; Università del Piemonte Orientale; Novara Italy
| | - Antonio Carrassi
- Dipartimento di Scienze Biomediche; Chirurgiche e Odontoiatriche Unità di Medicina Orale; Patologia Orale e Odontoiatria Geriatrica; Università di Milano; Milan Italy
| |
Collapse
|
15
|
López-Jornet P, Camacho-Alonso F, De la Mano-Espinosa T. Complementary and Alternative Medical Therapies in Patients with Burning Mouth Syndrome. J Altern Complement Med 2011; 17:289-90. [DOI: 10.1089/acm.2011.0026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Pia López-Jornet
- Department of Oral Medicine, University Clinic of Odontology, Hospital Morales Meseguer, Murcia, Spain
| | - Fabio Camacho-Alonso
- Department of Oral Medicine, University Clinic of Odontology, Hospital Morales Meseguer, Murcia, Spain
| | - Tamar De la Mano-Espinosa
- Department of Oral Medicine, University Clinic of Odontology, Hospital Morales Meseguer, Murcia, Spain
| |
Collapse
|