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Luo S, Lou F, Yan L, Dong Y, Zhang Y, Liu Y, Ji P, Jin X. Comprehensive analysis of the oral microbiota and metabolome change in patients of burning mouth syndrome with psychiatric symptoms. J Oral Microbiol 2024; 16:2362313. [PMID: 38835338 PMCID: PMC11149574 DOI: 10.1080/20002297.2024.2362313] [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: 12/07/2023] [Accepted: 05/27/2024] [Indexed: 06/06/2024] Open
Abstract
Background Burning mouth syndrome (BMS) is a chronic idiopathic facial pain with intraoral burning or dysesthesia. BMS patients regularly suffer from anxiety/depression, and the association of psychiatric symptoms with BMS has received considerable attention in recent years. The aims of this study were to investigate the potential interplay between psychiatric symptoms and BMS. Methods Using 16S rRNA sequencing and liquid chromatography-mass spectrometry (LC/MS) to evaluate the oral microbiota and saliva metabolism of 40 BMS patients [including 29 BMS patients with depression or anxiety symptoms (DBMS)] and 40 age matched healthy control (HC). Results The oral microbiota composition in BMS exhibited no significant differences from HC, although DBMS manifested decreased α-diversity relative to HC. Noteworthy was the discernible elevation in the abundance of proinflammatory microorganisms within the oral microbiome of individuals with DBMS. Parallel findings in LC/MS analyses revealed discernible disparities in metabolites between DBMS and HC groups. Principal differential metabolites were notably enriched in amino acid metabolism and lipid metabolism, exhibiting associations with infectious and immunological diseases. Furthermore, the integrated analysis underscores a definitive association between the oral microbiome and metabolism in DBMS. Conclusions This study suggests possible future modalities for better understanding the pathogenesis and personalized treatment plans of BMS.
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Affiliation(s)
- Shihong Luo
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Department of Oral Implantology, The Affiliated Stomatology Hospital of Southwest Medical University, Luzhou, China
| | - Fangzhi Lou
- College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Li Yan
- College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Yunmei Dong
- College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Yingying Zhang
- College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Yang Liu
- College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Ping Ji
- College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Xin Jin
- College of Stomatology, Chongqing Medical University, Chongqing, China
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He M, Huoshen W, Li X, Sun C. Salivary and serum biomarkers to evaluate psychological disorders in burning mouth syndrome: A systematic review and meta-analysis. J Oral Pathol Med 2024; 53:182-192. [PMID: 38438274 DOI: 10.1111/jop.13526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 01/26/2024] [Accepted: 02/16/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Burning mouth syndrome is a chronic pain syndrome mainly characterized by an intensive burning sensation of tongue. Previous studies have suggested that saliva/serum biomarkers in burning mouth syndrome might be associated with psychological disorders. The aim of systematic review was to observe whether the biomarkers in serum/saliva could be an alternative method to evaluate the psychological disorders in patients with burning mouth syndrome. MATERIALS AND METHODS The PubMed, Embase, and Cochrane Library databases were searched for papers published up to March 15, 2023. Risk of bias was measured by using the Newcastle-Ottawa Scale. RevMan was used for meta-analysis. RESULTS A total of 467 articles were screened, which of 12 studies were included. These studies collected 43 different biomarkers in saliva and 35 in serum. Of these biomarkers, only three (cortisol, α-amylase, and IL-6) were analyzed in two or more studies. Only salivary cortisol levels were significantly higher in the patient group compared to the controls (Mean Difference = 1.39; 95% CI [0.80-1.97]; p < 0.001). Moreover, cortisol might be relevant to psychological scores, especially anxiety. CONCLUSION Different papers have investigated salivary and serum biomarkers in burning mouth syndrome patients with controversial results. This meta-analysis showed that cortisol levels in saliva may be a potential biomarker to assess the psychological disorders in burning mouth syndrome patients.
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Affiliation(s)
- Mei He
- Department of Stomatology, Shenzhen Longhua District Central Hospital, Shenzhen, China
| | - Wuda Huoshen
- Department of Periodontics and Oral Mucosal Diseases, The Affiliated Stomatology Hospital of Southwest Medical University, Luzhou, China
| | - Xueqing Li
- Department of Periodontics and Oral Mucosal Diseases, The Affiliated Stomatology Hospital of Southwest Medical University, Luzhou, China
| | - Chen Sun
- Department of Periodontics and Oral Mucosal Diseases, The Affiliated Stomatology Hospital of Southwest Medical University, Luzhou, China
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Gholizadeh N, Sheykhbahaei N. Micronutrients status as a contributing factor in secondary burning mouth syndrome: A review of the literature. Health Sci Rep 2024; 7:e1906. [PMID: 38390354 PMCID: PMC10883099 DOI: 10.1002/hsr2.1906] [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: 09/03/2023] [Revised: 01/15/2024] [Accepted: 01/31/2024] [Indexed: 02/24/2024] Open
Abstract
Background and Aims Patients with burning mouth syndrome (BMS) experience an annoying feeling without clinical evidence of any mucosal lesion. Deficiency or excess of micronutrients is a common feature in secondary BMS. There is limited knowledge among oral healthcare providers regarding the significance of micronutrients in oral health, so the current review focuses on the critical role of these elements in oral health implications as secondary BMS. Methods For the data collection, the authors searched for key terms without time limitation (1900-2021) in databases comprised of PubMed, Google Scholar, Scopus, Web of Science (SCI), and Embase. Results The total number of matched articles with inclusion criteria involved in this review article was 59 original articles. Among these, 20 randomized clinical trials (RCT), 31 case-control or Crossectional, and 8 case reports/series are reviewed in this review article. Conclusion One of the important etiological factors in patients with secondary BMS is micronutrient imbalance. The iron, zinc, vitamin B family, vitamin D deficiency and increased levels of homocysteine and oxidant agents were examined in secondary BMS patients. In addition, oral medicine specialists must consider the possible toxic effects of some elements in restorations and dental prostheses. Further studies, such as RCTs in the future, are recommended.
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Affiliation(s)
- Narges Gholizadeh
- Department of Oral & Maxillofacial Medicine, School of Dentistry Tehran University of Medical Science Tehran Iran
| | - Nafiseh Sheykhbahaei
- Department of Oral & Maxillofacial Medicine, School of Dentistry Tehran University of Medical Science Tehran Iran
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Parlatescu I, Dugan C, Popescu BO, Tovaru S, Dobre M, Milanesi E. Non-Communicable Diseases and Associated Risk Factors in Burning Mouth Syndrome Patients. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2085. [PMID: 38138188 PMCID: PMC10744480 DOI: 10.3390/medicina59122085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/21/2023] [Accepted: 11/26/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Noncommunicable diseases (NCDs) are a group of non-transmissible conditions that tend to be of long duration and are the result of a combination of genetic, physiological, environmental, and behavioral factors. Although an association between oral disorders and NCDs has been suggested, the relationship between Burning Mouth Syndrome (BMS) and NCDs and their associated risk factors has not been deeply investigated. In this study, we aim to identify associations between BMS and NCDs in the Romanian population. Materials and Methods: Ninety-nine BMS patients and 88 age-matched controls (aged 50 and over) were clinically evaluated for the presence of eight noncommunicable diseases (NCDs) and their most common risk factors, including hypertension, dyslipidemia, smoking, and obesity. Results: The results of our study showed that the BMS in the Romanian population seems to be significantly associated with cardiovascular diseases (CVDs) (p < 0.001) and two of their risk factors, hypertension (p < 0.001) and dyslipidemia (p < 0.001). Moreover, evaluating the Framingham Risk Score (FRS) in the individuals not affected by CVDs (73 CTRL and 38 BMS), we found that 13.2% of BMS patients reported a moderate risk of developing CVDs in ten years, compared to the controls, all of whom presented a low risk (p = 0.002). Conclusions: Our findings suggest that a multidisciplinary clinical approach, which also includes a cardiovascular evaluation, is essential for the successful management of BMS. Moreover, these data highlighted the importance of introducing an integrated strategy for the prevention and care of NCDs in BMS patients.
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Affiliation(s)
- Ioanina Parlatescu
- Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (I.P.); (S.T.)
| | - Cosmin Dugan
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.D.); (B.O.P.); (E.M.)
| | - Bogdan Ovidiu Popescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.D.); (B.O.P.); (E.M.)
- Victor Babeș National Institute of Pathology, 050096 Bucharest, Romania
| | - Serban Tovaru
- Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (I.P.); (S.T.)
| | - Maria Dobre
- Victor Babeș National Institute of Pathology, 050096 Bucharest, Romania
| | - Elena Milanesi
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.D.); (B.O.P.); (E.M.)
- Victor Babeș National Institute of Pathology, 050096 Bucharest, Romania
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Dibello V, Ballini A, Lozupone M, Custodero C, Cantore S, Sardone R, Dibello A, Santarcangelo F, Barulli Kofler B, Petruzzi M, Daniele A, Solfrizzi V, Panza F. Exploring the Association of Burning Mouth Syndrome with Depressive and Anxiety Disorders in Middle-Aged and Older Adults: A Systematic Review. J Pers Med 2023; 13:1014. [PMID: 37374003 DOI: 10.3390/jpm13061014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/15/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Burning Mouth Syndrome (BMS) is an idiopathic condition mainly affecting middle-aged and older individuals with hormonal disturbances or psychiatric disorders and is characterized by chronic pain. The etiopathogenesis of this multifactorial syndrome is largely unknown. The objective of the present systematic review was therefore to evaluate the relationship of BMS with depressive and anxiety disorders in middle-aged and older individuals. METHODS We selected studies evaluating BMS and depressive and anxiety disorders assessed with validated tools, published from their inception up to April 2023, using PubMed, MEDLINE, EMBASE, Scopus, Ovid, and Google Scholar databases and adhering to the PRISMA 2020 guidelines/PRISMA 2020 27-item checklist. This study is registered on PROSPERO (CRD42023409595). The National Institutes of Health Quality Assessment Toolkits for Observational Cohort and Cross-Sectional Studies were used to examine the risk of bias. RESULTS Two independent investigators rated 4322 records against the primary endpoint and found 7 records meeting the eligibility requirements. Anxiety disorders were found to be the most common psychiatric disorders related to BMS (63.7%), followed by depressive disorders (36.3%). We found a moderate association of BMS with anxiety disorders, with multiple studies included (n = 7). Moreover, we found a low association of BMS with depressive disorders (included studies, n = 4). The role of pain appeared to be controversial in explaining these associations. CONCLUSIONS In middle-aged and older subjects, anxiety and depressive disorders may be potentially related to the development of BMS. Furthermore, also in these age groups, females showed higher risk of developing BMS than males, even when taking into account multimorbidity such as sleep disorders, personality traits, and biopsychosocial changes as suggested by study-specific findings.
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Affiliation(s)
- Vittorio Dibello
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Andrea Ballini
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of D-BRAIN, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Carlo Custodero
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Stefania Cantore
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
- Independent Researcher, 70124 Bari, Italy
| | - Rodolfo Sardone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Antonio Dibello
- Stella Maris Nursing Home and Day Care Center, Monopoli, 70043 Bari, Italy
| | | | - Bianca Barulli Kofler
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Massimo Petruzzi
- Interdisciplinary Department of Medicine, Section of Dentistry, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, 00168 Rome, Italy
- Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Vincenzo Solfrizzi
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Francesco Panza
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
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Peng DS, Lo CH, Tseng YL, Kuo SL, Chiang CP, Chiang ML. Efficacy of oral nystatin treatment for patients with oral mucosal dysesthesia but without objective oral mucosal manifestations and necessity of Candida culture test before oral nystatin treatment. J Dent Sci 2022; 17:1802-1813. [PMID: 36299322 PMCID: PMC9588811 DOI: 10.1016/j.jds.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 08/07/2022] [Indexed: 11/28/2022] Open
Abstract
Background/purpose Materials and methods Results Conclusion
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Affiliation(s)
- Ding-Shan Peng
- Department of Dentistry, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan
| | - Chih-Hui Lo
- School of Pharmacy, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Lun Tseng
- Department of Psychiatry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Shun Li Kuo
- Division of Chinese Medicine Obstetrics and Gynecology, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Pin Chiang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Corresponding author. Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Section 3, Chung-Yang Road, Hualien, 970, Taiwan.
| | - Meng-Ling Chiang
- Department of Pediatric Dentistry, Chang Gung Memorial Hospital at Taipei, Taipei, Taiwan
- Department of Oral Pathology and Oral Diagnosis, Chang Gung Memorial Hospital at Taipei, Taipei, Taiwan
- Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Corresponding author. Department of Pediatric Dentistry, Chang Gung Memorial Hospital at Taipei, No. 199, Dunhua North Road, Taipei 105, Taiwan.
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7
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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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Iuzbashian PG, Lvov AN, Tereshenko AV, Volel BA, Satrudinova RR, Romanov DV. [Pain syndromes and insomnia: the role of association with comorbid mental disorders (on the model of glossalgia)]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:13-18. [PMID: 34874649 DOI: 10.17116/jnevro202112110113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To test the association between pain severity and anxiety, depression, and somatoform symptoms in burning sleep syndrome (BMS). MATERIAL AND METHODS The study included 36 patients (33 women, 3 men), mean age 58.0±14.8 years. Psychopathological, clinical-dermatological, parametric, statistical methods were used. Psychometric examination included the Visual Analogue Scale (VAS) for assessment of pain (severity of glossalgia), PHQ-4 for self-assessment of severity of anxiety (GAD-2) and depression (PHQ-2), the Hospital Anxiety and Depression Scale (HADS), the Screening for Somatoform Symptoms-2 (SOMS-2), the Pittsburgh Sleep Quality Index (PSQI), the EQ-5D-5L quality of life assessment scale. RESULTS AND CONCLUSION Insomnia in chronic pain is very common. On the one hand, studies show that sleep deprivation can enhance pain perception. On the other hand, chronic pain can trigger a variety of sleep disorders. One of the localizations of chronic pain syndrome is the oral mucosa. Somatoform pain disorder related to oral mucosa called «glossalgia» or «burning mouth syndrome» (BMS). The prevalence of insomnia in the study sample was 61.1%. The statistically significant positive correlation was found between the severity of insomnia (PSQI) and the severity of anxiety on both GAD-2 and HADS, while insomnia showed no correlation with depression and pain severity. At the same time, the severity of anxiety showed statistically significant positive correlation with the severity of pain assessed by VAS.
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Affiliation(s)
- P G Iuzbashian
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - A N Lvov
- Central State Medical Academy of Department of Presidential Affairs, Moscow, Russia.,Lomonosov Moscow State University, Moscow, Russia
| | - A V Tereshenko
- Moscow Scientific and Practical Center of Dermatology, Venereology and Cosmetology, Moscow, Russia
| | - B A Volel
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Mental Health Research Center, Moscow, Russia
| | - R R Satrudinova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - D V Romanov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Mental Health Research Center, Moscow, Russia
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Jedel E, Elfström ML, Hägglin C. Differences in personality, perceived stress and physical activity in women with burning mouth syndrome compared to controls. Scand J Pain 2021; 21:183-190. [PMID: 33108343 DOI: 10.1515/sjpain-2020-0110] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 09/21/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Burning mouth syndrome (BMS) is a long-lasting pain condition which is commonly associated with anxiety symptoms and experience of adverse, stressful life events have been reported by those diagnosed with the syndrome. Stress-related biomarkers have been related to personality traits in BMS and a personality with high stress susceptibility and perceived stress may be of importance. Although biopsychosocial approaches are suggested to manage long-lasting orofacial pain, to date little is known about physical activity in women with BMS. The aim of this study was to investigate if personality, perceived stress and physical activity distinguish women with BMS from controls. METHODS Fifty-six women with BMS and 56 controls matched on age and gender completed Swedish universities Scales of Personality (SSP), Perceived Stress Questionnaire (PSQ) and a general questionnaire with an item on weekly physical activity frequency. In addition, health-related quality of life was explored by additional questionnaires and reported in a companion article (Jedel et al. Scand J Pain. 2020. PubMed PMID: 32853174). RESULTS SSP subscales Somatic Trait Anxiety, Psychic Trait Anxiety, Stress Susceptibility and Verbal Trait Aggression differed between women with BMS and controls and the personality factor scores for Neuroticism and Aggressiveness were higher. Perceived stress measured by PSQ index was higher for women with BMS compared to controls. Women with BMS reported lower physical activity frequency compared to controls and those reporting physical activity <4 days/week scored higher on PSQ compared to those with weekly physical activity ≥4 days/week. CONCLUSIONS Personality distinguished women with BMS from controls in this study. Perceived stress was higher and weekly physical activity was lower in women with BMS compared to controls. Our findings suggest physical activity should be more comprehensively measured in future BMS studies and, by extension, physical activity may be a treatment option for women with BMS. Pain management aiming to restore function and mobility with stress reduction should be considered in clinical decision making for women with BMS who have a personality with stress susceptibility, especially if reporting high perceived stress and insufficient physical activity.
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Affiliation(s)
- Elizabeth Jedel
- Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - Magnus L Elfström
- Division of Psychology, School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - Catharina Hägglin
- Public Dental Service, Region Västra Götaland, Gothenburg, Sweden.,Sahlgrenska Academy, Institute of Odontology, University of Gothenburg, Gothenburg, Sweden
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10
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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.
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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
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11
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Alberdi-Navarro J, Aguirre-Urizar JM, Ginestal-Gómez E. Clinical presentation of burning mouth syndrome in patients with oral lichenoid disease. Med Oral Patol Oral Cir Bucal 2020; 25:e805-e809. [PMID: 32851991 PMCID: PMC7648912 DOI: 10.4317/medoral.23812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 07/10/2020] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND To analyze the presence of burning mouth syndrome (BMS) in a group of patients diagnosed with oral lichenoid disease (OLD). MATERIAL AND METHODS A retrospective study of 217 patients diagnosed with OLD; 158 (72,8%) women and 59 (27,2%) men, with an average age upon diagnosis of 56,4 years (SD 11,88). We carried out a detailed and complete characterization of symptoms, with special emphasis on BMS diagnostic data specified by the International Headache Society. RESULTS Four patients (1.8%) presented with long-term clinical symptoms of burning mouth, indicative of BMS and they fulfilled the IHS 2018 criteria, except for criterion D, i.e."Oral mucosa is of normal appearance". The observed lichenoid mucosal lesions were not considered to be able to account for the reported intraoral pain in any of our patients. Thus neither diagnosis was considered to be exclusive. CONCLUSIONS Patients diagnosed with OLD, and who simultaneously present clinical characteristics of BMS should be studied in detail, in order to evaluate the possibility of both diagnoses concurring.
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Affiliation(s)
- J Alberdi-Navarro
- Oral Medicine and Oral and Maxillofacial Pathology Units Orofacial Pain and Temporomandibular Disorders Unit Dental Clinic Service, Department of Stomatology II School of Medicine and Nursing University of the Basque Country (UPV/EHU) 48940 Leioa, Bizkaia, Spain
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Radochová V, Slezák R, Radocha J. Oral Manifestations of Nutritional Deficiencies: Single Centre Analysis. ACTA MEDICA (HRADEC KRÁLOVÉ) 2020; 63:95-100. [PMID: 33002395 DOI: 10.14712/18059694.2020.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Oral manifestations of deficiency of iron, vitamin B12 and folic acid are thought to be common. Prevalence of these deficiencies among patients with compatible symptoms is not well known. The goal of this study was to summarize evidence from a dental practice of iron, vitamin B12 and folic acid deficiency in patients presenting with compatible oral manifestations. METHODS 250 patients who presented with burning mouth syndrome, angular cheilitis, recurrent aphthous stomatitis, papillar atrophy of the tongue dorsum or mucosal erythema were identified. Patients underwent clinical examination, and the blood samples were taken. RESULTS 250 patients (208 females; 42 males, mean age 44.1 years) with at least one corresponding symptom or sign were identified. The nutritional deficiency of one or more nutrients was found in 119 patients (47.6%). Seven times more females than males were noted to have one type of deficiency (104 females, 15 males). Iron deficiency as defined was diagnosed in 62 patients (24.8%), vitamin B12 or folic acid deficiency in 44 patients (17.6%) and both deficiencies (iron + vitamin B12/folic acid) in 13 patients (5.2%). The only predictive factor was gender and only for iron deficiency. The presence of more than one deficiency was noted in 10 patients (4.9%). CONCLUSION The most commonly observed deficiency in dental practice over the course of 11 years was an iron deficiency in the female population. Age, diet and reported co-morbidities did not show statistically significant predictable value in recognizing these deficiencies.
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Affiliation(s)
- Vladimíra Radochová
- Department of Dentistry, Faculty of Medicine in Hradec Králové, Charles University, and University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic.
| | - Radovan Slezák
- Department of Dentistry, Faculty of Medicine in Hradec Králové, Charles University, and University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic
| | - Jakub Radocha
- 4th Department of Internal Medicine - Hematology, Faculty of Medicine in Hradec Králové, Charles University, and University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic
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Chen Q, Shi Y, Jiang L, Zhou Y, Dan H, Jin X, Sun S, Zeng X. Management of burning mouth Syndrome: A position paper of the Chinese Society of Oral Medicine. J Oral Pathol Med 2020; 49:701-710. [PMID: 32589772 DOI: 10.1111/jop.13082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 05/07/2020] [Accepted: 06/08/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Burning mouth syndrome is a syndrome with tongue as the main affected site and burning pain as the main complaint. Although a variety of therapies have been reported to treat BMS, there is a lack of widely recognized therapies and it is still a dilemma for clinicians to treat BMS. OBJECTIVE To develop the position paper and provide the references for clinical practice of BMS in China. METHODS Under the guidance of WHO (World Health Organization) Handbook for Guideline Development, we used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach as a tool to develop this position paper in the following steps: setting up the groups, formulating the clinical questions and choosing the outcomes, retrieving and synthesizing of evidence, assessing the evidence, investigating the patients' values and preferences, developing the recommendations, reviewing the recommendations, and writing the position paper. RESULTS The 27 recommendations were formed from the following 7 aspects: pre-treatment examination, removal of stimuli, medication, physical therapy, psychological therapy, and antipsychotics. There are 3 strong recommendations and 12 weak recommendations in pre-treatment examination and removal of stimuli, as well as 12 weak recommendations in therapies. CONCLUSION The Chinese position paper for management of BMS has been developed, which could provide the references for clinical practice of BMS in China. Twenty-seven recommendations were formed based on consensus of experts on the balance of benefits vs side effects, evidence, cost, and patients' values and preferences, although the quality of evidence is relatively low.
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Affiliation(s)
- Qianming Chen
- State Key Laboratory of Oral Diseases, Dept. of Oral Medicine of West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Sichuan University, Chengdu, China
| | - Yujie Shi
- State Key Laboratory of Oral Diseases, Dept. of Oral Medicine of West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Sichuan University, Chengdu, China
| | - Lu Jiang
- State Key Laboratory of Oral Diseases, Dept. of Oral Medicine of West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Sichuan University, Chengdu, China
| | - Yu Zhou
- State Key Laboratory of Oral Diseases, Dept. of Oral Medicine of West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Sichuan University, Chengdu, China
| | - Hongxia Dan
- State Key Laboratory of Oral Diseases, Dept. of Oral Medicine of West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Sichuan University, Chengdu, China
| | - Xin Jin
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Silu Sun
- State Key Laboratory of Oral Diseases, Dept. of Oral Medicine of West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Sichuan University, Chengdu, China
| | - Xin Zeng
- State Key Laboratory of Oral Diseases, Dept. of Oral Medicine of West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Sichuan University, Chengdu, China
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Pakfetrat A, Talebi M, Dalirsani Z, Mohajeri A, Zamani R, Ghazi A. Evaluation of the effectiveness of crocin isolated from saffron in treatment of burning mouth syndrome: A randomized controlled trial. AVICENNA JOURNAL OF PHYTOMEDICINE 2019; 9:505-516. [PMID: 31763210 PMCID: PMC6823529 DOI: 10.22038/ajp.2019.12764] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 03/02/2019] [Accepted: 03/03/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Burning mouth syndrome (BMS) is a debilitating disorder with few limited treatment modalities. Because of the proven association between BMS symptoms, and depression and anxiety, treatment modalities that alleviate the two latter etiologic factors can be clinically effective. Thus, owing to the antidepressant and potential analgesic effects of crocin (as an active constituent of saffron), the present study was performed to compare the effect of crocin and citalopram (as control) on BMS symptoms and depression/anxiety in patients with BMS. MATERIALS AND METHODS The present double-blind randomized clinical trial was carried out on BMS patients. Patients were randomly divided into citalopram (n=21) and crocin (n=26) groups and treated for 11 weeks. BMS symptoms (based on Visual Analysis Scale (VAS)), as well as anxiety and depression (based on Hamilton questionnaire) were evaluated at baseline and during the treatment period. Mann-Whitney, Chi-Square test, Independent t-test, Friedman, and Spearman correlation were employed for statistical analysis. RESULTS Our findings showed a significant effect for crocin on the severity of BMS symptoms, anxiety and depression in BMS patients. CONCLUSION Crocin can be considered for treatment of BMS subjects with concurrent anxiety and/or depression.
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Affiliation(s)
- Atessa Pakfetrat
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehdi Talebi
- Family Medicine Department, Faculty of Psychiatry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zohreh Dalirsani
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ahmad Mohajeri
- Targeted Drug Delivery Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Roya Zamani
- Department of Oral Health, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Ala Ghazi
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Abstract
Background and Aim Burning mouth syndrome (BMS) may be defined as a burning sensation in the oral mucosa usually unaccompanied by clinical signs. Multiple conditions have been attributed to a burning sensation. The aim of this study was to determine the role of age and sex in BMS. Materials and Methods A total of 195 consecutive patients with BMS and 95 healthy patients without burning sensation were recruited in this study. Patients with BMS had experienced oral, burning sensations for at least 6 months without oral clinical signs, and with a normal blood count. Multiple logistic regression analyses were utilized to define the main predictors. Results Menopause, candidiasis, psychological disorders, job status, denture, and dry mouth were significantly frequent in BMS patients. Multivariate logistic regression indicated age (odds ratio (OR) =1.12, 95% confidence interval (CI): 1.08-1.15, P < 0.0001) and sex (OR = 3.14, 95% CI: 1.4-6.7, P < 0.002) significantly increase the odds of BMS. Psychological disorders (OR = 3.39, 95% CI: 1.2-9.5, P < 0.02) and candidiasis remain as predictive factors. Ultimately, age was defined as a critical predictor. Moreover, we can therefore predict that a 60-year-old woman with psychological disorders is 25 times more likely to suffer from BMS than a man 10 years younger who has no psychological disorder. Conclusion Age and sex were the main predictors in BMS. Psychological disorders and candidiasis were significantly associated with the occurrence of BMS.
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Affiliation(s)
- Maryam Rabiei
- Department of Oral and Maxillofacial Medicine, Dental School, Guilan University of Medical Sciences, Rasht, Iran
| | - Ehsan Kazemnezhad Leili
- Department of Biostatistics, Faculty of Midwifery and Nursing, Guilan University of Medical Sciences, Rasht, Iran
| | - Leili Alizadeh
- Department Oral Pathology, Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
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Acharya S, Carlén A, Wenneberg B, Jontell M, Hägglin C. Clinical characterization of women with burning mouth syndrome in a case-control study. Acta Odontol Scand 2018; 76:279-286. [PMID: 29284330 DOI: 10.1080/00016357.2017.1420226] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Burning mouth syndrome (BMS) is a chronic orofacial pain disorder that is defined by a burning sensation in the oral mucosa. The aim of this study was to investigate the underlying factors, clinical characteristics and self-reported oral and general health factors associated with BMS. MATERIAL AND METHODS Fifty-six women with BMS (mean age: 67.7) and their age-matched controls were included in the study. A general questionnaire, an OHRQL index and BMS-specific questionnaires were used. Each subject underwent an oral examination. RESULTS The mean severity of the BMS symptoms (VAS, 0-100) was 66.2 (SD 19.7). Overall, 45% of the patients reported taste disturbances. More of the patients than the controls rated their general health, oral health and life situation as 'less satisfactory'. The patients also reported more frequently on-going medications, diseases/disorders, xerostomia, allergy and skin diseases. Except for more bruxofacets among the patients, there were no significant differences regarding signs of parafunction. In a multiple logistic regression analysis, xerostomia and skin diseases showed the strongest prediction for BMS and no significant effect was found for medication, allergy or bruxofacets. CONCLUSIONS Skin diseases and xerostomia but not parafunction were strongly associated with BMS. Our findings provide the basis for additional studies to elucidate the causal factors of BMS.
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Affiliation(s)
- Shikha Acharya
- Department of Oral Microbiology and Immunology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anette Carlén
- Department of Oral Microbiology and Immunology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Bengt Wenneberg
- Department of Orofacial Pain, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mats Jontell
- Department of Oral Medicine and Pathology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Catharina Hägglin
- Department of Behavioral and Community Dentistry, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre of Gerodontology, Public Dental Service, Region Västra Götaland, Sweden
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17
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Farah CS, Amos K, Leeson R, Porter S. Candida
species in patients with oral dysesthesia: A comparison of carriage among oral disease states. J Oral Pathol Med 2018; 47:281-285. [DOI: 10.1111/jop.12675] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Camile S. Farah
- UWA Dental School; University of Western Australia; Nedlands WA Australia
| | - Kate Amos
- Private Practice; Coffs Harbour NSW Australia
| | - Rachel Leeson
- University College London, Eastman Dental Institute; London UK
| | - Stephen Porter
- University College London, Eastman Dental Institute; London UK
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Morr Verenzuela CS, Davis MDP, Bruce AJ, Torgerson RR. Burning mouth syndrome: results of screening tests for vitamin and mineral deficiencies, thyroid hormone, and glucose levels-experience at Mayo Clinic over a decade. Int J Dermatol 2017; 56:952-956. [PMID: 28436021 DOI: 10.1111/ijd.13634] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 02/03/2017] [Accepted: 03/18/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND Burning mouth syndrome (BMS) is a disorder characterized by chronic mouth pain in the absence of objective clinical abnormalities. Vitamin or mineral deficiencies may have a role in BMS, but data regarding the prevalence and relevance of hematinic deficiencies are conflicting. We aimed to determine the frequency of specific laboratory abnormalities in patients with BMS. METHODS We retrospectively reviewed the results of screening blood tests in patients with BMS at our institution between January 2003 and December 2013. RESULTS Among 659 patients with BMS, the most common decreased values or deficiencies were vitamin D3 (15%), vitamin B2 (15%), vitamin B6 (5.7%), zinc (5.7%), vitamin B1 (5.3%), thyrotropin (TSH) (3.2%), vitamin B12 (0.8%), and folic acid (0.7%). Laboratory values for fasting blood glucose and TSH were increased in 23.7% and 5.2%, respectively. CONCLUSIONS In patients with symptoms of BMS, our results suggest it is reasonable to screen for fasting blood glucose, vitamin D (D2 and D3 ), vitamin B6 , zinc, vitamin B1 , and TSH. Deficiencies of vitamin B12 and folic acid were rare (<1% abnormal).
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Affiliation(s)
| | - Mark D P Davis
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Alison J Bruce
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
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Abstract
Objective To review the clinical entity of primary burning mouth syndrome (BMS), its pathophysiological mechanisms, accurate new diagnostic methods and evidence-based treatment options, and to describe novel lines for future research regarding aetiology, pathophysiology, and new therapeutic strategies. Description Primary BMS is a chronic neuropathic intraoral pain condition that despite typical symptoms lacks clear clinical signs of neuropathic involvement. With advanced diagnostic methods, such as quantitative sensory testing of small somatosensory and taste afferents, neurophysiological recordings of the trigeminal system, and peripheral nerve blocks, most BMS patients can be classified into the peripheral or central type of neuropathic pain. These two types differ regarding pathophysiological mechanisms, efficacy of available treatments, and psychiatric comorbidity. The two types may overlap in individual patients. BMS is most frequent in postmenopausal women, with general population prevalence of around 1%. Treatment of BMS is difficult; best evidence exists for efficacy of topical and systemic clonazepam. Hormonal substitution, dopaminergic medications, and therapeutic non-invasive neuromodulation may provide efficient mechanism-based treatments for BMS in the future. Conclusion We present a novel comprehensive hypothesis of primary BMS, gathering the hormonal, neuropathic, and genetic factors presumably required in the genesis of the condition. This will aid in future research on pathophysiology and risk factors of BMS, and boost treatment trials taking into account individual mechanism profiles and subgroup-clusters.
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Affiliation(s)
- Satu K Jääskeläinen
- Department of Clinical Neurophysiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Alain Woda
- Université Clermont Auvergne, CROC and University Hospital, Odontology department; Clermont-Ferrand, France
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Evaluating the Etiologies of Burning Mouth Symptom in Patients of Shiraz Dental School from 2007 to 2015. IRANIAN RED CRESCENT MEDICAL JOURNAL 2017. [DOI: 10.5812/ircmj.42675] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Is it Sjögren's syndrome or burning mouth syndrome? Distinct pathoses with similar oral symptoms. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:482-495. [PMID: 28283095 DOI: 10.1016/j.oooo.2017.01.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 01/10/2017] [Accepted: 01/12/2017] [Indexed: 12/17/2022]
Abstract
Sjögren's syndrome (SS) and burning mouth syndrome (BMS) typically occur in postmenopausal women. Although these conditions have significantly different etiopathogeneses, patients with SS or BMS often present with analogous oral complaints. The similarities between the two conditions have led to considerable confusion on the part of medical and dental practitioners, and those with BMS or SS often wait years to receive a diagnosis. Therefore, it is imperative for clinicians to understand the characteristic subjective and objective features of each disease and how these can be used to distinguish them. This review will discuss the proposed etiology, clinical manifestations, histopathology, diagnostic criteria, and patient management of SS and BMS. We also identify key differences between the two pathoses that aid in establishing the correct diagnosis. Recognition of the defining features of each condition will lead to reduced time to diagnosis and improved patient management for these poorly understood conditions.
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Galli F, Lodi G, Sardella A, Vegni E. Role of psychological factors in burning mouth syndrome: A systematic review and meta-analysis. Cephalalgia 2016; 37:265-277. [DOI: 10.1177/0333102416646769] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background Burning mouth syndrome (BMS) is a chronic medical condition characterised by hot, painful sensations in the lips, oral mucosa, and/or tongue mucosa. On examination, these appear healthy, and organic causes for the pain cannot be found. Several studies have yielded scant evidence of the involvement of psychological and/or psychopathological factors, and several have outlined a model for the classification of BMS. Aim This review aims to provide a systematic review of research examining the psychological, psychiatric, and/or personality factors linked to BMS. Findings Fourteen controlled studies conducted between 2000 and the present were selected based on stringent inclusion/exclusion criteria. All studies but one reported at least some evidence for the involvement of psychological factors in BMS. Anxiety and depression were the most common and the most frequently studied psychopathological disorders among BMS patients. Discussion and conclusion Anxiety and depression play critical roles in this condition. Evidence on the role of personality characteristics of BMS patients has also been produced by a few studies. Further studies on the role of specific psychological factors in BMS are warranted, but the importance of a multidisciplinary approach (medical and psychological) to BMS is no matter of discussion.
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Affiliation(s)
- Federica Galli
- Department of Health Sciences, University of Milan, Italy
| | - Giovanni Lodi
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, University of Milan, Italy
| | - Andrea Sardella
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, University of Milan, Italy
| | - Elena Vegni
- Department of Health Sciences, University of Milan, Italy
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Tokura T, Kimura H, Ito M, Nagashima W, Sato N, Kimura Y, Arao M, Aleksic B, Yoshida K, Kurita K, Ozaki N. Temperament and character profiles of patients with burning mouth syndrome. J Psychosom Res 2015; 78:495-498. [PMID: 25796514 DOI: 10.1016/j.jpsychores.2015.02.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 02/11/2015] [Accepted: 02/12/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Burning mouth syndrome (BMS) is a chronic disease in which patients feel a burning sensation and pain in the oral cavity. Although personality traits have been suggested to influence the development and course of BMS, they have not yet been examined in detail. We therefore investigated the personality traits of BMS patients. METHODS Sample consisted of 65 BMS patients presenting to the Aichi-Gakuin Dental School Hospital between May 2005 and April 2009. They were also diagnosed as having pain disorder by a psychiatrist. The control group consisted of 116 healthy subjects. The Temperament and Character Inventory (TCI) was used to evaluate personality traits, while the Beck Depression Inventory (BDI) was used to evaluate the depression rate in both groups. RESULTS In TCI, we found that, in comparison to the control group, the novelty seeking score was significantly lower (p = 0.009), the harm avoidance score was significantly higher (p < 0.001), and the self-directedness score was significantly lower (p = 0.039) in the BMS group. To remove the influence of depression, we performed an analysis of covariance of each TCI item using the BDI score as a covariate. No significant differences were observed in harm avoidance or self-directedness, whereas the differences noted in novelty seeking were significant (p = 0.008). CONCLUSION The novelty seeking score was low in BMS patients in comparison to the control group. They also had high harm avoidance and low self-directedness tendencies, but these were attributed to the influence of depression.
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Affiliation(s)
- Tatsuya Tokura
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Hiroyuki Kimura
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Mikiko Ito
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan.
| | - Wataru Nagashima
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Naohiro Sato
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Yuki Kimura
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan.
| | - Munetaka Arao
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan.
| | - Branko Aleksic
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Keizo Yoshida
- Health Care Promotion Division, Denso Corporation, Kariya, Japan.
| | - Kenichi Kurita
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan.
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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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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Lopez-Jornet P, Lucero-Berdugo M, Castillo-Felipe C, Zamora Lavella C, Ferrandez-Pujante A, Pons-Fuster A. Assessment of self-reported sleep disturbance and psychological status in patients with burning mouth syndrome. J Eur Acad Dermatol Venereol 2014; 29:1285-90. [DOI: 10.1111/jdv.12795] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 09/19/2014] [Indexed: 01/03/2023]
Affiliation(s)
- P. Lopez-Jornet
- Faculty of Medicine and Dentistry; Department of Oral Medicine; Ageing Research Institute; University of Murcia; Murcia Spain
| | - M. Lucero-Berdugo
- Faculty of Medicine and Dentistry; Department of Oral Medicine; Ageing Research Institute; University of Murcia; Murcia Spain
| | - C. Castillo-Felipe
- Faculty of Medicine and Dentistry; Department of Oral Medicine; Ageing Research Institute; University of Murcia; Murcia Spain
| | - C. Zamora Lavella
- Faculty of Medicine and Dentistry; Department of Oral Medicine; Ageing Research Institute; University of Murcia; Murcia Spain
| | - A. Ferrandez-Pujante
- Faculty of Medicine and Dentistry; Department of Oral Medicine; Ageing Research Institute; University of Murcia; Murcia Spain
| | - A. Pons-Fuster
- Faculty of Medicine and Dentistry; Department of Oral Medicine; Ageing Research Institute; University of Murcia; Murcia Spain
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Lopez-Jornet P, Molino Pagan D, Andujar Mateos P, Rodriguez Agudo C, Pons-Fuster A. Circadian rhythms variation of pain in burning mouth syndrome. Geriatr Gerontol Int 2014; 15:490-5. [DOI: 10.1111/ggi.12303] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2014] [Indexed: 12/26/2022]
Affiliation(s)
- Pia Lopez-Jornet
- Department of Oral Medicine; Faculty of Medicine and Dentistry; Aging Research Institute; University of Murcia; Spain
| | - Diana Molino Pagan
- Department of Oral Medicine; Faculty of Medicine and Dentistry; Aging Research Institute; University of Murcia; Spain
| | - Paz Andujar Mateos
- Department of Oral Medicine; Faculty of Medicine and Dentistry; Aging Research Institute; University of Murcia; Spain
| | - Consuelo Rodriguez Agudo
- Department of Oral Medicine; Faculty of Medicine and Dentistry; Aging Research Institute; University of Murcia; Spain
| | - Alvaro Pons-Fuster
- Department of Oral Medicine; Faculty of Medicine and Dentistry; Aging Research Institute; University of Murcia; Spain
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Pastana SDG, Cantisano MH, Mariano BO, Bianchini EMG. Queixas orais e verificação da fala de indivíduos com síndrome da ardência bucal. REVISTA CEFAC 2013. [DOI: 10.1590/s1516-18462013000400019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVOS: identificar queixas referentes às funções orais relacionadas ao sintoma de ardência bucal e verificar alterações na articulação da fala MÉTODO: participaram do estudo 22 indivíduos com faixa etária entre 44 a 78 anos, diagnosticados na Clínica de Estomatologia da Universidade do Estado do Rio de Janeiro. Foi realizado levantamento dos dados a partir de questionário específico e gravação audiovisual da fala utilizando fichário evocativo. RESULTADOS: foram relatados sintomas específicos de ardência por 77% dos sujeitos e em associação com dor por 23%. Sintomas associados como boca seca, alteração do paladar e olfato foram referidos por 86% dos indivíduos. A língua foi referida com sintoma de ardência em 82% dos indivíduos, representando a estrutura mais acometida. A intensidade da ardência foi referida como moderada por 64%. A forma de ocorrência do sintoma foi relatada como contínua por 64% dos indivíduos. Do total, 82% relataram fazer uso de estratégias para minimizar o sintoma da ardência. Em relação às funções orais, 27% queixaram-se de cansaço na fala, 14% de cansaço na mastigação e 9% de engasgos à deglutição, sendo que de 32% relataram aumento da intensidade da ardência na fala e 9% na mastigação. Na análise de fala, em 95% da amostra, não houve ocorrência de alteração, sendo a imprecisão articulatória identificada em 5% dos indivíduos avaliados. CONCLUSÃO: foram identificadas queixas orais como cansaço ao falar e mastigar e aumento da intensidade do sintoma de ardência nestas funções, não tendo sido evidenciadas modificações na articulação da fala nos indivíduos com Síndrome da Ardência Bucal investigados nessa pesquisa.
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López-Jornet P, Juan H, Alvaro PF. Mineral and trace element analysis of saliva from patients with BMS: a cross-sectional prospective controlled clinical study. J Oral Pathol Med 2013; 43:111-6. [DOI: 10.1111/jop.12105] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Pía López-Jornet
- Hospital Morales Meseguer, Clínica Odontologica Universitaria, Oral Medicine, Ageing Research Institute, Faculty of Medicine and Dentistry, University of Murcia; Murcia Spain
| | - Hermogenes Juan
- Colaborate Hospital Morales Meseguer, Oral Medicine Ageing Research Institute, Faculty of Medicine and Dentistry; University of Murcia; Murcia Spain
| | - Pons-Fuster Alvaro
- Colaborate Ageing Research Institute, Faculty of Medicine and Dentistry; University of Murcia; Murcia Spain
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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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Mayahara M, Kataoka R, Arimoto T, Tamaki Y, Yamaguchi N, Watanabe Y, Yamasaki Y, Miyazaki T. Effects of surface roughness and dimorphism on the adhesion of Candida albicans to the surface of resins: scanning electron microscope analyses of mode and number of adhesions. ACTA ACUST UNITED AC 2013; 5:307-12. [PMID: 23766294 DOI: 10.1111/jicd.12055] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 04/08/2013] [Indexed: 11/30/2022]
Abstract
AIM Candida albicans is a common oral fungus but can cause serious conditions such as Candida stomatitis. We investigated C. albicans adhesion to the surface of denture-base resins at two growth phases. METHODS Fungal suspensions of logarithmic (9 h) and stationary phase (24 h) C. albicans (JCM2085) were used. Scanning electron microscopy (SEM) confirmed that yeast and mycelial forms were predominant in 9-h and 24-h cultures, respectively. Resin strips were polished to three surface roughness levels (Ra 3.2 μm, Ra 0.48 μm and Ra 0.06 μm) and were then immersed in C. albicans suspensions for both phases. The SEM images were taken at five sites on each strip. RESULTS Adhesion of mycelial-form C. albicans on rough surfaces (Ra = 3.2) was 2.2 times higher than on smooth surfaces (Ra = 0.06; 7030 vs 3580 adhesions/mm(2), P < 0.01). The hyphae of these mycelial forms fully penetrated the surface cracks. Fewer adhesions occurred for yeast-form C. albicans, regardless of surface type (440-620 adhesions/mm(2), P = n.s.). CONCLUSION Adhesion of yeast-form C. albicans was indifferent to surface roughness. In contrast, mycelial adhesion increased with surface roughness of the resin because mycelia infiltrated the minute protuberances on rough surfaces.
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Affiliation(s)
- Mitsuori Mayahara
- Department of Special Needs Dentistry, Division of Dental Education, School of Dentistry, Showa University, Tokyo, Japan
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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
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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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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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Abstract
OBJECTIVE The object of this study was to evaluate the dose-dependent efficacy and tolerability of milnacipran in patients with burning mouth syndrome (BMS) with inadequate response at low doses. METHODS A 12-week open-label dose-escalation study was conducted in 56 female patients (aged 20-83 years, with a mean age of 60.8 years). The initial dosage of milnacipran was 30 mg/d, and the dosage was raised up to 60 mg and 90 mg/d every 4 weeks until an improvement of at least 50% reduction of visual analog scale was achieved. RESULTS The mean ± SD effective daily dose of milnacipran was 63.9 ±16.7 mg. The cumulative improvement rate for the daily dose of 30 mg was 28.6%, and this rate rose (50.8%-67.9%) as the daily dose was increased (from 60 to 90 mg, respectively). The cumulative proportion of responders was significantly greater, with maximal daily doses of 60 and 90 mg, compared with that of 30 mg (P < 0.05, χ test). Most adverse events appeared at the low dose, and there was little evidence for dose-dependence of adverse effects. No serious safety issues were observed. CONCLUSION From the result of this study, dose escalation of milnacipran for patients with burning mouth syndrome with inadequate response at low doses may be helpful if the 30-mg daily dose has been tolerated well.
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de Souza FTA, Amaral TMP, dos Santos TPM, Abdo EN, Aguiar MCF, Teixeira AL, Kummer AM, Abreu MHNG, Silva TA. Burning Mouth Syndrome: A Therapeutic Approach Involving Mechanical Salivary Stimulation. Headache 2011; 52:1026-34. [DOI: 10.1111/j.1526-4610.2011.02037.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Morphological evaluation of tongue mucosa in burning mouth syndrome. Arch Oral Biol 2011; 57:94-101. [PMID: 21824605 DOI: 10.1016/j.archoralbio.2011.07.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Revised: 07/14/2011] [Accepted: 07/18/2011] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of the present study was to perform a morphological evaluation by immunofluorescence of biomarkers of keratinocyte intercellular adhesion, and of differentiation in the tongue mucosa of burning mouth syndrome patients (BMS), compared with a control group. DESIGN A prospective blinded evaluation of tongue mucosal specimens processed for light microscopy was performed. Intercellular adhesion was evaluated by investigating the expression of desmoglein 1, desmoglein 3, and of occludin. Keratin 10 and keratin 14 (markers of epithelial differentiation) were also evaluated, as keratin 16 (marker for activated keratinocytes after epithelial injury). Apoptotic cascade was investigated by p53 and activated caspase-3 expression. The basal membrane integrity was analysed through laminin immunoreactivity. RESULTS In both groups, a preserved three-dimensional architecture of the tongue was observed. Desmoglein 1 and desmoglein 3 epithelial distributions were similar in the desmosomes of patients and control subjects. Again, keratin 10 immunoreactivity and distribution pattern of keratin 14 in the epithelial compartment was similar in both groups. In control samples, keratin 16 immunoreactivity was scant throughout the epithelium with a punctuate and scattered cytoplasmic labelling. In contrast, in all BMS patients keratinocyte cytoplasm was homogeneously labelled for keratin 16, with a more intense staining than controls. Furthermore, keratin 16 staining progressively decreased proceeding towards the most superficial epithelial layers. CONCLUSIONS The results of this study are consistent with and support the clinically normal features of oral mucosa in BMS, and suggest that keratin 16 may be involved in the cell mechanisms underlying the syndrome occurrence.
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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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Abetz LM, Savage NW, Kenardy J. Changes in the oral cavity might reflect psychological disorders in some patients. ACTA ACUST UNITED AC 2011; 2:128-34. [PMID: 25426606 DOI: 10.1111/j.2041-1626.2011.00047.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM The treatment of oral dysesthesias, such as burning mouth syndrome, can be challenging. Patient acceptance of the role of psychological etiological factors might be improved if there are clinical signs that patients could confirm themselves, which could be used as reinforcement of clinical discussions. Published associations between psychological disorder and various oral signs and symptoms are not suited to this purpose, as they are ambiguous in origin and implication. Others, used clinically in this situation, are not supported by published literature. Therefore, the purpose of this study was to determine if a demonstrable relationship could be established between psychological profile and the appearance and function of the oral cavity. METHODS Seventy-nine participants underwent an oral examination and completed a Depression Anxiety Stress Scale-21 questionnaire. Correlations were calculated between clinical variables and the raw Depression Anxiety Stress Scale scores. Univariate analyses determined variables with significant differences between a high-risk and normal group, and multiple logistic regression models were calculated for these. RESULTS Various oral signs and symptoms were found to correlate with depression, anxiety, and/or stress, with some predictive of psychological disturbance. CONCLUSIONS These signs and symptoms might be used to reinforce the psychological aspects of an oral dysesthesia.
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Affiliation(s)
- Lanny M Abetz
- Department of Oral Medicine and Oral Pathology, The University of Queensland School of Dentistry, Brisbane, Qld, Australia Centre for National Research on Disability and Rehabilitation Medicine, School of Medicine, The University of Queensland, Brisbane, Qld, Australia
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López-Jornet P, Camacho-Alonso F, Andujar-Mateos P. A prospective, randomized study on the efficacy of tongue protector in patients with burning mouth syndrome. Oral Dis 2010; 17:277-82. [PMID: 20860765 DOI: 10.1111/j.1601-0825.2010.01737.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To apply a tongue protector with habit-modifying therapy through self-control, in the patients with burning mouth syndrome (BMS). METHODS A prospective, randomized study was made of 65 consecutive patients with BMS. Fifty subjects were randomized to two groups: group A (informed) and group B (informed and the application of a tongue protector). The symptoms were evaluated by VAS, whereas the psychological profile was assessed using the HAD, with application of the quality of life questionnaires SF-36 and OHIP-49. The duration of treatment was 2 months. RESULTS Fifty patients (46 females and 4 males) completed the study. The VAS scores in group B were 8.2 at baseline and 4.5 after 2 months. The respective scores in group A were 7.1 and 5.6 - the differences between the two groups being significant (P < 0.001). In group B the OHIP-49 yielded lower scores for most of the scales, with significant differences vs group A. In group B the SF 36 yielded significant differences vs group A in physical role, bodily pain, general health and emotional role. CONCLUSIONS Parafunctional traumatism of the tongue should be taken into account in the pathogenesis of BMS with a view to exploring new therapeutic options.
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Affiliation(s)
- P López-Jornet
- Department of Oral Medicine, University of Murcia, Murcia, Spain.
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Marino R, Torretta S, Capaccio P, Pignataro L, Spadari F. Different therapeutic strategies for burning mouth syndrome: preliminary data. J Oral Pathol Med 2010; 39:611-6. [DOI: 10.1111/j.1600-0714.2010.00922.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Matsuoka H, Himachi M, Furukawa H, Kobayashi S, Shoki H, Motoya R, Saito M, Abiko Y, Sakano Y. Cognitive profile of patients with burning mouth syndrome in the Japanese population. Odontology 2010; 98:160-4. [PMID: 20652795 DOI: 10.1007/s10266-010-0123-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Accepted: 01/25/2010] [Indexed: 02/08/2023]
Abstract
The present study investigated which cognitive characteristics, including cancer phobia, self-efficacy, pain-related catastrophizing, and anxiety sensitivity, affect burning mouth syndrome (BMS) symptoms in the Japanese population. A total of 46 BMS patients (44 women and 2 men; mean age, 59.98 +/- 9.57 years; range, 30-79 years) completed a battery of questionnaires, including measures of pain severity, oral-related quality of life (QOL), stress-response, pain-related catastrophizing, self-efficacy, anxiety sensitivity, and tongue cancer phobia. The Pain Catastrophizing Scale (PCS), General Self-Efficacy Scale (GSES), and Anxiety Sensitivity Index (ASI) scores in the BMS patients were compared with the scores of Japanese healthy participants (PCS, n = 449; GSES, n = 278; ASI, n = 9603) reported in previous studies. Catastrophizing and anxiety sensitivity were significantly higher in the BMS patients than in the healthy subjects (P < 0.001). In BMS patients, catastrophizing was significantly correlated with pain severity, stress-response, psychological disability, social disability, and handicap. Cancer phobia was significantly correlated with psychological disability and handicap. Since catastrophizing showed a higher correlation with BMS symptoms than cancer phobia, catastrophizing might be a more significant cognitive factor affecting symptoms than cancer phobia in BMS patients in the Japanese population.
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Affiliation(s)
- Hirofumi Matsuoka
- Health Sciences University of Hokkaido Hospital, Sapporo, Hokkaido, Japan
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Barker KE, Batstone MD, Savage NW. Comparison of treatment modalities in burning mouth syndrome. Aust Dent J 2010; 54:300-5; quiz 396. [PMID: 20415927 DOI: 10.1111/j.1834-7819.2009.01154.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Burning mouth syndrome (BMS) is characterized by a spontaneous burning pain in the oral mucosa without known organic cause or standardized treatment. The aims of this study were to assess and compare the efficacy of clonazepam and diazepam in relieving the symptoms associated with BMS and evaluate for which patients this treatment might be effective by correlating treatment efficacy with underlying psychological status. METHODS The medical records of BMS patients attending an oral medicine private practice (1999-2004) were reviewed. The patients were then contacted and asked to complete a short questionnaire regarding their response to diazepam/clonazepam drug therapies. A second group of patients attending the above clinic (n = 30) were asked to fill out a hospital anxiety and depression assessment form in an attempt to correlate treatment success with underlying psychological status. RESULTS A total of 71.4 per cent of patients treated with clonazepam had partial or complete resolution of their oral symptoms, while 55.1 per cent of patients treated with diazepam had improvement of their oral symptoms. There was no correlation between underlying anxiety or depression and efficacy of benzodiazepine medication. CONCLUSIONS A greater percentage of patients taking clonazepam reported either partial or complete relief of symptoms compared to diazepam. However, the differences were not statistically significant. There was no correlation found between underlying psychopathology and treatment success with benzodiazepines.
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Affiliation(s)
- K E Barker
- Oral Medicine, School of Dentistry, The University of Queensland, Brisbane QLD.
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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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46
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Risk factors in burning mouth syndrome: a case–control study based on patient records. Clin Oral Investig 2010; 15:571-5. [DOI: 10.1007/s00784-010-0419-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Accepted: 04/19/2010] [Indexed: 01/04/2023]
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47
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Toida M, Nanya Y, Takeda-Kawaguchi T, Baba S, Iida K, Kato K, Hatakeyama D, Makita H, Yamashita T, Shibata T. Oral complaints and stimulated salivary flow rate in 1188 adults. J Oral Pathol Med 2010; 39:407-19. [PMID: 20202092 DOI: 10.1111/j.1600-0714.2009.00852.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Recently, oral sensory complaints (OSC) were proposed as a disease entity to represent idiopathic sensory disturbances of dry mouth, burning mouth, and taste disturbance, even though neither the status of OSC in the general population nor its underlying mechanism has yet been elucidated. Moreover, these three OSC-related complaints have not been assessed in combination by means of a visual analog scale (VAS) in a large-scale, community-dwelling population of a broad age range. METHODS In a 1188-member community-dwelling adult population, comprised of 373 males and 815 females, aged 20-90 years, the three OSC-related complaints and stimulated salivary flow rate (SSFR) were assessed by means of a VAS and modified Saxon test, respectively. Association of each complaint with age, gender, SSFR, and other complaints was analyzed. RESULTS Increases in both prevalence and intensity of subjective dry mouth and burning mouth were associated closely with decreasing SSFR. Even for taste disturbance, which may be affected less significantly by salivation status than the other two complaints, a significant association was suggested between decreasing SSFR and especially severe taste disturbance. However, these oral complaints were found in considerable prevalence even in the individuals with high SSFR. Often overlapping presentation of these complaints and a close association in intensity between the complaints to each other were also found. CONCLUSIONS Hyposalivation may be a significant and common etiology for the three oral complaints, although the considerable prevalence of complaints without hyposalivation suggests other etiologies, including those related to the OSC.
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Affiliation(s)
- Makoto Toida
- Department of Oral and Maxillofacial Sciences, Gifu University Graduate School of Medicine, Gifu, Japan.
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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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