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Gramacy A, Villa A. Topical gabapentin solution for the management of burning mouth syndrome: A retrospective study. PLoS One 2023; 18:e0295559. [PMID: 38096135 PMCID: PMC10721041 DOI: 10.1371/journal.pone.0295559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/24/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVE The aim of this retrospective study was to evaluate the effectiveness and safety of topical gabapentin solution (250 mg/mL) for the management of burning mouth syndrome (BMS). STUDY DESIGN A retrospective chart review was conducted of all patients diagnosed with BMS and managed with gabapentin 250 mg/mL solution (swish and spit) between January 2021 and October 2022. Patient-reported outcomes included changes in burning score ranked on a 10-point numeric rating scale (NRS) and reported adverse drug reactions (ADR). Wilcoxon signed-rank test was used to assess differences in the oral burning score ranked on a NRS (0-10) between the baseline visit and the second visit. RESULTS A total of 19 patients (68.4% females) with BMS were included and evaluated for follow-up at a median of 86 days (range: 29-195). Overall, patients reported a median 2-point burning decrease on a 0-10 NRS between the baseline visit and the second visit (p < 0.01). ADRs were reported by 3 patients (15.8%). CONCLUSION Although this was a small retrospective study, BMS management with topical gabapentin (250 mg/mL) appears to be effective and well-tolerated. Future randomized prospective studies are needed to verify these preliminary findings.
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Affiliation(s)
- Amanda Gramacy
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, United States of America
| | - Alessandro Villa
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, United States of America
- Oral Medicine, Oral Oncology and Dentistry, Miami Cancer Institute, Baptist Health South Florida, Miami, Florida, United States of America
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Takao C, Watanabe M, Nayanar G, Tu T, Umezaki Y, Takenoshita M, Motomura H, Nagamine T, Toyofuku A. Clinical Features and Variations of Pain Expressions in 834 Burning Mouth Syndrome Patients With or Without Psychiatric Comorbidities. Cureus 2023; 15:e51139. [PMID: 38283479 PMCID: PMC10811297 DOI: 10.7759/cureus.51139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction Burning mouth syndrome (BMS) is characterized as chronic burning pain or unpleasant discomfort in the oral region without any corresponding clinical abnormalities. The aim of this study is to investigate the difference in clinical features and the variations of pain expressions between BMS patients with and without psychiatric comorbidities. Methodology The patients with BMS who first visited between April 2016 and March 2020 were involved and the clinical data including the presence of psychiatric comorbidities and scores of self-rating depression scale (SDS), pain catastrophizing scale (PCS), and pain quality from short-form McGill pain questionnaire (SF-MPQ) were collected retrospectively. Results In 834 patients with BMS (700 females, 63.9 ± 13.1 years old), 371 patients (44.5%) had psychiatric comorbidities. There was no significant between-group difference in demographic data. However, significantly higher scores were observed in SDS (p < 0.001) and PCS (p < 0.001) in the patients with psychiatric comorbidities. Moreover, the patients with psychiatric comorbidities showed significantly stronger pain intensity (p < 0.001) besides higher scores of each descriptor in SF-MPQ. In addition, they had chosen more descriptors in SF-MPQ (p < 0.001); furthermore, the number of selected pain descriptors showed a stronger correlation with PCS than with SDS regardless of the presence of psychiatric comorbidities. Conclusion BMS patients may complain of various pain expressions regardless of the psychiatric comorbidities; however, more severe complaints relating to high pain catastrophizing are more likely in patients with psychiatric comorbidities. These results suggested that underlying anxiety exacerbated the variety of pain expressions in BMS patients with psychiatric comorbidities.
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Affiliation(s)
- Chihiro Takao
- Department of Psychosomatic Dentistry, Tokyo Medical and Dental University, Tokyo, JPN
| | - Motoko Watanabe
- Department of Psychosomatic Dentistry, Tokyo Medical and Dental University, Tokyo, JPN
| | - Gayatri Nayanar
- Department of Psychosomatic Dentistry, Tokyo Medical and Dental University, Tokyo, JPN
| | - Trang Tu
- Department of Basic Dental Science, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VNM
- Department of Psychosomatic Dentistry, Tokyo Medical and Dental University, Tokyo, JPN
| | - Yojiro Umezaki
- Department of Geriatric Dentistry, Fukuoka Dental College, Fukuoka, JPN
| | - Miho Takenoshita
- Department of Psychosomatic Dentistry, Tokyo Medical and Dental University, Tokyo, JPN
| | - Haruhiko Motomura
- Department of Psychosomatic Dentistry, Tokyo Medical and Dental University, Tokyo, JPN
| | - Takahiko Nagamine
- Department of Psychiatric Internal Medicine, Sunlight Brain Research Center, Yamaguchi, JPN
- Department of Psychosomatic Dentistry, Tokyo Medical and Dental University, Tokyo, JPN
| | - Akira Toyofuku
- Department of Psychosomatic Dentistry, Tokyo Medical and Dental University, Tokyo, JPN
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The influence of intolerance of uncertainty on the correlation between the severity of symptoms and satisfaction with oral state in patients with burning mouth syndrome. Clin Oral Investig 2022; 26:6563-6568. [PMID: 35790598 DOI: 10.1007/s00784-022-04606-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 06/20/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Intolerance of uncertainty (IU) is thought to be involved with the psychological factors that influence the symptoms in patients with burning mouth syndrome (BMS) and affect their limited satisfaction with the treatments provided. However, the influence of IU on satisfaction has not been explored in detail. Therefore, the purpose of this study was to investigate whether IU can affect the satisfaction of patients with BMS. METHODS A total of 34 patients with BMS and 100 patients without the disease who visited the general dental clinic were included in the study. They were required to complete a questionnaire measuring the subjective severity of their symptoms and satisfaction with their oral state, and a short IU scale. The BMS patients were separated from the control patients based on the IU score. The coefficients between the severity of symptoms and satisfaction were calculated to examine the influence of IU on the relationship between the two variables. RESULTS The relationship between satisfaction and severity of symptoms was significant in BMS patients with high IU, but not in control patients with low IU. CONCLUSION This study demonstrated that IU in BMS patients influences the relationship between the severity of symptoms and the satisfaction, thus indicating that the dissatisfaction in BMS patients with high IU might be prevented by decreasing the IU. CLINICAL RELEVANCE Limited satisfaction experienced by BMS patients can influence the patient-doctor relationship. This study provides suggestions for building a good patient-doctor relationship.
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Use of Clonazepam Mouthwash in Burning Mouth Syndrome With Concurrent Psychiatric Conditions: A Case Report. J Acad Consult Liaison Psychiatry 2022; 63:98-101. [DOI: 10.1016/j.jaclp.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/15/2021] [Accepted: 08/19/2021] [Indexed: 10/19/2022]
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Orliaguet M, Misery L. Neuropathic and Psychogenic Components of Burning Mouth Syndrome: A Systematic Review. Biomolecules 2021; 11:biom11081237. [PMID: 34439903 PMCID: PMC8393188 DOI: 10.3390/biom11081237] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 12/27/2022] Open
Abstract
The pathophysiology of primary burning mouth syndrome (BMS) has been extensively debated but is poorly understood despite a large number of hypotheses attempting to explain its etiopathogenic mechanisms. The aim of the present work was to systematically review papers that could provide arguments in favour of the neuropathic and psychogenic components of primary BMS for a better understanding of the disease. This systematic review (SR) was registered in PROSPERO (CRD42021224160). The search was limited to articles in English or French from 1990 to 01 December 2020. A total of 113 articles were considered for data extraction. We divided them into four subgroups: pharmacological and nonpharmacological management studies (n = 23); neurophysiological studies (n = 35); biohistopathological studies (n = 25); and questionnaire-based studies (n = 30). Several of these studies have shown neuropathic involvement at various levels of the neuraxis in BMS with the contribution of quantitative sensory testing (QST), functional brain imaging, and biohistopathological or pharmacologic studies. On the other hand, the role of psychological factors in BMS has also been the focus of several studies and has shown a link with psychiatric disorders such as anxiety and/or depression symptoms. Depending on the patient, the neuropathic and psychogenic components may exist simultaneously, with a preponderance of one or the other, or exist individually. These two components cannot be dissociated to define BMS. Consequently, BMS may be considered nociplastic pain.
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Affiliation(s)
- Marie Orliaguet
- LIEN, Department of Oral Surgery, University of Western Brittany, F-29200 Brest, France;
| | - Laurent Misery
- LIEN, Department of Dermatology, University of Western Brittany, F-29200 Brest, France
- Correspondence: ; Tel.: +33-2-9888-3527
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Handa S, Keith DA, Abou-Ezzi J, Rosèn A. Neuropathic orofacial pain: Characterization of different patient groups using the ICOP first edition, in a tertiary level Orofacial Pain Clinic. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:653-661. [PMID: 34518134 DOI: 10.1016/j.oooo.2021.07.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/09/2021] [Accepted: 07/26/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To characterize patients with chronic neuropathic orofacial pain in accordance with the International Classification of Orofacial Pain (ICOP first edition) criteria. STUDY DESIGN A retrospective chart review of 108 patients was conducted. The most common categories observed were trigeminal neuralgia (TN) (25.9%), burning mouth syndrome (BMS) (11.1%), persistent idiopathic facial pain (PIFP) (26.9%), and posttraumatic trigeminal neuropathic pain (PTTNP) (26.9%); 9.3% of patients could not be categorized. RESULTS TN and BMS was more prevalent in the sixth decade, and PIFP and PTTN were more prevalent in the fifth decade. All categories showed female predilection. The pain in TN was predominantly episodic, described as "sharp shooting" and like an "electric shock," unilateral and affecting the V2 division, and with trigger zones in 50% of patients. Pain in BMS was predominantly constant and described as "burning," with the tongue being the most common site. Pain in PIFP and PTTNP was as follows: varied from constant to episodic; described as "burning," "sharp shooting," "throbbing," or "dull aching"; intraoral or extraoral; and mostly involving the V2 or V3 division. CONCLUSION This study is the first to characterize patients with neuropathic orofacial pain using the new ICOP criteria. PIFP and PTTNP were most commonly misdiagnosed categories. Using diagnostic criteria will increase the understanding of this patient group.
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Affiliation(s)
- Shruti Handa
- Instructor, Department of Surgery, Division of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA, USA.
| | - David A Keith
- Professor, Department of Surgery, Division of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA, USA
| | - Jeanelle Abou-Ezzi
- Student, Department of Human Ecology, Cornell University, New York, NY, USA
| | - Annika Rosèn
- Professor, Department of Clinical Dentistry, University of Bergen, Bergen, Norway; Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
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Salivary Hormones and Quality of Life in Female Postmenopausal Burning Mouth Patients-A Pilot Case-Control Study. Dent J (Basel) 2020; 8:dj8040111. [PMID: 33019769 PMCID: PMC7711961 DOI: 10.3390/dj8040111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 12/03/2022] Open
Abstract
The objective of our study was to investigate salivary levels of estradiol, progesterone and dehydroepiandrosterone (DHEA), and quality of life, in female postmenopausal women with burning mouth syndrome. The study included new patients diagnosed with burning mouth syndrome and excluded local and systemic causes. Unstimulated saliva samples were taken in the morning from 9 AM and 11 AM and immediately frozen for hormone analysis. The patients filled out a self-perceived quality of life questionnaire Oral Health Impact Profile-14 and determined the intensity of mucosal symptoms according to the visual-analog scale grading 0 to 10. A total of 40 patients were included. The study group had significantly lower levels of salivary estradiol. No difference was observed in levels of progesterone and DHEA between the groups. The levels of salivary hormones did not exhibit a significant correlation according to the Spearman correlation test with a self-perceived quality of life questionnaire (OHIP-14) in the study group or in the control group. Further research on a larger number of patients is needed to verify these results. This information might help to enable more precise and efficient treatment.
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Kwong KCL, Yeoh SC, Balasubramaniam R. Is oral dysaesthesia a somatic symptom disorder? J Oral Pathol Med 2020; 49:499-504. [PMID: 32531871 DOI: 10.1111/jop.13064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/04/2020] [Indexed: 12/20/2022]
Abstract
Oral dysaesthesia is a condition characterised by persistent alteration to oral sensation, perceived by the patient to be abnormal and unpleasant, in the absence of mucosal pathology. Its aetiology remains uncertain. The condition was attributed as a psychosomatic disease for much of the 20th century, but with newer technologies, recent literature has mostly focused on a possible peripheral or central neuropathic aetiology to oral dysaesthesia. Despite this, psychotropic medications and psychological treatments remain forefront in the armamentarium for the management of oral dysaesthesia. This article aims to review the literature surrounding the pathogenesis of oral dysaesthesia and explore whether oral dysaesthesia is a somatic symptom disorder.
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Affiliation(s)
- Kenelm Chun Lam Kwong
- Department of Oral Medicine, Oral Pathology and Special Needs Dentistry, Westmead Hospital, Westmead, NSW, Australia
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Nosratzehi T, Payandeh A, DehYadegari F. The Complaints, Type, and Severity of Stressful Events in Patients with Burning Mouth Syndrome Referring to Zahedan School of Dentistry, Iran. Clin Cosmet Investig Dent 2020; 12:123-130. [PMID: 32308496 PMCID: PMC7154002 DOI: 10.2147/ccide.s229910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 01/14/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Burning mouth syndrome (BMS) is a burning sensation in oral mucosa without visible lesions in clinical examinations. The present study aimed at comparing complaints, frequency, type, and severity of stressful events between patients with BMS and healthy individuals referred to Zahedan School of Dentistry, Zahedan, Iran. Materials and Methods In the present study, 30 patients with BMS were matched with controls by age and gender after enrollment. The Holmes-Rahe questionnaire and the complaint registration form were used to compare the frequency of complaints, and the type and severity of stressful events between the groups. Data were analyzed by descriptive statistics, Chi-squared and t-tests. Results The mean age of the subjects in the case and control groups was 40.13 ± 2.30 and 40.07 ± 2.31 years, respectively. The obtained results showed no statistically significant difference between the groups in terms of mean age and gender distribution (P>0.05). The results of the Chi-squared test showed a significant difference in the frequency of complaints between the two groups (P<0.001). The t-test results indicated that the average severity of complaints and the average severity of stressful events were significantly different between patients with BMS and controls (P<0.001). The results of Chi-squared test revealed that the mean frequency of complaints (P<0.001) and mean frequency of stressful events (P<0.001) were significantly different between the two groups. Conclusions Based on the study results, the frequency of complaints, and the type and severity of stressful events were significantly different between patients with BMS and healthy individuals referred to the clinic of Zahedan School of Dentistry.
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Affiliation(s)
- Tahereh Nosratzehi
- Department of Oral Medicine, Oral and Dental Disease Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Abolfazl Payandeh
- Department of Biostatistics and Epidemiology, Community Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Farnaz DehYadegari
- Department of Oral Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
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Freilich JE, Kuten-Shorrer M, Treister NS, Woo SB, Villa A. Burning mouth syndrome: a diagnostic challenge. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 129:120-124. [DOI: 10.1016/j.oooo.2019.09.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 09/27/2019] [Accepted: 09/30/2019] [Indexed: 01/03/2023]
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Alrashdan MS, Alkhader M. Psychological factors in oral mucosal and orofacial pain conditions. Eur J Dent 2019; 11:548-552. [PMID: 29279685 PMCID: PMC5727744 DOI: 10.4103/ejd.ejd_11_17] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The psychological aspects of chronic pain conditions represent a key component of the pain experience, and orofacial pain conditions are not an exception. In this review, we highlight how psychological factors affect some common oral mucosal and orofacial pain conditions (namely, oral lichen planus, recurrent aphthous stomatitis, burning mouth syndrome, and temporomandibular disorders) with emphasis on the significance of supplementing classical biomedical treatment modalities with appropriate psychological counseling to improve treatment outcomes in targeted patients. A literature search restricted to reports with highest relevance to the selected mucosal and orofacial pain conditions was carried out to retrieve data.
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Affiliation(s)
- Mohammad S Alrashdan
- Department of Oral Medicine and Oral Surgery, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Mustafa Alkhader
- Department of Oral Medicine and Oral Surgery, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
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Oral medicine psychiatric liaison clinic: study of 1202 patients attending over an 18-year period. Int J Oral Maxillofac Surg 2019; 48:644-650. [PMID: 30609954 DOI: 10.1016/j.ijom.2018.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 10/12/2018] [Accepted: 12/11/2018] [Indexed: 11/23/2022]
Abstract
Patients with orofacial pain and discomfort often suffer from psychiatric disorders. However, few studies involving a large sample have examined the diagnostic results of patients with orofacial pain or discomfort in relation to psychiatric disorders. The purpose of this study was to summarize and clarify the characteristics and demographic data of 1202 patients attending the psychiatric liaison clinic at Aichi Gakuin University Hospital. Psychiatric diagnosis was performed by psychiatrists for all patients, based on the Diagnostic and Statistical Manual of Mental Disorders, fifth edition. Among the 1202 patients, 992 (82.5%) were female. The average age of the patients was 57.2±15.0years. The predominant broad categories of orofacial pain and discomfort seen were burning mouth syndrome (n=484, 40.3%), persistent idiopathic facial pain (n=258, 21.5%), and oral dysesthesia (n=215, 17.9%). The predominant broad categories of psychiatric diagnoses seen were somatic symptoms and related disorders (n=934, 77.7%) and depressive disorders (n=76, 6.3%). Among the 934 patients with somatic symptoms and related disorders, 678 had a somatic symptom disorder with predominant pain. The results confirmed that most patients with orofacial pain and discomfort were middle-aged and elderly women suffering from a somatic symptom disorder with predominant pain.
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Burning Mouth Syndrome: Aetiopathogenesis and Principles of Management. Pain Res Manag 2017; 2017:1926269. [PMID: 29180911 PMCID: PMC5664327 DOI: 10.1155/2017/1926269] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 09/18/2017] [Accepted: 09/19/2017] [Indexed: 01/24/2023]
Abstract
Burning mouth syndrome (BMS) is a chronic debilitating oral condition characterised by a burning sensation of the oral mucosa in an otherwise apparently normal person. Its aetiology and pathogenesis are obscure, but both psychogenic factors and peripheral and central neuropathies appear to be implicated. There is no cure for BMS, and treatment with either local or systemic medications focuses on the relief of symptoms and on improving quality of life. In recalcitrant cases, psychological/psychiatric intervention may be helpful. In order to improve treatment outcomes, a better understanding of the pathogenesis of this syndrome might provide a basis for the development of more effective management strategies. In this short review, we discuss current knowledge of the diagnosis, aetiopathogenesis, and management of BMS.
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Arduino PG, Cafaro A, Garrone M, Gambino A, Cabras M, Romagnoli E, Broccoletti R. A randomized pilot study to assess the safety and the value of low-level laser therapy versus clonazepam in patients with burning mouth syndrome. Lasers Med Sci 2016; 31:811-6. [PMID: 26873501 DOI: 10.1007/s10103-016-1897-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 01/27/2016] [Indexed: 12/26/2022]
Abstract
Comparison between low-level laser therapy (LLLT) and clonazepam for treating burning mouth syndrome (BMS) patients has never been documented; the aim of this study was to assess the effects of LLLT photobiomodulation versus medical therapy with clonazepam on BMS. Thirty-three patients (25 female, 8 male, mean age = 67.12) were randomly allocated to two different groups: the first one (group A, 18 patients) underwent two laser irradiation sessions weekly for 5 weeks, whereas the second one (group B, 15 patients) received topical clonazepam therapy [half a tablet (2 mg) in the mouth without swallowing for 3 min, three times a day for 21 days]. LLLT was delivered with a continuous wave 980-nm aluminum gallium arsenide (AlGaAs) diode laser and the output of 300 mW, delivering a Fluence of 10 J/cm(2), using a "spot technique," with an average power density of about 1 W/cm(2). The laser probe was held perpendicularly at a distance of about 2 mm from the mucosa. Visual analogue scale (VAS), McGill Pain Questionnaire, present pain intensity (PPI), and Oral Health Impact Profile (OHIP-49) assessed sensation of pain. Hospital Anxiety and Depression Scale and Geriatric Depression Scale assessed levels of anxiety and depression. Twelve weeks after the end of treatment, patients treated with LLLT experienced a decrease in pain sensation reported for all the parameters analyzed: VAS (P = 0.004), McGill Pain Questionnaire (P = 0.002), PPI (P = 0.002), and OHIP-49 (P = 0.010). The group treated with clonazepam had less favorable results for VAS (P = 0.33), McGill Pain Questionnaire (P = 0.005), PPI (P = 0.013), and OHIP-49 (P = 0.25). Levels of anxiety and depression did not change statistically in any groups (P > 0.05). Comparing the two groups, LLLT appeared to be superior in improving pain perception, but statistically only at 8 weeks after the end of the protocol proposed (P = 0.026). Based on this preliminary trial, LLLT is capable of reducing the symptoms of patients with BMS with a constant and long-lasting effect, experienced since the end of the first applications.
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Affiliation(s)
- Paolo G Arduino
- Department of Surgical Sciences, Oral Medicine Section, University of Turin, Unito Lingotto Dental Institute c/o Lingotto, Via Nizza 230, 10126, Turin, Italy.
| | - Adriana Cafaro
- Department of Surgical Sciences, Oral Medicine Section, University of Turin, Unito Lingotto Dental Institute c/o Lingotto, Via Nizza 230, 10126, Turin, Italy
| | - Marco Garrone
- Department of Surgical Sciences, Oral Medicine Section, University of Turin, Unito Lingotto Dental Institute c/o Lingotto, Via Nizza 230, 10126, Turin, Italy
| | - Alessio Gambino
- Department of Surgical Sciences, Oral Medicine Section, University of Turin, Unito Lingotto Dental Institute c/o Lingotto, Via Nizza 230, 10126, Turin, Italy
| | - Marco Cabras
- Department of Surgical Sciences, Oral Medicine Section, University of Turin, Unito Lingotto Dental Institute c/o Lingotto, Via Nizza 230, 10126, Turin, Italy
| | - Ercole Romagnoli
- Department of Surgical Sciences and Integrated Diagnostics, Genoa University, Genoa, Italy
| | - Roberto Broccoletti
- Department of Surgical Sciences, Oral Medicine Section, University of Turin, Unito Lingotto Dental Institute c/o Lingotto, Via Nizza 230, 10126, Turin, Italy
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Valença MM, de Oliveira DA, Martins HADL. Alice in Wonderland Syndrome, Burning Mouth Syndrome, Cold Stimulus Headache, and HaNDL: Narrative Review. Headache 2015; 55:1233-48. [DOI: 10.1111/head.12688] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2015] [Indexed: 12/29/2022]
Affiliation(s)
- Marcelo M. Valença
- Neurology and Neurosurgery Unit, Department of Neuropsychiatry; Federal University of Pernambuco; Brazil
- Neurology and Neurosurgery Unit; Hospital Esperança; Brazil
| | - Daniella A. de Oliveira
- Neurology and Neurosurgery Unit, Department of Neuropsychiatry; Federal University of Pernambuco; Brazil
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dos Santos LDFC, de Andrade SC, Nogueira GEC, Leão JC, de Freitas PM. Phototherapy on the Treatment of Burning Mouth Syndrome: A Prospective Analysis of 20 Cases. Photochem Photobiol 2015; 91:1231-6. [PMID: 26138316 DOI: 10.1111/php.12490] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 06/02/2015] [Indexed: 11/29/2022]
Abstract
The aim of this study was to report the effect of laser phototherapy (LPT) on the treatment of burning mouth syndrome (BMS). This prospective clinical study reports on preliminary outcomes of twenty volunteers diagnosed with BMS who have undergone the conventional treatment prior to laser phototherapy. LPT consisted of weekly sessions of LPT (660 nm), for a period of 10 weeks. The laser protocol consisted of the following parameters: 40 mW, 10 J cm(2) and 0.4 J per point, irradiation time of 10 s. In all sessions, the burning intensity was evaluated with a 10 cm Visual Analogue Scale (VAS). The burning intensity evaluation by VAS was performed immediately before and after each LPT session. Nonparametric test of Wilcoxon was used for statistical analysis, considering a significance level of 5%. All volunteers reported reduced burning intensity in all sessions when compared to the previous one and reduction in VAS scores by up to 49% in the last clinical session when compared to the first session. When only the VAS baseline of the first session was compared with the consecutive sessions, there was a statistically significant reduction in VAS scores in almost all sessions. The LPT may be an alternative treatment for the relief of oral burning symptoms in patients with BMS.
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Affiliation(s)
| | - Samantha C de Andrade
- Departamento de Clínica e Odontologia Preventiva, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brasil
| | - Gessé E C Nogueira
- Instituto de Pesquisas Energéticas e Nucleares, Centro de Lasers e Aplicações, São Paulo, SP, Brasil
| | - Jair C Leão
- Departamento de Clínica e Odontologia Preventiva, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brasil
| | - Patrícia M de Freitas
- Laboratório Especial de Lasers em Odontologia (LELO), Departamento de Dentística, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, SP, Brasil
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Kolkka-Palomaa M, Jääskeläinen SK, Laine MA, Teerijoki-Oksa T, Sandell M, Forssell H. Pathophysiology of primary burning mouth syndrome with special focus on taste dysfunction: a review. Oral Dis 2015; 21:937-48. [DOI: 10.1111/odi.12345] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 04/13/2015] [Accepted: 04/19/2015] [Indexed: 12/16/2022]
Affiliation(s)
- M Kolkka-Palomaa
- Department of Oral and Maxillofacial Diseases; Turku University Hospital; Turku Finland
| | - SK Jääskeläinen
- Department of Clinical Neurophysiology; Turku University Hospital; Turku Finland
- Department of Clinical Neurophysiology; University of Turku; Turku Finland
| | - MA Laine
- Institute of Dentistry; University of Turku; Turku Finland
| | - T Teerijoki-Oksa
- Department of Oral and Maxillofacial Diseases; Turku University Hospital; Turku Finland
| | - M Sandell
- Functional Foods Forum; University of Turku; Turku Finland
- Food Chemistry and Food Development; Department of Biochemistry; University of Turku; Turku Finland
| | - H Forssell
- Institute of Dentistry; University of Turku; Turku Finland
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Peculiar alexithymic traits in burning mouth syndrome: case-control study. Clin Oral Investig 2015; 19:1799-805. [PMID: 25677240 DOI: 10.1007/s00784-015-1416-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/29/2015] [Indexed: 12/30/2022]
Abstract
OBJECTIVES The present case-control study aims to assess the occurrence of alexithymic traits in burning mouth syndrome (BMS) subjects and to correlate alexithymic traits to anxious and depressive traits in BMS subjects. MATERIALS AND METHODS Prospectively enrolled BMS and control subjects were administered the 20-item Toronto Alexithymia Scale (TAS-20). Anxiety and depressive traits were assessed using the Hamilton Anxiety Rating Scale and the Montgomery and Asberg Depression Rating Scale. Occurrence of alexithymic traits was compared between BMS and control subjects. Correlation tests were used to measure the importance of alexithymic traits related to demographic characteristics, pain intensity (VAS score), and to the other psychometric scores. RESULTS Fifty-eight BMS subjects (46 females and 12 males) had a mean TAS-20 score significantly higher when compared to controls (p < 0.001; r = 0.72), corresponding to an occurrence rate of alexithymic traits of 79.3 versus 6.9%. Alexithymic traits in BMS subjects were just related to depressive traits (p = 0.02; ρ = 0.31). CONCLUSIONS The high occurrence of alexithymia in BMS is an adjunctive issue in favor of its multifactorial pathogenesis, with a not negligible role for somatization. CLINICAL RELEVANCE Clinicians should be aware of the high occurrence of alexithymic traits among BMS subjects as such traits may affect the doctor-patient relationship.
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de Souza FTA, Kummer A, Silva MLV, Amaral TMP, Abdo EN, Abreu MHNG, Silva TA, Teixeira AL. The association of openness personality trait with stress-related salivary biomarkers in burning mouth syndrome. Neuroimmunomodulation 2015; 22:250-5. [PMID: 25322841 DOI: 10.1159/000367714] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 08/20/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Burning mouth syndrome (BMS) is a chronic disorder defined as a burning sensation in the oral mucosa without evidence of pathological findings. Its pathophysiology is largely unknown, but psychiatric disorders and personality traits have been implicated. OBJECTIVE This study investigated whether there is any association between salivary biomarkers and personality traits in BMS patients. METHODS It was a cross-sectional, controlled study that evaluated 30 individuals with BMS and 32 controls. All subjects were assessed with a structured psychiatric interview (Mini International Neuropsychiatric Interview) and the Big Five inventory. Salivary levels of brain-derived neurotrophic factor (BDNF), neural growth factor, tumor necrosis factor-α, interleukin (IL)-6, IL-10 and cortisol were determined. RESULTS We found that BMS patients exhibited more traits of neuroticism and lower openness than controls. Openness showed a moderate and negative correlation with cortisol, BDNF and IL-6. CONCLUSION Personality traits are associated with salivary biomarkers in BMS.
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Affiliation(s)
- Fabrício T A de Souza
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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Forssell H, Jääskeläinen S, List T, Svensson P, Baad-Hansen L. An update on pathophysiological mechanisms related to idiopathic oro-facial pain conditions with implications for management. J Oral Rehabil 2014; 42:300-22. [DOI: 10.1111/joor.12256] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2014] [Indexed: 01/03/2023]
Affiliation(s)
- H. Forssell
- Department of Oral and Maxillofacial Surgery; Institute of Dentistry; University of Turku; Turku Finland
| | - S. Jääskeläinen
- Department of Clinical Neurophysiology; University of Turku and Turku University Hospital; Turku Finland
| | - T. List
- Department of Orofacial Pain and Jaw Function; Faculty of Odontology; Malmö University; Malmö Denmark
- Department of Rehabilitation Medicine; Skåne University Hospital; Lund Denmark
- Scandinavian Center for Orofacial Neuroscience (SCON); Aarhus University; Aarhus Denmark
| | - P. Svensson
- Scandinavian Center for Orofacial Neuroscience (SCON); Aarhus University; Aarhus Denmark
- Section of Clinical Oral Physiology; Department of Dentistry; HEALTH; Aarhus University; Aarhus Denmark
| | - L. Baad-Hansen
- Scandinavian Center for Orofacial Neuroscience (SCON); Aarhus University; Aarhus Denmark
- Section of Clinical Oral Physiology; Department of Dentistry; HEALTH; Aarhus University; Aarhus Denmark
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22
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Suicidal behavior in a patient with burning mouth syndrome. Case Rep Psychiatry 2014; 2014:405106. [PMID: 25247103 PMCID: PMC4160603 DOI: 10.1155/2014/405106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 08/17/2014] [Indexed: 11/23/2022] Open
Abstract
Introduction. Chronic pain of the oral cavity is a long-term condition and like all other types of chronic pain is associated with numerous comorbidities such as depression or anxiety. Case Presentation. This is a case of a 93-year-old patient suffering from chronic oral cavity pain who repeatedly stabbed his palate due to ongoing local pain, over the last few months, which he could not further tolerate. The patient was suffering from depression and also a diagnosis of “burning mouth syndrome” (BMS) was made. Discussion. Burning mouth syndrome (BMS) is characterized by a burning sensation in the tongue or other oral sites. BMS has high psychiatric comorbidity but can occur in the absence of psychiatric diagnosis. Patients with multiple forms of pain must be considered as potential candidates for underdiagnosed depression (major) and suicidal thoughts.
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Gupta D, Sheikh S, Pallagatti S, Kasariya K, Buttan A, Gupta M. Burning Mouth Syndrome due to Television Moans, an Enigma for Oral Physician: Treatment with Counseling. J Dent Res Dent Clin Dent Prospects 2014; 8:118-22. [PMID: 25093058 PMCID: PMC4120905 DOI: 10.5681/joddd.2014.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Accepted: 02/16/2014] [Indexed: 11/17/2022] Open
Abstract
Burning mouth syndrome (BMS) is a relatively common disease that can severely affect the quality of life of the patient. It causes chronic orofacial pain or oral burning sensation even in the absence of any detectable organic cause. The etiology of BMS is complex and multifactorial. It has been associated with menopause, trigger events and even genetic polymorphisms. Although its etiology remains unclear, there is still much evidence that psychological elements like stress, anxiety or depression do play a significant role. There are several studies in the literature which only report the association of BMS with psychological factors. But to the best of our knowledge, there is no such case reported in the literature which has actually highlighted the management of such a case with psychogenic elements involved. In this case report, apart from discussing the role of psychological factors, the treatment of BMS with emphasis on counseling is also emphasized. Further, it is of interest to know that such patients with psychologically induced burning mouth syndrome have to be evaluated to their deepest details. Even their commonly overlooked gestures and habits like watching a particular television soap opera may be involved in their disease process. It can be concluded that psychological counseling in general dental practice can provide an effective cure for chronic oral burning sensation with psychological factors involved.
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Affiliation(s)
- Deepak Gupta
- Senior Lecturer, Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India
| | - Soheyl Sheikh
- Professor and Head of the Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India
| | - Shambulingappa Pallagatti
- Senior Lecturer, Department of Conservative Dentistry and Endodontics, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India
| | - Kartikaya Kasariya
- Senior Lecturer, Department of Periodontics, Sardar Patel Post Graduate Institute of Dental and Medical Sciences and Research, Lucknow, Uttar Pra-desh, India
| | - Amit Buttan
- Physician, DNB Anesthesia, Kasturba Hospital, Daryaganj, New Delhi, India
| | - Maqul Gupta
- Family Physician, Appolo Hospital, Ludhiana, Punjab, India
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Ślebioda Z, Szponar E. Burning mouth syndrome - a common dental problem in perimenopausal women. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2014; 13:198-202. [PMID: 26327855 PMCID: PMC4520363 DOI: 10.5114/pm.2014.43825] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 03/20/2014] [Accepted: 05/29/2014] [Indexed: 01/14/2023]
Abstract
Burning mouth syndrome (BMS) is characterized by the presence of burning, paresthesia or pain of the oral mucosa in the absence of pathologic lesions revealed during the clinical examination. Moreover, the pain may be accompanied by oral dryness, hypersensitivity to some food compounds and taste disorders. Etiopathogenesis of this condition remains unclear. Potential local causative factors include among the others mechanical irritation, parafunctions and dysfunctions of the stomatognathic system, contact allergy to dental materials and electro-galvanic phenomena. Potential systemic causes include diabetes mellitus, B group vitamin deficiency (vitamins B1, B2, B6 and B12), folic acid and iron deficiency, hormonal imbalance, gastrointestinal diseases, psychiatric and neurological disorders and drug-induced side effects. The hypothesis concerning the role of hormonal changes in the development of BMS seems to be confirmed by a high incidence of this condition in perimenopausal women. Up to now, due to an unclear etiology of the disease, the treatment is very often ineffective and mainly symptomatic, which may exacerbate patient's anxiety and discomfort. In this paper we present the main etiologic factors of the burning mouth syndrome. We discuss the basic diagnostic and therapeutic methods and the influence of hormonal replacement therapy on the course of BMS based on the current medical reports.
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Affiliation(s)
- Zuzanna Ślebioda
- Department of Oral Mucosa Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Elżbieta Szponar
- Department of Oral Mucosa Diseases, Poznan University of Medical Sciences, Poznan, Poland
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Abstract
Burning mouth syndrome (BMS) is a chronic condition that is characterized by burning symptoms of the oral mucosa without obvious clinical examination findings. This syndrome has complex characteristics, but its cause remains largely enigmatic, making treatment and management of patients with BMS difficult. Despite not being accompanied by evident organic changes, BMS can significantly reduce the quality of life for such patients. Therefore, it is incumbent on dental professionals to diagnose and manage patients with BMS as a part of comprehensive care.
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Affiliation(s)
- Jaisri R Thoppay
- College of Graduate Studies, Georgia Regents University, 1430 John Wesley Gilbert Drive, Augusta, GA 3091, USA
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Mendak-Ziółko M, Konopka T, Bogucki ZA. Evaluation of select neurophysiological, clinical and psychological tests for burning mouth syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 114:325-32. [PMID: 22862972 DOI: 10.1016/j.oooo.2012.04.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2011] [Revised: 03/23/2012] [Accepted: 04/01/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The objective of this study was to identify, among an array of potential risk factors for burning mouth syndrome (BMS), those that are potentially the most significant in the development of the disease. STUDY DESIGN Sixty-three participants, divided into group I (with BMS: 33 patients ages 41 to 82 years [mean age: 61.5 ± 9.4]) and group II (without BMS: 30 healthy volunteers ages 42-83 years [mean age: 60.5 ± 10.5]) were studied. All underwent a dental examination and psychological tests. Neurological tests (neurophysiological test, electroneurography, and tests of the autonomic nervous system) were performed. Mean parameters were analyzed by Student t test, Kruskal-Wallis test, and χ(2) test, and multifactor analysis was performed with logistic regression and by calculating the odds ratio. RESULTS In the logistic regression test, 3 factors were significant in the etiopathogenesis of BMS: a value more than 39 μV for the amplitude of the positive peak of the potential induced by stimulating the trigeminal nerve on the left side (P2-L); a value above 5.96 ms for the latency of wave V of the brainstem auditory evoked potentials on the right side (V-R); and a value over 2.35 ms for the latency of the sensory ulnar nerve response. CONCLUSIONS The BMS sufferer was characterized as having mild sensory and autonomic small fiber neuropathy with concomitant central disorders.
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Abstract
Pain in the tongue or oral tissues described as "burning" has been referred to by many terms including burning mouth syndrome. When a burning sensation in the mouth is caused by local or systemic factors, it is called secondary burning mouth syndrome and when these factors are treated the pain will resolve. When burning mouth syndrome occurs in the absence of identified risk indicators, the term primary burning mouth syndrome is utilized. This article focuses on descriptions, etiologic theories, and management of primary burning mouth syndrome, a condition for which underlying causative agents have been ruled out.
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Affiliation(s)
- Heidi C Crow
- Department of Oral Diagnostic Sciences, University at Buffalo, 355 Squire Hall, 3435 Main Street, Buffalo, NY 14214, USA.
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Kossioni AE, Kossionis GE, Polychronopoulou A. Self-reported oral complaints in older mentally ill patients. Geriatr Gerontol Int 2012; 13:358-64. [PMID: 22762860 DOI: 10.1111/j.1447-0594.2012.00907.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to investigate the prevalence of self-reported oral complaints in older hospitalized mentally ill patients and relate them to the primary psychiatric diagnosis. METHODS A total of 89 older hospitalized psychiatric patients consented to participate in the study, and were interviewed and clinically examined. The medical data were obtained from the hospital's medical records. RESULTS The mean age of the patients was 73 years (range 59-94 years). A total of 54% suffered from psychotic disorders, 26% from dementia and 20% from mood disorders. The most common oral complaint was xerostomia (45%), followed by dysgeusia (28%), oral malodor (26%), pain when chewing (25%), burning mouth (23%), chewing difficulties (12%) and sialorrhoea (2%). The prevalence of burning mouth, dysgeusia and oral malodor differed significantly among psychiatric diagnoses and was increased in patients with mood disorders. A close association was recorded between burning mouth, dysgeusia, xerostomia and oral malodor complaints. Stepwise logistic regression showed that the use of antidepressants and burning mouth complaints were significantly associated with mood disorders. CONCLUSIONS An increased prevalence of oral complaints was recorded in the elderly psychiatric patients with mood disorders. Those patients should be systematically evaluated and managed for oral complaints, and particularly for burning mouth. The close association between burning mouth complaints and mood disorders requires further investigation to clarify the potential diagnostic value of the symptom for mood disorders.
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Schiavone V, Adamo D, Ventrella G, Morlino M, De Notaris EB, Ravel MG, Kusmann F, Piantadosi M, Pollio A, Fortuna G, Mignogna MD. Anxiety, Depression, and Pain in Burning Mouth Syndrome: First Chicken or Egg? Headache 2012; 52:1019-25. [DOI: 10.1111/j.1526-4610.2012.02171.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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de Souza FTA, Teixeira AL, Amaral TMP, dos Santos TPM, Abreu MHNG, Silva TA, Kummer A. Psychiatric disorders in burning mouth syndrome. J Psychosom Res 2012; 72:142-6. [PMID: 22281456 DOI: 10.1016/j.jpsychores.2011.11.008] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 11/08/2011] [Accepted: 11/11/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND Prevalence of psychiatric disorders in burning mouth syndrome (BMS) is high, but their role in the pathogenesis of BMS remains unclear. OBJECTIVE The authors aimed to assess the frequency of psychiatric disorders and the severity of psychopathology in BMS. METHODS Thirty BMS patients and thirty-one controls underwent a psychiatric evaluation which included a structured interview (MINI-Plus) and five psychometric scales. A Visual Analogue Scale (VAS) was used to measure the intensity of burning sensation. RESULTS Patients with BMS showed a higher frequency of current major depressive disorder, past major depressive disorder, generalized anxiety disorder, hypochondria and cancerophobia (p<0.05). In BMS patients, generalized anxiety disorder was significantly associated with current major depression and social phobia (p<0.05). As expected, cancerophobia was significantly associated with hypochondria (p<0.05). Patients with BMS had higher scores in Hamilton Rating Scale for Depression (HRSD), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI) and Dutch Fatigue Scale (DUFS) (p<0.05). CONCLUSION BMS patients may have a particular psychological and/or psychiatric profile. Psychometric scales might be useful in screening psychiatric disorders, as well as for assessment of treatment outcomes. In the presence of clinical relevant psychiatric symptoms, patients must be treated appropriately.
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Affiliation(s)
- Fabrício T A de Souza
- Dept. of Oral Pathology, School of Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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Carbone M, Pentenero M, Carrozzo M, Ippolito A, Gandolfo S. Lack of efficacy of alpha-lipoic acid in burning mouth syndrome: A double-blind, randomized, placebo-controlled study. Eur J Pain 2012; 13:492-6. [DOI: 10.1016/j.ejpain.2008.06.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2008] [Revised: 05/26/2008] [Accepted: 06/07/2008] [Indexed: 10/21/2022]
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Taiminen T, Kuusalo L, Lehtinen L, Forssell H, Hagelberg N, Tenovuo O, Luutonen S, Pertovaara A, Jääskeläinen S. Psychiatric (axis I) and personality (axis II) disorders in patients with burning mouth syndrome or atypical facial pain. Scand J Pain 2011; 2:155-160. [DOI: 10.1016/j.sjpain.2011.06.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Accepted: 06/20/2011] [Indexed: 10/17/2022]
Abstract
Abstract
Background and aims
Burning mouth syndrome (BMS) and atypical facial pain (AFP) are often persistent idiopathic pain conditions that mainly affect middle-aged and elderly women. They have both been associated with various psychiatric disorders. This study examined current and lifetime prevalence of psychiatric axis I (symptom-based) and II (personality) disorders in patients with chronic idiopathic orofacial pain, and investigated the temporal relationship of psychiatric disorders and the onset of orofacial pain.
Method
Forty patients with BMS and 23 patients with AFP were recruited from Turku university hospital clinics. Mean age of the patients was 62.3 years (range 35–84) and 90% were female. BMS and AFP diagnoses were based on thorough clinical evaluation, and all patients had undergone clinical neurophysiological investigations including blink reflex and thermal quantitative tests. Current and lifetime DSM-IV diagnoses of axis I and II disorders were made on clinical basis with the aid of SCID-I and II-interviews. The detected prevalence rates and their 95% confidence intervals based on binomial distribution were compared to three previous large population-based studies.
Results
Of the 63 patients, 26 (41.3%) had had an axis I disorder that preceded the onset of orofacial pain, and 33 (52.4%) had had a lifetime axis I disorder. Rate of current axis I disorders was 36.5%, indicating that only about 16% of lifetime disorders had remitted, and they tended to run chronic course. The most common lifetime axis I disorders were major depression (30.2%), social phobia (15.9%), specific phobia (11.1%), and panic disorder (7.9%). Twelve patients (19.0%) had at least one cluster C personality disorder already before the emergence of orofacial pain. Patients with cluster C personality disorders are characterized as fearful and neurotic. None of the patients had cluster A (characterized as odd and eccentric) or B (characterized as dramatic, emotional or erratic) personality disorders. The most common personality disorders were obsessive–compulsive personality (14.3%), dependent personality (4.8%), and avoidant personality (3.2%). The majority of the patients (54%) had also one or more chronic pain conditions other than orofacial pain. In almost all patients (94%) they were already present at the onset of orofacial pain.
Conclusions
Our results suggest that major depression, persistent social phobia, and neurotic, fearful, and obsessive–compulsive personality characteristics are common in patients with chronic idiopathic orofacial pain. Most psychiatric disorders precede the onset of orofacial pain and they tend to run a chronic course.
Implications
We propose that the high psychiatric morbidity, and comorbidity to other chronic pain conditions, in chronic idiopathic orofacial pain can be best understood in terms of shared vulnerability to both chronic pain and specific psychiatric disorders, most likely mediated by dysfunctional brain dopamine activity.
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Affiliation(s)
- Tero Taiminen
- Department of Psychiatry , Turku University Hospital , Turku , Finland
| | - Laura Kuusalo
- Department of Psychiatry , Turku University Hospital , Turku , Finland
| | - Laura Lehtinen
- Department of Psychiatry , Turku University Hospital , Turku , Finland
| | - Heli Forssell
- Department of Oral Diseases , Turku University Hospital , Turku , Finland
| | - Nora Hagelberg
- Department of Anesthesiology, Intensive Care, Emergency Care and Pain Medicine , Turku University Hospital , Turku , Finland
| | - Olli Tenovuo
- Department of Neurology , Turku University Hospital , Turku , Finland
| | - Sinikka Luutonen
- Department of Psychiatry , Turku University Hospital , Turku , Finland
| | - Antti Pertovaara
- Department of Physiology, Institute of Biomedicine , University of Helsinki , Helsinki , Finland
| | - Satu Jääskeläinen
- Department of Clinical Neurophysiology , Turku University Hospital , Turku , Finland
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Souza FTA, Santos TPM, Bernardes VF, Teixeira AL, Kümmer AM, Silva TA, Abreu MHNG. The impact of burning mouth syndrome on health-related quality of life. Health Qual Life Outcomes 2011; 9:57. [PMID: 21801374 PMCID: PMC3158539 DOI: 10.1186/1477-7525-9-57] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Accepted: 07/29/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Burning mouth syndrome is a chronic disorder that is characterized by a burning sensation and a normal clinical appearance of the oral mucosa. This condition often affects the health-related quality of life in patients. As such, the aim of this study was to compare the health-related quality of life of patients with BMS and healthy controls, using the validated Portuguese versions of the SF-36 and OHIP-49 questionnaires. METHODS A calculated sample of Brazilian patients with BMS (n = 26) was compared with a control group (n = 27), paired for gender and age. Sociodemographic information and clinical characteristics were obtained, and interviews were conducted using the SF-36 and OHIP-49. To evaluate the normality of the variables, we used the Kolmogorov-Smirnov test. The chi-square test, Fisher exact test and Mann-Whitney U-Test were used to compare sociodemographic and clinical characteristics of individuals with BMS and controls Mann-Whitney U-test were carried out to compare SF-36 and OHIP-49 between BMS patients and controls. The significance level was set at 0.05. To compare the dimensions of the SF-36 and OHIP-49 between BMS patients and controls, we considered Bonferroni correction. So for comparison of the dimensions, the significance level was set at 0.00625 for SF-36 and at 0.00714 for OHIP-49. RESULTS The clinical and demographic data were similar in both groups (P > 0.05). SF-36 scores were significantly lower in all domains for patients with BMS (P < 0.00625). OHIP-49 scores were higher for individuals with BMS (P < 0.00714). CONCLUSIONS BMS has a negative impact on the health-related quality of life of individuals, as can be shown by instruments such as the SF-36 and OHIP-49. So, the evaluation of quality of life might be useful for more information about the nature and severity of BMS, to evaluate the effects of treatment protocols, in order to improve their outcomes by means a humanized clinical practice.
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Affiliation(s)
- Fabrício T A Souza
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Burning mouth syndrome and mast cell activation disorder. ACTA ACUST UNITED AC 2011; 111:465-72. [PMID: 21420635 DOI: 10.1016/j.tripleo.2010.11.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2010] [Revised: 11/23/2010] [Accepted: 11/29/2010] [Indexed: 11/20/2022]
Abstract
Burning mouth syndrome (BMS), a chronic diffuse oral pain syndrome affecting ∼1% of the general population, is diagnosed when explanatory oral pathology and other identifiable causes are absent. BMS has been recognized for decades, but its etiology remains unknown and has not previously been attributed to mast cell disease. Three cases of BMS are reported in which evidence of an underlying mast cell activation disorder (MCAD) was found; all 3 patients' oral pain responded well to MCAD-directed therapy. Mediators released from mast cells have a wide range of local and remote effects and potentially may cause the neuropathic changes and/or inflammation thought to lead to the symptoms of BMS. Mast cell disease either in oral tissue or at sites remote from the mouth should be considered in the differential diagnosis of BMS.
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Minor JS, Epstein JB. Burning mouth syndrome and secondary oral burning. Otolaryngol Clin North Am 2011; 44:205-19, vii. [PMID: 21093630 DOI: 10.1016/j.otc.2010.09.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Burning mouth syndrome is a complex disorder of unclear etiology that is most prevalent in perimenopausal women. It is often accompanied by dysguesia and subjective xerostomia. Recent evidence implicates both central and peripheral neuropathies, possibly representing a phantom pain syndrome in some patients. Ensuring that the patient's oral burning is not secondary to some other local or systemic factor is central to appropriate management. Current standard therapies include clonazepam, paroxetine, and cognitive behavioral therapy, and several promising new alternatives are described.
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Affiliation(s)
- Jacob S Minor
- Department of Otolaryngology, University of Colorado at Denver, Denver, CO 80045, USA.
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Mignogna MD, Adamo D, Schiavone V, Ravel MG, Fortuna G. Burning mouth syndrome responsive to duloxetine: a case report. PAIN MEDICINE 2011; 12:466-9. [PMID: 21223496 DOI: 10.1111/j.1526-4637.2010.01035.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Burning mouth syndrome (BMS) is a chronic, idiopathic, intraoral mucosal pain condition in the absence of specific oral lesions and systemic disease. Among evidence-based pharmacological treatments for this disorder, topical and systemic clonazepam, levosulpiride, selective serotonin reuptake inhibitors have been used with partial results. CASE We report a case of a 65-year-old otherwise healthy woman with a 3-year history of oral burning. Clinical and laboratory evaluations allowed us to make a diagnosis of burning mouth syndrome. She was treated with duloxetine (60 mg p.o. qd), a selective serotonin, and norepinephrine reuptake inhibitor, obtaining a complete remission of symptoms, evaluated via standardized clinical rating scales, and an improvement of her quality of life and level of functioning. DISCUSSION The pathogenesis of BMS still remains unclear. Recently, it has been suggested an underlying neuropathic mechanism, demonstrating a dysfunction in the trigeminal nociceptive pathways at peripheral and/or central nervous system level. The rationale behind the administration of duloxetine resides in its central mechanism of action, and analgesic effects previously demonstrated in diabetic peripheral neuropathy, and fibromyalgia. Also, it has been shown to reduce painful physical symptoms associated with depression. CONCLUSION We hypothesize that duloxetine might represent a useful, effective, and additional therapeutic option in the treatment of BMS.
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Affiliation(s)
- Michele D Mignogna
- Oral Medicine Unit, Department of Odontostomatological and Maxillofacial Sciences, Federico II University of Naples, Naples, Italy.
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Van Heerden WFP, Van Zyl AW. Burning mouth syndrome. S Afr Fam Pract (2004) 2011. [DOI: 10.1080/20786204.2011.10874053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- WFP Van Heerden
- Department of Oral Pathology and Oral Biology, School of Dentistry, University of Pretoria, South Africa
| | - AW Van Zyl
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Pretoria, South Africa
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Takenoshita M, Sato T, Kato Y, Katagiri A, Yoshikawa T, Sato Y, Matsushima E, Sasaki Y, Toyofuku A. Psychiatric diagnoses in patients with burning mouth syndrome and atypical odontalgia referred from psychiatric to dental facilities. Neuropsychiatr Dis Treat 2010; 6:699-705. [PMID: 21127687 PMCID: PMC2987502 DOI: 10.2147/ndt.s12605] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Burning mouth syndrome (BMS) and atypical odontalgia (AO) are two conditions involving chronic oral pain in the absence of any organic cause. Psychiatrically they can both be considered as "somatoform disorder". From the dental point of view, however, the two disorders are quite distinct. BMS is a burning or stinging sensation in the mouth in association with a normal mucosa whereas AO is most frequently associated with a continuous pain in the teeth or in a tooth socket after extraction in the absence of any identifiable cause. Because of the absence of organic causes, BMS and AO are often regarded as psychogenic conditions, although the relationship between oral pain and psychologic factors is still unclear. Some studies have analyzed the psychiatric diagnoses of patients with chronic oral pain who have been referred from dental facilities to psychiatric facilities. No study to date has investigated patients referred from psychiatric facilities to dental facilities. OBJECTIVE To analyze the psychiatric diagnoses of chronic oral pain patients, diagnosed with BMS and AO, and referred from psychiatric facilities to dental facilities. STUDY DESIGN Psychiatric diagnoses and disease conditions of BMS or AO were investigated in 162 patients by reviewing patients' medical records and referral forms. Psychiatric diagnoses were categorized according to the International Statistical Classification of Disease and Related Health Problems, Tenth Revision. RESULTS The proportion of F4 classification (neurotic, stress-related, and somatoform disorders) in AO patients was significantly higher than in BMS patients. BMS patients were more frequently given a F3 classification (mood/affective disorders). However, 50.8% of BMS patients and 33.3% of AO patients had no specific psychiatric diagnoses. CONCLUSION Although BMS and AO are both chronic pain disorders occurring in the absence of any organic cause, the psychiatric diagnoses of patients with BMS and AO differ substantially.
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Affiliation(s)
- Miho Takenoshita
- Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
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Abstract
OBJECTIVE To investigate the clinical features of burning mouth syndrome (BMS) in a large cohort of patients and to correlate them with the results of tongue biopsy. METHODS We screened 98 patients complaining of oral burning pain for at least 6 months. Forty-two patients were excluded after screening for contact sensitivity to dental materials, food allergies, tongue injuries, malignancies, connective tissue and metabolic disorders, oral infectious diseases, vitamin deficiencies, and other systemic diseases known to cause neuropathy. Fifty-six patients underwent neurologic examination and assessment of pain intensity, depression, anxiety, quality of sleep, and quality of life. Tongue biopsy with the quantification of epithelial nerve fibers (ENF) was performed in 51 patients. RESULTS Compared with 9 healthy participants (4.13+/-1.85 SD), epithelial innervation density was significantly reduced in 38 patients (1.35+/-1.46 SD; P<0.0001) and normal in 13 patients (6.1+/-2.19 SD). The clinical features differed in the two groups: patients with reduced ENF density complained of pain in the whole tongue, lips, hard palate, and alveolar ridges, reported dysgeusia and xerostomia in 29% of cases (P<0.001), and 24% of them were depressed. Patients with normal innervation complained of pain on the tip of the tongue, reported dysgeusia and xerostomia in 7.7% of cases, and 54% of them were depressed (P<0.017). DISCUSSION The diagnostic criteria for BMS are not defined yet and the relationship with depression and anxiety is debated. We proposed a biopsy-supported approach for the diagnosis. Our study shows that BMS can present with two distinct clinical pictures and that tongue biopsy can contribute to the assessment of the diagnosis. Mood disorders occur frequently and should be considered when approaching patients and treatment options. These observations could help physicians in identifying patients with BMS and addressing them with the appropriate diagnostic work-up and treatment.
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Bakhtiari S, Khalighi HR, Azimi S, Alavi K, Ayoobi Valoogerdi H, Namazi Z. Correlation between Burning Mouth Syndrome and Anxiety in the Elderly Inmates of Sanitaria in Tehran. J Dent Res Dent Clin Dent Prospects 2010; 4:37-41. [PMID: 22991594 PMCID: PMC3429973 DOI: 10.5681/joddd.2010.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Accepted: 02/24/2010] [Indexed: 11/17/2022] Open
Abstract
Background and aims
Burning mouth syndrome (BMS) is a chronic pain disorder characterized by a chief complaint of oral burning/pain with no clinically observable oral mucosal lesions. The prevalence of BMS has been reported to be 2.5-5.1% in the general population and several psychological disorders have been reported as associated or predisposing factors for BMS. The aim of this study was to determine the correlation between BMS and anxiety in the elderly residents of sani-taria in Tehran, Iran.
Materials and methods
In a cross-sectional analytical study, 50 patients with BMS were included along with 50 healthy individuals as controls. Inclusion criteria were: age over 60 years, burning sensation in the mouth, normal oral mu-cosa, absence of diabetes, satisfactory prosthesis, absence of iron deficiency and other nutrients, and no heavy smoking habits. Similar inclusion criteria were considered for the control group without any oral complaints. Burning/pain severity was assessed by a 100-mm visual analog scale and the severity of anxiety (state, trait, and total) was determined by Cattell's Anxiety Scale. Data was analyzed by t-test and Pearson's correlation coefficient.
Results
Individuals with BMS assessed their burning/pain severity to be 27.4 mm (95% CI=25.2 - 29.6 mm). Standard-ized total anxiety scale in individuals with and without BMS (±SE for mean) was 5.9±0.2 and 4.6±0.3 with significant dif-ferences (p=0.001). Similar significant differences were observed in state and trait anxiety between the two groups.
Conclusion It seems that both state and trait anxiety are associated with burning mouth syndrome.
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Affiliation(s)
- Sedighe Bakhtiari
- Assistant Professor, Department of Oral Medicine, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
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Balasubramaniam R, Klasser GD, Delcanho R. Separating oral burning from burning mouth syndrome: unravelling a diagnostic enigma. Aust Dent J 2009; 54:293-9. [DOI: 10.1111/j.1834-7819.2009.01153.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Miziara ID, Filho BCA, Oliveira R, Rodrigues dos Santos RM. Group psychotherapy: an additional approach to burning mouth syndrome. J Psychosom Res 2009; 67:443-8. [PMID: 19837207 DOI: 10.1016/j.jpsychores.2009.01.013] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2007] [Revised: 12/19/2008] [Accepted: 01/28/2009] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Glossodynia or burning mouth syndrome (BMS) is a common and poorly understood disorder. Its treatment is uncertain. Otherwise, there is some evidence of the importance of psychological factors in the genesis of this disease. OBJECTIVES Verify the usefulness of group psychotherapy as an adjuvant therapeutic method in the treatment of BMS. CASUISTICS AND METHODS: The study group consisted of 64 consecutive patients with a clinical diagnosis of BMS seen at the Stomatology Outpatient Clinic, ENT Department, Sao Paulo University Medical School, between May 2002 and May 2007. All the patients were submitted to physical examination, laboratorial screening tests, psychological assessment (Crown-Crisp Experimental Inventory), and answered a short form of the McGill Pain Questionnaire. Only 44 patients who did not show any abnormality in the protocol exams entered the study. Twenty-four of them underwent group psychotherapy. Twenty patients received placebo. Chi-square test was applied to compare the results of treatment with or without psychotherapy. RESULTS There were 15 men and 29 women in the study group. Tongue burning was the main complaint of the patients. Improvement of symptoms was reported by 17 (70.8%) of the patients undergoing psychotherapy, while among those who did not eight (40%) had improvement of symptoms (P=.04). CONCLUSION Psychological assessment demonstrated a close correlation between symptoms and psychological factors, suggesting that group psychotherapy is an important alternative to conventional treatment methods.
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Affiliation(s)
- Ivan Dieb Miziara
- Division of Otorhinolaryngology, University Hospital of the Faculty ofMedicine, University of São Paulo, São Paulo - SP - Brazil.
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Salivary dehydroepiandrosterone (DHEA) levels in patients with the complaint of burning mouth: a case-control study. ACTA ACUST UNITED AC 2009; 108:537-43. [DOI: 10.1016/j.tripleo.2009.06.022] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2009] [Revised: 06/27/2009] [Accepted: 06/27/2009] [Indexed: 11/19/2022]
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Abstract
Burning mouth syndrome (BMS) is a chronic disease characterized by burning of the oral mucosa associated with a sensation of dry mouth and/or taste alterations. BMS occurs more frequently among postmenopausal women. The pathophysiology of the disease is still unknown, and evidence is conflicting; although some studies suggest a central origin, others point to a peripheral neuropathic origin. The efficacy of some medications in the treatment of BMS suggests that the dopaminergic system may be involved.
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Anxiety and salivary cortisol levels in patients with burning mouth syndrome: case-control study. ACTA ACUST UNITED AC 2008; 105:460-5. [DOI: 10.1016/j.tripleo.2007.10.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2006] [Revised: 09/16/2007] [Accepted: 10/03/2007] [Indexed: 11/18/2022]
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Sardella A, Lodi G, Demarosi F, Tarozzi M, Canegallo L, Carrassi A. Hypericum perforatum extract in burning mouth syndrome: a randomized placebo-controlled study. J Oral Pathol Med 2008; 37:395-401. [DOI: 10.1111/j.1600-0714.2008.00663.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Madrid C, Bouferrache K, Biollaz B, Möller P, Toma S. [Primary and secondary stomatodynia: a difficult diagnosis]. ANNALES D'OTO-LARYNGOLOGIE ET DE CHIRURGIE CERVICO FACIALE : BULLETIN DE LA SOCIETE D'OTO-LARYNGOLOGIE DES HOPITAUX DE PARIS 2007; 124 Suppl 1:S56-S67. [PMID: 18047866 DOI: 10.1016/s0003-438x(07)80012-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Primary stomatodynia involves mainly women after menopause presenting somatization, depression and anxiety at values higher than control subjects. This chronic pain is often an intense burning pain beginning in the tongue the entire oral cavity, increasing in intensity through the day with a high level of emotional after effects. These patients often describe two associated symptoms: mouth dryness sensation and altered taste. The causes remain uncertain. The participation of female sexual hormones and neuropathic factors has been suggested possibly through a sensory neuropathy of small fibers of the oral mucosa. Normal clinical examinations and non clinical tests differentiate primary from secondary stomatodynia. The management consists in using low doses of topical clonazepam without swallowing or systemic clonazepam. The association of this drug with tricyclic antidepressants has given variable results. A cognitive behavioural management has been successfully attempted.
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Affiliation(s)
- C Madrid
- Service de stomatologie et de médecine dentaire, Polyclinique médicale universitaire, Université de Lausanne, Suisse.
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Maltsman-Tseikhin A, Moricca P, Niv D. Burning Mouth Syndrome: Will Better Understanding Yield Better Management? Pain Pract 2007; 7:151-62. [PMID: 17559486 DOI: 10.1111/j.1533-2500.2007.00124.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
"Burning mouth syndrome" (BMS) refers to a chronic orofacial pain disorder usually unaccompanied by mucosal lesions or other clinical signs of organic disease. BMS is typically characterized by a continuous, spontaneous, and often intense burning sensation as if the mouth or tongue were scalded or on fire. Burning mouth syndrome is a relatively common condition. The estimated prevalence of BMS reported in recent studies ranges between 0.7 and 4.6% of the general population. About 1.3 million American adults, mostly women in the postmenopausal period, are afflicted with BMS. The etiology of this disorder is poorly understood even though new evidence for a possible neuropathic pathogenesis of idiopathic BMS is emerging. Burning mouth syndrome may present as an idiopathic condition (primary BMS type) distinct from the symptom of oral burning that can potentially arise from various local or systemic abnormalities (secondary BMS type), including nutritional deficiencies, hormonal changes associated with menopause, local oral infections, denture-related lesions, xerostomia, hypersensitivity reactions, medications, and systemic diseases including diabetes mellitus. In more than a third of patients, multiple, concurrent causes of BMS may be identified. It is important to note that the diagnosis of BMS should be established only after all other possible causes have been ruled out. Professional delay in diagnosing, referring, and appropriately managing of BMS patients occurs frequently. Treatment should be tailored to each patient and it is recommended to practice the treatment in a multidisciplinary facility. This article discusses our current understanding of the etiology and pathogenesis of BMS. The authors have tried to emphasize new pharmacological approaches to manage this challenging disorder.
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Affiliation(s)
- Alexander Maltsman-Tseikhin
- Center for Pain Medicine, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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