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Banik S, Ghosh A, Sato H, Onoue S. The efficacy of alpha‐lipoic acid in the management of burning mouth syndrome: An updated systematic review of randomized controlled clinical trials. Health Sci Rep 2023; 6:e1186. [PMID: 37021013 PMCID: PMC10069235 DOI: 10.1002/hsr2.1186] [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: 10/24/2022] [Revised: 03/03/2023] [Accepted: 03/14/2023] [Indexed: 04/05/2023] Open
Abstract
Background and Aims Burning mouth syndrome (BMS) causes burning or uncomfortable feelings in the oral cavity without any obvious injuries. This condition's etiopathogenesis is still unknown, consequently, BMS management is very challenging. Alpha‐lipoic acid (ALA) is a naturally occurring potent bioactive compound that has been found to be useful in the management of BMS in many studies. Therefore, we conducted a comprehensive systematic review to investigate the usefulness of ALA in the management of BMS based on randomized controlled trials (RCTs). Methods Different electronic databases, including PubMed, Scopus, Embase, Web of Science, and Google Scholar, were extensively searched to find relevant studies. Results This study included nine RCTs that matched the inclusion criteria. In most studies, ALA was given at a dose of 600–800 mg/day, with up to two months of follow‐up. The majority of studies (six out of nine studies) indicated that ALA was more effective in BMS patients than in the placebo‐controlled group. Conclusions This comprehensive systematic review provides evidence of the positive outcomes of the treatment of BMS with ALA. However, more research might be needed before ALA can be considered the first‐line therapy for BMS.
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Affiliation(s)
- Sujan Banik
- Department of Pharmacy, Faculty of ScienceNoakhali Science and Technology UniversityNoakhaliBangladesh
- Laboratory of Biopharmacy, School of Pharmaceutical SciencesUniversity of ShizuokaShizuokaJapan
| | - Antara Ghosh
- Laboratory of Biopharmacy, School of Pharmaceutical SciencesUniversity of ShizuokaShizuokaJapan
| | - Hideyuki Sato
- Laboratory of Biopharmacy, School of Pharmaceutical SciencesUniversity of ShizuokaShizuokaJapan
| | - Satomi Onoue
- Laboratory of Biopharmacy, School of Pharmaceutical SciencesUniversity of ShizuokaShizuokaJapan
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2
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Farag AM, Kuten-Shorrer M, Natto Z, Ariyawardana A, Mejia LM, Albuquerque R, Carey B, Chmieliauskaite M, Miller CS, Ingram M, Nasri-Heir C, Sardella A, Carlson CR, Klasser GD. WWOM VII: Effectiveness of systemic pharmacotherapeutic interventions in the management of BMS: A systematic review and meta-analysis. Oral Dis 2023; 29:343-368. [PMID: 33713052 DOI: 10.1111/odi.13817] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/08/2021] [Accepted: 02/22/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To determine the effectiveness of systemic pharmacotherapeutic interventions compared to placebo in burning mouth syndrome (BMS) randomized controlled trials (RCTs) based on the core outcome domains recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT). METHODS A systematic literature review of RCTs, concerning systemic pharmacotherapeutic interventions for BMS, published from January 1994 through October 2019, and meta-analysis was performed. RESULTS Fourteen RCTs (n = 734 participants) were included. Of those, nine were eligible for the quantitative assessment due to the availability/homogeneity of data for at least one of the IMMPACT domains. Pain intensity was the only domain reported in all RCTs. Weighted mean changes in pain intensity, based on visual analogue scale (ΔVAS), were reported in three RCTs at 6 ± 2 weeks and only one RCT at 10+ weeks follow-ups. Quantitative assessment, based on ΔVAS, yielded very low evidence for the effectiveness of alpha-lipoic acid and clonazepam, low evidence for effectiveness of trazodone and melatonin, and moderate evidence for herbal compounds. CONCLUSIONS Based on the RCTs studied, variable levels of evidence exist that suggest that select pharmacological interventions are associated with improved symptoms. However, the underreporting of IMMPACT domains in BMS RCTs restricts the multidimensional assessment of systemic interventions outcomes. Standardized outcome measures need to be applied to future RCTs to improve understanding of intervention outcomes.
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Affiliation(s)
- Arwa M Farag
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King AbdulAziz University, Jeddah, Saudi Arabia.,Division of Oral Medicine, Department of Diagnostic Sciences, Tufts School of Dental Medicine, Boston, MA, USA
| | - Michal Kuten-Shorrer
- Division of Oral Medicine, Department of Diagnostic Sciences, Tufts School of Dental Medicine, Boston, MA, USA.,Department of Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Zuhair Natto
- Department of Dental Public Health, Faculty of Dentistry, King AbdulAziz University, Jeddah, Saudi Arabia.,Department of Periodontology, School of Dental Medicine, Tufts University, Boston, MA, USA
| | - Anura Ariyawardana
- College of Medicine and Dentistry, James Cook University, Cairns, Australia.,Metro South Oral Health, Brisbane, Australia
| | - Lina M Mejia
- Department of Oral Medicine and Diagnostic Sciences, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Rui Albuquerque
- Oral Medicine Department, Guy's and St Thomas Hospital NHS Foundation Trust, King's college London, London, UK
| | - Barbara Carey
- Oral Medicine Department, Guy's and St Thomas Hospital NHS Foundation Trust, King's college London, London, UK
| | - Milda Chmieliauskaite
- Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Craig S Miller
- Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - Mark Ingram
- Medical Center Library, University of Kentucky Libraries, Lexington, KY, USA
| | - Cibele Nasri-Heir
- Center for Temporomandibular Disorders and Orofacial Pain, Department of Diagnostic Sciences, Rutgers School of Dental Medicine, The State University of New Jersey, Newark, NJ, USA
| | - Andrea Sardella
- Unit of Oral Medicine, Oral Pathology and Gerodontology, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milano, Italy
| | - Charles R Carlson
- Orofacial Pain Clinic, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - Gary D Klasser
- Department of Diagnostic Sciences, School of Dentistry, Louisiana State University Health Sciences Center, New Orleans, LA, USA
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3
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Alvarenga-Brant R, Costa FO, Mattos-Pereira G, Esteves-Lima RP, Belém FV, Lai H, Ge L, Gomez RS, Martins CC. Treatments for Burning Mouth Syndrome: A Network Meta-analysis. J Dent Res 2023; 102:135-145. [PMID: 36214096 DOI: 10.1177/00220345221130025] [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: 01/24/2023] Open
Abstract
The aim of this systematic review and network meta-analysis (NMA) of randomized controlled trials was to evaluate the effectiveness of treatments for pain relief of burning mouth syndrome (BMS). Five databases and gray literature were searched. Independent reviewers selected studies, extracted data, and assessed the risk of bias. The primary outcome was pain relief or burning sensation, and the secondary outcomes were side effects, quality of life, salivary flow, and TNF-α and interleukin 6 levels. Four comparable interventions were grouped into different network geometries to ensure the transitivity assumption for pain: photobiomodulation therapy, alpha-lipoic acid, phytotherapics, and anxiolytics/antidepressants. Mean difference (MD) and 95% CI were calculated for continuous outcomes. The minimal important difference to consider a therapy beneficial against placebo was an MD of at least -1 for relief of pain. To interpret the results, the GRADE approach for NMA was used with a minimally contextualized framework and the magnitude of the effect. Forty-four trials were included (24 in the NMA). The anxiolytic (clonazepam) probably reduces the pain of BMS when compared with placebo (MD, -1.88; 95% CI, -2.61 to -1.16; moderate certainty). Photobiomodulation therapy (MD, -1.90; 95% CI, -3.58 to -0.21) and pregabalin (MD, -2.40; 95% CI, -3.49 to -1.32) achieved the minimal important difference of a beneficial effect with low or very low certainty. Among all tested treatments, only clonazepam is likely to reduce the pain of BMS when compared with placebo. The majority of the other treatments had low and very low certainty, mainly due to imprecision, indirectness, and intransitivity. More randomized controlled trials comparing treatments against placebo are encouraged to confirm the evidence and test possible alternative treatments (PROSPERO CRD42021255039).
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Affiliation(s)
- R Alvarenga-Brant
- Department of Clinical Dentistry, Pathology and Oral Surgery, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - F O Costa
- Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - G Mattos-Pereira
- Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - R P Esteves-Lima
- Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - F V Belém
- Department of Pediatric Dentistry, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - H Lai
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - L Ge
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - R S Gomez
- Department of Clinical Dentistry, Pathology and Oral Surgery, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - C C Martins
- Department of Pediatric Dentistry, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
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4
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Abstract
Burning mouth syndrome (BMS) is a rare chronic neuropathic pain condition characterized by recurring burning pain or dysesthesia in the absence of any local or systemic causes of symptoms. The exact pathophysiology of BMS is unknown, but recent research suggests a medley of neuropathic, endocrinological, and psychosocial elements. This article presents a case history and reviews the epidemiology, diagnostic criteria, clinical features, diagnostic investigations, pathophysiology, and management of BMS.
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Affiliation(s)
- Shehryar Nasir Khawaja
- Orofacial Pain Medicine, Shaukat Khanum Memorial Cancer Hospitals and Research Centres, Lahore and Peshawar, Pakistan; Tufts University, School of Dental Medicine, Boston, MA, USA.
| | - Omar F Alaswaiti
- Orofacial Pain Program, Tufts University, School of Dental Medicine, 1 Kneeland St, Boston, MA 02111, USA
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5
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Nosratzehi T. Burning mouth syndrome: a review of therapeutic approach. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 19:83-90. [PMID: 34881535 DOI: 10.1515/jcim-2021-0434] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 11/15/2021] [Indexed: 01/03/2023]
Abstract
Burning mouth syndrome (BMS) is described by an intense burning sensation of the tongue or other oral areas without a clear etiopathology. The diagnosis of BMS is challenging due to variations of manifestations. The management of BMS is complicated due to the complex etiology of the disease. Many medications and treatment methods have been recommended for BMS management, but no one confirmed as the standard method. In this study, the therapeutic approaches of BMS were evaluated. The data of the article was obtained from PubMed/MEDLINE, Cochrane Library, and Web of Science. The following terms including "burning mouth syndrome", "therapy", and "treatment" were used for search in the databases. A wide range of articles about the therapeutic approach of BMS was searched and reviewed. Pharmacological and non-pharmacological approaches have been used for BMS management. Pharmacological treatments are including Capsaicin, Clonazepam, Low-dose aripiprazole, Alpha-lipoic acid, Duloxetine, Amitriptyline, Gabapentin, and Pregabalin, and ultra-micronized palmitoylethanolamide. Non-pharmacological therapies for BMS are cognitive therapy, Electroconvulsive therapy, Laser therapy, Acupuncture and auriculotherapy, Transcranial Magnetic Stimulation (rTMS), Salivary Mechanical Stimulation, and Botulinum Toxin. A detailed assessment of the etiology and pathophysiology of BMS, and having information about novel therapeutic interventions are essential for the management of BMS.
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Affiliation(s)
- Tahereh Nosratzehi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Oral and Dental Disease Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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6
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Chmieliauskaite M, Stelson EA, Epstein JB, Klasser GD, Farag A, Carey B, Albuquerque R, Mejia L, Ariyawardana A, Nasri-Heir C, Sardella A, Carlson C, Miller CS. Consensus agreement to rename burning mouth syndrome and improve International Classification of Diseases-11 disease criteria: an international Delphi study. Pain 2021; 162:2548-2557. [PMID: 34534179 PMCID: PMC8449012 DOI: 10.1097/j.pain.0000000000002243] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 02/09/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT The International Classification of Diseases (ICD-11) proposes revisions in the nomenclature, disease definition, and diagnostic criteria for "burning mouth syndrome" (BMS). This process could benefit from additional systematically collected expert input. Thus, the purpose of this study was to use the Delphi method to (1) determine whether revision in nomenclature and alternative names for "BMS" are warranted and (2) identify areas of consensus among experts for changes to the disease description and proposed diagnostic criteria of "BMS," as described in the ICD-11 (World Health Organization). From 31 international invited experts, 23 who expressed interest were sent the survey. The study used 4 iterative surveys, each with a response rate of ≥82%. Consensus was predefined as 70% of participants in agreement. Data were summarized using both descriptive statistics and qualitative thematic analysis. Consensus indicated that BMS should not be classified as a syndrome and recommended instead renaming to "burning mouth disorder." Consensus included deletion of 2 diagnostic criteria: (1) emotional distress or functional disability and (2) the number of hours symptoms occur per day. Additional items that reached consensus clarified the disease definition and proposed more separate diagnostic criteria, including a list of local and systemic factors to evaluate as potential secondary causes of oral burning. Experts in this study recommended and came to consensus on select revisions to the proposed ICD-11 BMS nomenclature, diagnostic criteria, and disease definition. The revisions recommended have the potential to improve clarity, consistency, and accuracy of diagnosis for this disorder.
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Affiliation(s)
- Milda Chmieliauskaite
- Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Elisabeth A. Stelson
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Joel B. Epstein
- Cedars-Sinai Medical System and City of Hope Comprehensive Cancer Center, Los Angeles, California, United States of America
| | - Gary D. Klasser
- Department of Diagnostic Sciences, School of Dentistry, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States of America
| | - Arwa Farag
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King AbdulAziz University Jeddah, Saudi Arabia nad Department of Diagnostic Sciences, Oral medicine Division, Tufts University School of Dental Medicine, Boston, Massachusetts, United States of America
| | - Barbara Carey
- Department of Oral Medicine, Guýs and St. Thomas NHS Foundation Trust. Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, United Kingdom
| | - Rui Albuquerque
- Department of Oral Medicine, Guýs and St. Thomas NHS Foundation Trust. Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, United Kingdom
| | - Lina Mejia
- College of dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida
| | - Anura Ariyawardana
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Clinical Principal Dentist, Metro South Oral Health, Brisbane, Queensland, Australia
| | - Cibele Nasri-Heir
- Center for Temporomandibular Disorders and Orofacial Pain, Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, New Jersey, United States of America
| | - Andrea Sardella
- Department of Biomedical, Surgical and Dental Sciences, Unit of Oral Medicine, Oral Pathology and Gerodontology, University of Milan, Milan, Italy, Europe
| | - Charles Carlson
- Department of Psychology and Orofacial Pain Center, University of Kentucky, Lexington, Kentucky, United States of America
| | - Craig S. Miller
- Department of Oral Health Practice and Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky, United States of America
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7
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Farag AM, Albuquerque R, Ariyawardana A, Chmieliauskaite M, Forssell H, Nasri‐Heir C, Klasser GD, Sardella A, Mignogna MD, Ingram M, Carlson CR, Miller CS. World Workshop in Oral Medicine VII: Reporting of IMMPACT‐recommended outcome domains in randomized controlled trials of burning mouth syndrome: A systematic review. Oral Dis 2019; 25 Suppl 1:122-140. [DOI: 10.1111/odi.13053] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 01/27/2019] [Accepted: 01/29/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Arwa M. Farag
- Department of Oral Diagnostic Sciences, Faculty of Dentistry King AbdulAziz University Jeddah Saudi Arabia
- Division of Oral Medicine, Department of Diagnostic Sciences Tufts School of Dental Medicine Boston Massachusetts
| | - Rui Albuquerque
- Oral Medicine Department Guy’s and St. Thomas Hospital NHS Foundation Trust, King’s College London London UK
| | - Anura Ariyawardana
- College of Medicine and Dentistry James Cook University Brisbane Queensland Australia
- Clinical Principal Dentist Metro South Oral Health Brisbane Queensland Australia
| | - Milda Chmieliauskaite
- Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, School of Dental Medicine Case Western Reserve University Cleveland Ohio
| | - Heli Forssell
- Department of Oral and Maxillofacial Surgery, Institute of Dentistry University of Turku Turku Finland
| | - Cibele Nasri‐Heir
- Department of Diagnostic Sciences, Center for Temporomandibular Disorders and Orofacial Pain, Rutgers School of Dental Medicine The State University of New Jersey Newark New Jersey
| | - Gary D. Klasser
- Department of Diagnostic Sciences, School of Dentistry Louisiana State University Health Sciences Center New Orleans, Los Angeles
| | - Andrea Sardella
- Department of Biomedical, Surgical and Dental Sciences, Unit of Oral Medicine, Oral Pathology and Gerodontology University of Milan Milano Italy
| | - Michele D. Mignogna
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine Federico II University of Naples Naples Italy
| | - Mark Ingram
- Medical Center Library, College of Communication and Information University of Kentucky Lexington Kentucky
| | - Charles R. Carlson
- Orofacial Pain Clinic, College of Dentistry University of Kentucky Lexington Kentucky
| | - Craig S. Miller
- Department of Oral Health Practice, College of Dentistry University of Kentucky Lexington Kentucky
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8
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Ariyawardana A, Chmieliauskaite M, Farag AM, Albuquerque R, Forssell H, Nasri‐Heir C, Klasser GD, Sardella A, Mignogna MD, Ingram M, Carlson CR, Miller CS. World Workshop on Oral Medicine VII: Burning mouth syndrome: A systematic review of disease definitions and diagnostic criteria utilized in randomized clinical trials. Oral Dis 2019; 25 Suppl 1:141-156. [DOI: 10.1111/odi.13067] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 02/14/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Anura Ariyawardana
- College of Medicine and DentistryJames Cook University Queensland Australia
- Clinical Principal DentistMetro South Oral Health Brisbane Queensland Australia
| | - Milda Chmieliauskaite
- Department of Oral and Maxillofacial Medicine and Diagnostic SciencesSchool of Dental MedicineCase Western Reserve University Cleveland Ohio
| | - Arwa M. Farag
- Department of Oral Diagnostic SciencesFaculty of DentistryKing AbdulAziz University Jeddah Saudi Arabia
- Division of Oral MedicineDepartment of Diagnostic SciencesTufts School of Dental Medicine Boston Massachusetts
| | - Rui Albuquerque
- Oral Medicine DepartmentGuy's and St Thomas Hospital NHS Foundation TrustKing's college London London UK
| | - Heli Forssell
- Department of Oral and Maxillofacial SurgeryInstitute of DentistryUniversity of Turku Turku Finland
| | - Cibele Nasri‐Heir
- Department of Diagnostic SciencesRutgers School of Dental MedicineCenter for Temporomandibular Disorders and Orofacial PainRutgers The State University of New Jersey Newark New Jersy
| | - Gary D. Klasser
- Department of Diagnostic SciencesSchool of DentistryLouisiana State University Health Sciences Center New Orleans Louisiana
| | - Andrea Sardella
- Department of Biomedical, Surgical and Dental SciencesUnit of Oral Medicine, Oral Pathology and GerodontologyUniversity of Milan Milano Italy
| | - Michele D. Mignogna
- Department of Neurosciences, Reproductive and Odontostomatological SciencesSchool of MedicineFederico II University of Naples Naples Italy
| | - Mark Ingram
- Medical Center LibraryUniversity of Kentucky Lexington Kentucky
| | - Charles R. Carlson
- Department of PsychologyCollege of Art & SciencesCollege of DentistryOrofacial Pain ClinicUniversity of Kentucky Lexington Kentucky
| | - Craig S. Miller
- Department of Oral Health PracticeCollege of DentistryUniversity of Kentucky Lexington Kentucky
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9
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What still remains missing from participants' selection criteria in clinical trials and systematic reviews? J Am Dent Assoc 2019; 149:931-934. [PMID: 30724166 DOI: 10.1016/j.adaj.2018.08.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 08/30/2018] [Indexed: 01/09/2023]
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10
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Kim Y, Yoo T, Han P, Liu Y, Inman JC. A pragmatic evidence-based clinical management algorithm for burning mouth syndrome. J Clin Exp Dent 2018; 10:e321-e326. [PMID: 29750091 PMCID: PMC5937967 DOI: 10.4317/jced.54247] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 02/17/2018] [Indexed: 11/05/2022] Open
Abstract
Background Burning mouth syndrome is a poorly understood disease process with no current standard of treatment. The goal of this article is to provide an evidence-based, practical, clinical algorithm as a guideline for the treatment of burning mouth syndrome. Material and Methods Using available evidence and clinical experience, a multi-step management algorithm was developed. A retrospective cohort study was then performed, following STROBE statement guidelines, comparing outcomes of patients who were managed using the algorithm and those who were managed without. Results Forty-seven patients were included in the study, with 21 (45%) managed using the algorithm and 26 (55%) managed without. The mean age overall was 60.4 ±16.5 years, and most patients (39, 83%) were female. Cohorts showed no statistical difference in age, sex, overall follow-up time, dysgeusia, geographic tongue, or psychiatric disorder; xerostomia, however, was significantly different, skewed toward the algorithm group. Significantly more non-algorithm patients did not continue care (69% vs. 29%, p=0.001). The odds ratio of not continuing care for the non-algorithm group compared to the algorithm group was 5.6 [1.6, 19.8]. Improvement in pain was significantly more likely in the algorithm group (p=0.001), with an odds ratio of 27.5 [3.1, 242.0]. Conclusions We present a basic clinical management algorithm for burning mouth syndrome which may increase the likelihood of pain improvement and patient follow-up. Key words:Burning mouth syndrome, burning tongue, glossodynia, oral pain, oral burning, therapy, treatment.
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Affiliation(s)
- Yohanan Kim
- MD, Department of Otolaryngology - Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Timothy Yoo
- BS, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Peter Han
- MD, Department of Otolaryngology - Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Yuan Liu
- MD, Department of Otolaryngology - Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Jared C Inman
- MD, Department of Otolaryngology - Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA
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11
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Barbosa NG, Gonzaga AKG, de Sena Fernandes LL, da Fonseca AG, Queiroz SIML, Lemos TMAM, da Silveira ÉJD, de Medeiros AMC. Evaluation of laser therapy and alpha-lipoic acid for the treatment of burning mouth syndrome: a randomized clinical trial. Lasers Med Sci 2018; 33:1255-1262. [PMID: 29502160 DOI: 10.1007/s10103-018-2472-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 02/20/2018] [Indexed: 12/16/2022]
Abstract
The aim of this study was to evaluate the efficacy of low-level laser therapy (LLLT) and alpha-lipoic acid (ALA) in the treatment of burning mouth syndrome (BMS) and secondary oral burning (SOB) by unstimulated sialometry, symptom assessment, and measurement of salivary TNF-α levels. Forty-four patients were randomized into four treatment groups: BMS/laser (n = 10), BMS/ALA (n = 5), SOB/laser (n = 15), and SOB/ALA (n = 14). The control group consisted of eight healthy female subjects. Unstimulated salivary flow was measured before and after treatment, and the collected saliva was stored at - 20 °C for the analysis of TNF-α. Symptoms were evaluated before and after treatment using a pain visual analog scale. Most patients were women (81.8%) during menopause (72.2%). LLLT and ALA were efficient in increasing salivary flow only in BMS but provided symptom relief in both conditions. TNF-α levels did not differ between patients with BMS and SOB or between those patients and the control group. No differences were observed in posttreatment TNF-α levels in either condition. The results of this study suggest that LLLT and ALA are efficient therapies in reducing burning mouth symptoms, with LLLT being more efficient than ALA.
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Affiliation(s)
- Natália Guimarães Barbosa
- Postgraduate Program in Oral Pathology, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Amanda Katarinny Goes Gonzaga
- Postgraduate Program in Oral Pathology, Federal University of Rio Grande do Norte, Natal, RN, Brazil. .,Departamento de Odontologia, Universidade Federal do Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN, CEP 59056-000, Brazil.
| | - Luzia Leiros de Sena Fernandes
- Postgraduate Program in Technological Development and Innovation in Medicines, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Aldilane Gonçalves da Fonseca
- Postgraduate Program in Technological Development and Innovation in Medicines, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Telma Maria Araújo Moura Lemos
- Postgraduate Program in Technological Development and Innovation in Medicines, Federal University of Rio Grande do Norte, Natal, Brazil
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12
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Häggman-Henrikson B, Alstergren P, Davidson T, Högestätt ED, Östlund P, Tranaeus S, Vitols S, List T. Pharmacological treatment of oro-facial pain - health technology assessment including a systematic review with network meta-analysis. J Oral Rehabil 2017; 44:800-826. [DOI: 10.1111/joor.12539] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2017] [Indexed: 01/11/2023]
Affiliation(s)
- B. Häggman-Henrikson
- Department of Orofacial Pain and Jaw Function; Faculty of Odontology; Malmö University; Malmö Sweden
- Department of Odontology/Clinical Oral Physiology; Umeå University; Umeå Sweden
- Faculty of Odontology; Health Technology Assessment - Odontology (HTA-O); Malmö University; Malmö Sweden
| | - P. Alstergren
- Department of Orofacial Pain and Jaw Function; Faculty of Odontology; Malmö University; Malmö Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON); Malmö Sweden
- Department of Rehabilitation Medicine; Skåne University Hospital; Malmö Sweden
| | - T. Davidson
- Faculty of Odontology; Health Technology Assessment - Odontology (HTA-O); Malmö University; Malmö Sweden
- Department of Medical and Health Sciences; Division of Health Care Analysis; Linköping University; Linköping Sweden
| | - E. D. Högestätt
- Department of Laboratory Medicine; Clinical Chemistry and Pharmacology; Lund University; Lund Sweden
| | - P. Östlund
- Department of Odontology/Clinical Oral Physiology; Umeå University; Umeå Sweden
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU); Stockholm Sweden
| | - S. Tranaeus
- Department of Odontology/Clinical Oral Physiology; Umeå University; Umeå Sweden
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU); Stockholm Sweden
| | - S. Vitols
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU); Stockholm Sweden
- Department of Medicine; Division of Clinical Pharmacology; Karolinska Institute; Stockholm Sweden
| | - T. List
- Department of Orofacial Pain and Jaw Function; Faculty of Odontology; Malmö University; Malmö Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON); Malmö Sweden
- Department of Rehabilitation Medicine; Skåne University Hospital; Malmö Sweden
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13
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Liu YF, Kim Y, Yoo T, Han P, Inman JC. Burning mouth syndrome: a systematic review of treatments. Oral Dis 2017; 24:325-334. [PMID: 28247977 DOI: 10.1111/odi.12660] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 02/12/2017] [Accepted: 02/19/2017] [Indexed: 01/12/2023]
Abstract
Burning mouth syndrome (BMS) is a chronic oral pain syndrome that primarily affects peri- and postmenopausal women. It is characterized by oral mucosal burning and may be associated with dysgeusia, paresthesia, dysesthesia, and xerostomia. The etiology of the disease process is unknown, but is thought to be neuropathic in origin. The goal of this systematic review was to assess the efficacy of the various treatments for BMS. Literature searches were conducted through PubMed, Web of Science, and Cochrane Library databases, which identified 22 randomized controlled trials. Eight studies examined alpha-lipoic acid (ALA), three clonazepam, three psychotherapy, and two capsaicin, which all showed modest evidence of potentially decreasing pain/burning. Gabapentin was seen in one study to work alone and synergistically with ALA. Other treatments included vitamins, benzydamine hydrochloride, bupivacaine, Catuama, olive oil, trazodone, urea, and Hypericum perforatum. Of these other treatments, Catuama and bupivacaine were the only ones with significant positive results in symptom improvement. ALA, topical clonazepam, gabapentin, and psychotherapy may provide modest relief of pain in BMS. Gabapentin may also boost the effect of ALA. Capsaicin is limited by its side effects. Catuama showed potential for benefit. Future studies with standardized methodology and outcomes containing more patients are needed.
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Affiliation(s)
- Y F Liu
- Department of Otolaryngology - Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Y Kim
- Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - T Yoo
- Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - P Han
- Department of Otolaryngology - Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - J C Inman
- Department of Otolaryngology - Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, 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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Jørgensen MR, Pedersen AML. Analgesic effect of topical oral capsaicin gel in burning mouth syndrome. Acta Odontol Scand 2017; 75:130-136. [PMID: 28007005 DOI: 10.1080/00016357.2016.1269191] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To investigate the effectiveness of repeated topical application of oral capsaicin gel in two different concentrations for relief of burning/stinging sensations in patients with burning mouth syndrome (BMS). MATERIAL AND METHODS This randomized double-blind cross-over study included 22 female patients with BMS. The patients were randomized for topical application of either 0.01% or 0.025% oral capsaicin gel on the dorsal part of tongue three times daily for 14 days, followed by 14 days wash-out period, and finally treatment with the other concentration of oral gel three times daily for 14 days. A visual analogue scale (VAS) was used to assess the severity of pain five times during the intervention period. RESULTS 18 patients completed the intervention. Their VAS score at baseline was 5.5 ± 0.6 cm (mean ± SD). Treatment with the two concentrations of capsaicin gels significantly improved the burning/stinging symptoms assessed on VAS compared with baseline (p = 0.002). There was no statistically significant difference between the two concentrations of the gels on relieving symptoms. Four patients dropped out during the intervention period due to gastrointestinal side-effects. CONCLUSIONS Topical capsaicin might be an alternative for the short-term treatment of BMS. However, further studies are needed to investigate especially the gastro-intestinal side-effects which may limit its long-term use.
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Affiliation(s)
- Mette Rose Jørgensen
- Department of Odontology, Section for Oral Medicine, Clinical Oral Physiology, Oral Anatomy and Pathology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
| | - Anne Marie Lynge Pedersen
- Department of Odontology, Section for Oral Medicine, Clinical Oral Physiology, Oral Anatomy and Pathology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
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16
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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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17
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McMillan R, Forssell H, Buchanan JAG, Glenny A, Weldon JC, Zakrzewska JM. Interventions for treating burning mouth syndrome. Cochrane Database Syst Rev 2016; 11:CD002779. [PMID: 27855478 PMCID: PMC6464255 DOI: 10.1002/14651858.cd002779.pub3] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Burning mouth syndrome (BMS) is a term used for oral mucosal pain (burning pain or discomfort in the tongue, lips or entire oral cavity) without identifiable cause. General population prevalence varies from 0.1% to 3.9%. Many BMS patients indicate anxiety, depression, personality disorders and impaired quality of life (QoL). This review updates the previous versions published in 2000 and 2005. OBJECTIVES To determine the effectiveness and safety of any intervention versus placebo for symptom relief and changes in QoL, taste, and feeling of dryness in people with BMS. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 31 December 2015), the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 11) in the Cochrane Library (searched 31 December 2015), MEDLINE Ovid (1946 to 31 December 2015), and Embase Ovid (1980 to 31 December 2015). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. We placed no restrictions on the language or date of publication when searching the electronic databases SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing any treatment against placebo in people with BMS. The primary outcomes were symptom relief (pain/burning) and change in QoL. Secondary outcomes included change in taste, feeling of dryness, and adverse effects. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. Outcome data were analysed as short-term (up to three months) or long-term (three to six months). MAIN RESULTS We included 23 RCTs (1121 analysed participants; 83% female). Interventions were categorised as: antidepressants and antipsychotics, anticonvulsants, benzodiazepines, cholinergics, dietary supplements, electromagnetic radiation, physical barriers, psychological therapies, and topical treatments.Only one RCT was assessed at low risk of bias overall, four RCTs' risk of bias was unclear, and 18 studies were at high risk of bias. Overall quality of the evidence for effectiveness was very low for all interventions and all outcomes.Twenty-one RCTs assessed short-term symptom relief. There is very low-quality evidence of benefit from electromagnetic radiation (one RCT, 58 participants), topical benzodiazepines (two RCTs, 111 participants), physical barriers (one RCT, 50 participants), and anticonvulsants (one RCT, 100 participants). We found insufficient/contradictory evidence regarding the effectiveness of antidepressants, cholinergics, systemic benzodiazepines, dietary supplements or topical treatments. No RCT assessing psychological therapies evaluated short-term symptom relief.Four studies assessed long-term symptom relief. There is very low-quality evidence of a benefit from psychological therapies (one RCT, 30 participants), capsaicin oral rinse (topical treatment) (one RCT, 18 participants), and topical benzodiazepines (one RCT, 66 participants). We found no evidence of a difference for dietary supplements or lactoperoxidase oral rinse. No studies assessing antidepressants, anticonvulsants, cholinergics, electromagnetic radiation or physical barriers evaluated long-term symptom relief.Short-term change in QoL was assessed by seven studies (none long-term).The quality of evidence was very low. A benefit was found for electromagnetic radiation (one RCT, 58 participants), however findings were inconclusive for antidepressants, benzodiazepines, dietary supplements and physical barriers.Secondary outcomes (change in taste and feeling of dryness) were only assessed short-term, and the findings for both were also inconclusive.With regard to adverse effects, there is very low-quality evidence that antidepressants increase dizziness and drowsiness (one RCT, 37 participants), and that alpha lipoic acid increased headache (two RCTs, 118 participants) and gastrointestinal complaints (3 RCTs, 138 participants). We found insufficient/contradictory evidence regarding adverse events for anticonvulsants or benzodiazepines. Adverse events were poorly reported or unreported for cholinergics, electromagnetic radiation, and psychological therapies. No adverse events occurred from physical barriers or topical therapy use. AUTHORS' CONCLUSIONS Given BMS' potentially disabling nature, the need to identify effective modes of treatment for sufferers is vital. Due to the limited number of clinical trials at low risk of bias, there is insufficient evidence to support or refute the use of any interventions in managing BMS. Further clinical trials, with improved methodology and standardised outcome sets are required in order to establish which treatments are effective. Future studies are encouraged to assess the role of treatments used in other neuropathic pain conditions and psychological therapies in the treatment of BMS.
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Affiliation(s)
- Roddy McMillan
- Eastman Dental HospitalDepartment of Oral Medicine and Facial Pain256 Gray's Inn RoadLondonUKWC1X 8LD
| | - Heli Forssell
- University of TurkuOral & Maxillofacial Surgery, Institute of DentistryLemminkäisenkatu 220520TurkuFinland
| | - John AG Buchanan
- Barts and The London School of Medicine and DentistryDepartment of Oral MedicineTurner StreetLondonUKE1 2AD
| | - Anne‐Marie Glenny
- The University of ManchesterDivision of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and HealthJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Jo C Weldon
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Joanna M Zakrzewska
- Eastman Dental HospitalDepartment of Oral Medicine and Facial Pain256 Gray's Inn RoadLondonUKWC1X 8LD
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Cui Y, Xu H, Chen FM, Liu JL, Jiang L, Zhou Y, Chen QM. Efficacy evaluation of clonazepam for symptom remission in burning mouth syndrome: a meta-analysis. Oral Dis 2016; 22:503-11. [PMID: 26680638 DOI: 10.1111/odi.12422] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 12/05/2015] [Accepted: 12/08/2015] [Indexed: 02/05/2023]
Affiliation(s)
- Y Cui
- State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu Sichuan China
| | - H Xu
- State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu Sichuan China
- West China School of Public Health; Sichuan University; Chengdu Sichuan China
| | - FM Chen
- State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu Sichuan China
| | - JL Liu
- State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu Sichuan China
| | - L Jiang
- State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu Sichuan China
| | - Y Zhou
- State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu Sichuan China
| | - QM Chen
- State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu Sichuan China
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19
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Cheung D, Trudgill N. Managing a patient with burning mouth syndrome. Frontline Gastroenterol 2015; 6:218-222. [PMID: 28839812 PMCID: PMC5369598 DOI: 10.1136/flgastro-2014-100431] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Revised: 05/23/2014] [Accepted: 05/26/2014] [Indexed: 02/04/2023] Open
Abstract
A 64-year-old woman presented with an increasing frequency of symptoms of heartburn and retrosternal pain over the last few months, and a constant and intense burning pain affecting her tongue tip, mouth and lips for the past 5 years. She found consuming hot drinks exacerbated the burning oral pain and chewing gum seemed to alleviate some of her symptoms. She thought these oral sensations were caused by frequently licking her finger tips to separate prints in her work in publishing. She had been previously diagnosed with gastro-oesophageal reflux disease (GORD), and her heartburn symptoms had been controlled until recently with lansoprazole 15 mg daily. Her past medical history included irritable bowel syndrome and depression, for which she had been treated with mebeverine and paroxetine for a number of years. She was a non-smoker and did not consume alcohol. Clinical examination was unremarkable with no oral lesions on examination. Her routine laboratory tests, including autoimmune serology, haematinics and thyroid function tests were all within normal limits. She underwent a gastroscopy, which revealed moderate reflux oesophagitis, and following commencing omeprazole 20 mg twice daily, her heartburn resolved. However, her oral burning symptoms were not affected and a diagnosis of burning mouth syndrome (BMS) was made. Following explanation and reassurance concerning the cause of her BMS symptoms, she chose not to receive treatment for this but to access cognitive behavioural therapy in the future if her symptoms worsened.
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Affiliation(s)
- Danny Cheung
- Department of Gastroenterology, Sandwell General Hospital, West Bromwich, UK
| | - Nigel Trudgill
- Department of Gastroenterology, Sandwell General Hospital, West Bromwich, UK
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20
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Palacios-Sánchez B, Moreno-López LA, Cerero-Lapiedra R, Llamas-Martínez S, Esparza-Gómez G. Alpha lipoic acid efficacy in burning mouth syndrome. A controlled clinical trial. Med Oral Patol Oral Cir Bucal 2015; 20:e435-40. [PMID: 26034927 PMCID: PMC4523256 DOI: 10.4317/medoral.20410] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 03/06/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND A double-blind placebo-controlled trial was conducted in order to evaluate the efficacy of alpha lipoic acid (ALA) and determine the statistical significance of the outcome variables. Burning mouth syndrome (BMS) is defined as an oral burning sensation in the absence of clinical signs which could justify the syndrome. Recent studies suggest the existence of neurological factors as a possible cause of the disease. MATERIAL AND METHODS 60 patients with BMS, in two groups: case group with 600 mg/day and placebo as control group; with follow up of 2 months. RESULTS 64% of ALA patients reported some level of improvement, with a level of maintenance of 68.75% one month after treatment. 27.6% of the placebo group also demonstrated some reduction in BMS symptoms. CONCLUSIONS Long-term evolution and the intensity of symptoms are variables that reduce the probability of improvement with ALA treatment.
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21
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Forssell H, Jääskeläinen S, List T, Svensson P, Baad-Hansen L. An update on pathophysiological mechanisms related to idiopathic oro-facial pain conditions with implications for management. J Oral Rehabil 2014; 42:300-22. [DOI: 10.1111/joor.12256] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2014] [Indexed: 01/03/2023]
Affiliation(s)
- H. Forssell
- Department of Oral and Maxillofacial Surgery; Institute of Dentistry; University of Turku; Turku Finland
| | - S. Jääskeläinen
- Department of Clinical Neurophysiology; University of Turku and Turku University Hospital; Turku Finland
| | - T. List
- Department of Orofacial Pain and Jaw Function; Faculty of Odontology; Malmö University; Malmö Denmark
- Department of Rehabilitation Medicine; Skåne University Hospital; Lund Denmark
- Scandinavian Center for Orofacial Neuroscience (SCON); Aarhus University; Aarhus Denmark
| | - P. Svensson
- Scandinavian Center for Orofacial Neuroscience (SCON); Aarhus University; Aarhus Denmark
- Section of Clinical Oral Physiology; Department of Dentistry; HEALTH; Aarhus University; Aarhus Denmark
| | - L. Baad-Hansen
- Scandinavian Center for Orofacial Neuroscience (SCON); Aarhus University; Aarhus Denmark
- Section of Clinical Oral Physiology; Department of Dentistry; HEALTH; Aarhus University; Aarhus Denmark
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22
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Pagano G, Aiello Talamanca A, Castello G, Cordero MD, d'Ischia M, Gadaleta MN, Pallardó FV, Petrović S, Tiano L, Zatterale A. Current experience in testing mitochondrial nutrients in disorders featuring oxidative stress and mitochondrial dysfunction: rational design of chemoprevention trials. Int J Mol Sci 2014; 15:20169-208. [PMID: 25380523 PMCID: PMC4264162 DOI: 10.3390/ijms151120169] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 10/29/2014] [Accepted: 10/30/2014] [Indexed: 02/07/2023] Open
Abstract
An extensive number of pathologies are associated with mitochondrial dysfunction (MDF) and oxidative stress (OS). Thus, mitochondrial cofactors termed "mitochondrial nutrients" (MN), such as α-lipoic acid (ALA), Coenzyme Q10 (CoQ10), and l-carnitine (CARN) (or its derivatives) have been tested in a number of clinical trials, and this review is focused on the use of MN-based clinical trials. The papers reporting on MN-based clinical trials were retrieved in MedLine up to July 2014, and evaluated for the following endpoints: (a) treated diseases; (b) dosages, number of enrolled patients and duration of treatment; (c) trial success for each MN or MN combinations as reported by authors. The reports satisfying the above endpoints included total numbers of trials and frequencies of randomized, controlled studies, i.e., 81 trials testing ALA, 107 reports testing CoQ10, and 74 reports testing CARN, while only 7 reports were retrieved testing double MN associations, while no report was found testing a triple MN combination. A total of 28 reports tested MN associations with "classical" antioxidants, such as antioxidant nutrients or drugs. Combinations of MN showed better outcomes than individual MN, suggesting forthcoming clinical studies. The criteria in study design and monitoring MN-based clinical trials are discussed.
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Affiliation(s)
- Giovanni Pagano
- Istituto Nazionale Tumori Fondazione G. Pascale-Cancer Research Center at Mercogliano (CROM)-IRCCS, Naples I-80131, Italy.
| | - Annarita Aiello Talamanca
- Istituto Nazionale Tumori Fondazione G. Pascale-Cancer Research Center at Mercogliano (CROM)-IRCCS, Naples I-80131, Italy.
| | - Giuseppe Castello
- Istituto Nazionale Tumori Fondazione G. Pascale-Cancer Research Center at Mercogliano (CROM)-IRCCS, Naples I-80131, Italy.
| | - Mario D Cordero
- Research Laboratory, Dental School, Universidad de Sevilla, Sevilla 41009, Spain.
| | - Marco d'Ischia
- Department of Chemical Sciences, University of Naples "Federico II", Naples I-80126, Italy.
| | - Maria Nicola Gadaleta
- National Research Council, Institute of Biomembranes and Bioenergetics, Bari I-70126, Italy.
| | - Federico V Pallardó
- CIBERER (Centro de Investigación Biomédica en Red de Enfermedades Raras), University of Valencia-INCLIVA, Valencia 46010, Spain.
| | - Sandra Petrović
- Vinca" Institute of Nuclear Sciences, University of Belgrade, Belgrade 11001, Serbia.
| | - Luca Tiano
- Biochemistry Unit, Department of Clinical and Dental Sciences, Polytechnical University of Marche, Ancona I-60131, Italy.
| | - Adriana Zatterale
- Genetics Unit, Azienda Sanitaria Locale (ASL) Napoli 1 Centro, Naples I-80136, Italy.
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Miziara I, Chagury A, Vargas C, Freitas L, Mahmoud A. Therapeutic options in idiopathic burning mouth syndrome: literature review. Int Arch Otorhinolaryngol 2014; 19:86-9. [PMID: 25992157 PMCID: PMC4392507 DOI: 10.1055/s-0034-1378138] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 04/15/2014] [Indexed: 01/22/2023] Open
Abstract
Introduction Burning mouth syndrome (BMS) is characterized by a burning sensation in the tongue, palate, lips, or gums of no well-defined etiology. The diagnosis and treatment for primary BMS are controversial. No specific laboratory tests or diagnostic criteria are well established, and the diagnosis is made by excluding all other possible disorders. Objective To review the literature on the main treatment options in idiopathic BMS and compare the best results of the main studies in 15 years. Data Synthesis We conducted a literature review on PubMed/MEDLINE, SciELO, and Cochrane-BIREME of work in the past 15 years, and only selected studies comparing different therapeutic options in idiopathic BMS, with preference for randomized and double-blind controlled studies. Final Comments Topical clonazepam showed good short-term results for the relief of pain, although this was not presented as a definitive cure. Similarly, α-lipoic acid showed good results, but there are few randomized controlled studies that showed the long-term results and complete remission of symptoms. On the other hand, cognitive therapy is reported as a good and lasting therapeutic option with the advantage of not having side effects, and it can be combined with pharmacologic therapy.
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Affiliation(s)
- Ivan Miziara
- Department of Otolaryngology, Universidade de São Paulo, São Paulo, Brazil
| | - Azis Chagury
- Department of Otolaryngology, Universidade de São Paulo, São Paulo, Brazil
| | - Camila Vargas
- Department of Otolaryngology, Universidade de São Paulo, São Paulo, Brazil
| | - Ludmila Freitas
- Department of Otolaryngology, Universidade de São Paulo, São Paulo, Brazil
| | - Ali Mahmoud
- Department of Otolaryngology, Universidade de São Paulo, São Paulo, Brazil
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Sun A, Wu KM, Wang YP, Lin HP, Chen HM, Chiang CP. Burning mouth syndrome: a review and update. J Oral Pathol Med 2013; 42:649-55. [PMID: 23772971 DOI: 10.1111/jop.12101] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2013] [Indexed: 01/06/2023]
Abstract
Burning mouth syndrome (BMS) is characterized by the presence of burning sensation of the oral mucosa in the absence of clinically apparent mucosal alterations. It occurs more commonly in middle-aged and elderly women and often affects the tongue tip and lateral borders, lips, and hard and soft palate. In addition to a burning sensation, the patients with BMS may also complain unremitting oral mucosal pain, dysgeusia, and xerostomia. BMS can be classified into two clinical forms: primary and secondary BMS. The primary BMS is essential or idiopathic, in which the organic local/systemic causes cannot be identified and a neuropathological cause is likely. The diagnosis of primary BMS depends mainly on exclusion of etiological factors. The secondary BMS is caused by local, systemic, and/or psychological factors; thus, its diagnosis depends on identification of the exact causative factor. When local, systemic or psychological factors are present, treatment or elimination of these factors usually results in a significant clinical improvement of BMS symptoms. Vitamin, zinc, or hormone replacement therapy has been found to be effective for reducing the oral burning or pain symptom in some BMS patients with deficiency of the corresponding factor. If patients still have the symptoms after the removal of potential causes, drug therapy should be instituted. Previous randomized controlled clinical trials found that drug therapy with capsaicin, alpha-lipoic acid, clonazepam, and antidepressants may provide relief of oral burning or pain symptom. In addition, psychotherapy and behavioral feedback may also help eliminate the BMS symptoms.
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Affiliation(s)
- Andy Sun
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
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Corsalini M, Di Venere D, Pettini F, Lauritano D, Petruzzi M. Temporomandibular disorders in burning mouth syndrome patients: an observational study. Int J Med Sci 2013; 10:1784-9. [PMID: 24273452 PMCID: PMC3837237 DOI: 10.7150/ijms.6327] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 10/07/2013] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Burning Mouth Syndrome (BMS) is a chronic disease characterized by absence of any lesions and burning of the oral mucosa associated to a sensation of dry mouth and/or taste alterations. The purpose of our study is to estimate signs and symptoms of Temporomandibular Disorders (TMD) in patients with BMS and to investigate for the existence of an association between BMS and TMD. MATERIALS AND METHODS Forty-four BMS patients were enrolled; BMS subtype was established according to the classification of Lamey. After a gnathological evaluation, according to the protocol of the European Academy of Craniomandibular Disorders, patients were classified by RDC/TMD criteria. The data were compared and analyzed using a chi-square test to describe the existence of an association between BMS and TMD. RESULTS 65.9% the BMS patients showed disorders classified as primary signs and symptoms of TMD according to RDC / TMD criteria, and 72.7% showed parafunctional habits. The chi-square test revealed a statistically significant association (p = 0.035) between BMS and TMD. CONCLUSION The data suggest that there is a possible relationship not yet well understood between BMS and TMD, may be for neurophatic alterations assumed for BMS that could be also engaged in TMD pathogenesis.
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Affiliation(s)
- Massimo Corsalini
- 1. MD, DMD Assistant professor, Dental School University of Bari, Section of TMD Diagnosis and Treatment
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Ni Riordain R, McCreary C. Patient-reported outcome measures in burning mouth syndrome - a review of the literature. Oral Dis 2012; 19:230-5. [DOI: 10.1111/j.1601-0825.2012.01952.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sohaib M, Anjum FM, Khan MI, Arshad MS, Shahid M. Enhancement of lipid stability of broiler breast meat and meat products fed on alpha lipoic acid and alpha tocopherol acetate supplemented feed. Lipids Health Dis 2012; 11:57. [PMID: 22640892 PMCID: PMC3473250 DOI: 10.1186/1476-511x-11-57] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2012] [Accepted: 05/28/2012] [Indexed: 12/14/2022] Open
Abstract
This study was designed to investigate the effect of alpha lipoic acid (ALA) and alpha tocopherol acetate (ATA) on the antioxidant potential, lipid stability and the quality of the broiler breast meat and meat products. The treatment plan was as (T1 = control feed, T2 = 200 mg ATA + 25 mg ALA/kg feed, T3 = 200 mg ATA + 75 mg ALA/kg feed, T4 = 200 mg ATA + 150 mg ALA/kg feed, T5 = Oxidized oil (4%), T6 = 200 mg ATA + 150 mg ALA + Oxidized oil (4%)/kg feed). After two weeks of acclimatization the birds were fed with ALA and ATA enriched diet. The results revealed that maximum deposition of ALA took place in T4 which contain maximum dose of ALA. The TBARS and DPPH values of the broiler breast meat were in T4 (0.14 ± 0.01 MDA/kg of meat, 76.69 ± 0.14%) and in T5 were (0.24 ± 0.15 MDA/Kg of meat, 44.98 ± 0.04%) accordingly. ATA concentration were also highest in T4 (206.43 ± 0.22 mg/g of meat) and lowest in T5 (79.09 ± 0.06 mg/g of meat). Sensory evaluation results showed that nuggets and patties made of T5 containing oxidized oil were least liked and T4 got highest score. In a nutshell, 150 mg/kg feed dietary supplementation of ALA with constant level of ATA can ameliorate the antioxidant potential, lipid stability and nutritional qualities of broiler breast meat and meat products.
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Affiliation(s)
- Muhammad Sohaib
- National Institute of Food Science and Technology, University of Agriculture, Faisalabad, Pakistan.
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Spanemberg JC, Cherubini K, de Figueiredo MAZ, Yurgel LS, Salum FG. Aetiology and therapeutics of burning mouth syndrome: an update. Gerodontology 2012; 29:84-9. [DOI: 10.1111/j.1741-2358.2010.00384.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Carbone M, Pentenero M, Carrozzo M, Ippolito A, Gandolfo S. Lack of efficacy of alpha-lipoic acid in burning mouth syndrome: A double-blind, randomized, placebo-controlled study. Eur J Pain 2012; 13:492-6. [DOI: 10.1016/j.ejpain.2008.06.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2008] [Revised: 05/26/2008] [Accepted: 06/07/2008] [Indexed: 10/21/2022]
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31
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de Moraes M, do Amaral Bezerra BA, da Rocha Neto PC, de Oliveira Soares ACA, Pinto LP, de Lisboa Lopes Costa A. Randomized trials for the treatment of burning mouth syndrome: an evidence-based review of the literature. J Oral Pathol Med 2011; 41:281-7. [DOI: 10.1111/j.1600-0714.2011.01100.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Shivpuri A, Sharma S, Trehan M, Gupta N. Burning mouth syndrome: A comprehensive review of literature. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.ajoms.2011.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Napeñas JJ, Zakrzewska JM. Diagnosis and management of trigeminal neuropathic pains. Pain Manag 2011; 1:353-65. [DOI: 10.2217/pmt.11.35] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Trigeminal neuropathic pains have presented diagnostic and therapeutic challenges to providers. In addition, knowledge of pathophysiology, current classification systems, taxonomy and phenotyping of these conditions are incomplete. While trigeminal neuralgia is the most identifiable and studied, other conditions are being recognized and require distinct management approaches. Furthermore, other facial pain conditions such as atypical odontalgia and burning mouth syndrome are now considered to have neuropathic elements in their etiology. This article reviews current knowledge on the pathophysiology, diagnosis and management of neuropathic pain conditions involving the trigeminal nerve, to include: trigeminal neuralgia, trigeminal neuropathic pain (with traumatically induced neuralgia and atypical odontalgia) and burning mouth syndrome. Treatment modalities are reviewed based on current and best available evidence. Trigeminal neuralgia is managed with anticonvulsant drugs as the first line, with surgical options providing variable results. Trigeminal neuropathic pain is managed medically based on the guidelines for other neuropathic pain conditions. Burning mouth syndrome is also treated with a number of neuropathic medications, both topical and systemic. In all these conditions, patients need to be thoroughly educated about their condition, involved in its management, and be provided with supportive and adjunctive treatment resources.
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Affiliation(s)
- Joel J Napeñas
- Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA
| | - Joanna M Zakrzewska
- Division of Diagnostic, Surgical and Medical Sciences, Eastman Dental Hospital, London, UK
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Minor JS, Epstein JB. Burning mouth syndrome and secondary oral burning. Otolaryngol Clin North Am 2011; 44:205-19, vii. [PMID: 21093630 DOI: 10.1016/j.otc.2010.09.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Burning mouth syndrome is a complex disorder of unclear etiology that is most prevalent in perimenopausal women. It is often accompanied by dysguesia and subjective xerostomia. Recent evidence implicates both central and peripheral neuropathies, possibly representing a phantom pain syndrome in some patients. Ensuring that the patient's oral burning is not secondary to some other local or systemic factor is central to appropriate management. Current standard therapies include clonazepam, paroxetine, and cognitive behavioral therapy, and several promising new alternatives are described.
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Affiliation(s)
- Jacob S Minor
- Department of Otolaryngology, University of Colorado at Denver, Denver, CO 80045, USA.
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35
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Becker S, Schmidt C, Berghaus A, Tschiesner U, Olzowy B, Reichel O. Does laryngopharyngeal reflux cause intraoral burning sensations? A preliminary study. Eur Arch Otorhinolaryngol 2011; 268:1375-81. [PMID: 21359587 DOI: 10.1007/s00405-011-1543-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Accepted: 02/17/2011] [Indexed: 11/25/2022]
Abstract
Intraoral burning sensations are a common problem in the otolaryngological practice. The aim of this study was to evaluate if laryngopharyngeal reflux can cause intraoral burning sensations by measuring oropharyngeal acid reflux. Patients with recurring intraoral burning sensations underwent oropharyngeal pH monitoring in our outpatient clinic. The pH catheter was placed at the level of the uvula. The catheter contained an externally worn transmitter, which wirelessly sent the data to a monitor. In addition, patients were instructed to indicate meals or the occurrence of burning sensations by pressing provided buttons on the monitor. Corresponding events of burning sensations and a significant decrease in oropharyngeal pH values should be visualized. Twenty two patients suffering from recurring intraoral burning sensations underwent oropharyngeal pH measurement for 21-25 h. We could find oropharyngeal reflux episodes in 11 patients. However, we could not detect any episodes of burning sensations in the mouth corresponding with a decrease in oropharyngeal pH values. Our results suggest that there is no causal connection between LPR episodes and the occurrence of intraoral burning sensations in the examined patients. Although further studies with more patients are necessary in the future, we conclude from our findings that recurring intraoral burning sensations are not an indication for proton pump inhibitor therapy.
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Affiliation(s)
- Sven Becker
- Department of Otorhinolaryngology-Head and Neck Surgery, Ludwig Maximilians University, Munich, Germany
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36
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Ni Riordain R, Moloney E, O’Sullivan K, McCreary C. Burning mouth syndrome and oral health-related quality of life: is there a change over time? Oral Dis 2010; 16:643-7. [DOI: 10.1111/j.1601-0825.2010.01666.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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37
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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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38
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Dietary alpha lipoic acid supplementation prevents synovial inflammation and bone destruction in collagen-induced arthritic mice. Rheumatol Int 2010; 31:1583-90. [PMID: 20496068 DOI: 10.1007/s00296-010-1505-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Accepted: 04/27/2010] [Indexed: 10/19/2022]
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disorder characterized by chronic inflammation and joint destruction. In this study, we investigated whether dietary supplementation with alpha lipoic acid (ALA) suppresses collagen-induced arthritis (CIA) in mice. Mice were randomly divided into three groups: (1) a control CIA group was fed a normal diet, (2) a CIA group was fed a 0.1% ALA diet (average ALA intake of 160 mg/kg/day), and (3) a CIA group was fed a 0.5% ALA diet (average ALA intake of 800 mg/kg/day). The ALA-fed mice showed a decreased incidence and severity of arthritis compared to the normal diet group. Radiographic findings revealed a dramatic decrease in bone destruction, and histological findings showed extensively suppressed pathological changes in the ALA-fed mice. The ALA-fed mice exhibited inhibited generation of tartrate resistant acid phosphatase (TRAP)-positive osteoclasts in vivo. Additionally, ALA-fed mice reduced production of various proinflammatory cytokines and the soluble receptor activator of NF-κB ligand (sRANKL) in the joint tissues and the sera. In conclusion, dietary supplementation with ALA attenuated inflammatory responses and bone destruction in CIA mice.
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40
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Toida M, Kato K, Makita H, Long NK, Takeda T, Hatakeyama D, Yamashita T, Shibata T. Palliative effect of lafutidine on oral burning sensation. J Oral Pathol Med 2009; 38:262-8. [DOI: 10.1111/j.1600-0714.2008.00736.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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41
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Cavalcanti DR, Da Silveira FRX. Alpha lipoic acid in burning mouth syndrome - a randomized double-blind placebo-controlled trial. J Oral Pathol Med 2009; 38:254-61. [DOI: 10.1111/j.1600-0714.2008.00735.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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42
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LÓPEZ-JORNET P, CAMACHO-ALONSO F, LEON-ESPINOSA S. Efficacy of alpha lipoic acid in burning mouth syndrome: a randomized, placebo-treatment study. J Oral Rehabil 2009; 36:52-7. [DOI: 10.1111/j.1365-2842.2008.01914.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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43
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Cervigón I, Torres L, Palomo Á. Burning Mouth Syndrome and α-Lipoic Acid. ACTAS DERMO-SIFILIOGRAFICAS 2009. [DOI: 10.1016/s1578-2190(09)70036-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
Burning mouth syndrome (BMS) is a chronic disease characterized by burning of the oral mucosa associated with a sensation of dry mouth and/or taste alterations. BMS occurs more frequently among postmenopausal women. The pathophysiology of the disease is still unknown, and evidence is conflicting; although some studies suggest a central origin, others point to a peripheral neuropathic origin. The efficacy of some medications in the treatment of BMS suggests that the dopaminergic system may be involved.
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45
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Steele JC, Bruce AJ, Drage LA, Rogers RS. α-Lipoic acid treatment of 31 patients with sore, burning mouth. Oral Dis 2008; 14:529-32. [DOI: 10.1111/j.1601-0825.2007.01414.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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46
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Klasser GD, Fischer DJ, Epstein JB. Burning Mouth Syndrome: Recognition, Understanding, and Management. Oral Maxillofac Surg Clin North Am 2008; 20:255-71, vii. [DOI: 10.1016/j.coms.2007.12.012] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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47
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Stuginski-Barbosa J, Rodrigues GGR, Bigal ME, Speciali JG. Burning mouth syndrome responsive to pramipexol. J Headache Pain 2008; 9:43-5. [PMID: 18219443 PMCID: PMC3476177 DOI: 10.1007/s10194-008-0003-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2007] [Accepted: 11/25/2007] [Indexed: 10/25/2022] Open
Abstract
Burning mouth syndrome (BMS) is characterized by burning discomfort or pain in otherwise normal oral mucosa. It is usually refractory. Treatment modalities are scarce. Herein we report one case of primary disabling BMS, previously refractory to multiple regimens, with complete and persistent improvement with pramipexol, a nonergot dopamine agonist which has high selectivity for dopaminergic D2 receptors. We discuss potential pathophysiological implications of our findings.
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Affiliation(s)
- J. Stuginski-Barbosa
- The Department of Neurology, School of Medicine at Ribeirão Preto, Ribeirão Preto, SP Brazil
| | - G. G. R. Rodrigues
- The Department of Neurology, School of Medicine at Ribeirão Preto, Ribeirão Preto, SP Brazil
| | - M. E. Bigal
- Neurology, The Albert Einstein College of Medicine, Bronx, NY USA
| | - J. G. Speciali
- The Department of Neurology, School of Medicine at Ribeirão Preto, Ribeirão Preto, SP Brazil
- Hospital das Clínicas de Ribeirão Preto, Avenida Bandeirantes, 3900, Ribeirão Preto, SP 14400-000 Brazil
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48
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Patton LL, Siegel MA, Benoliel R, De Laat A. Management of burning mouth syndrome: systematic review and management recommendations. ACTA ACUST UNITED AC 2007; 103 Suppl:S39.e1-13. [PMID: 17379153 DOI: 10.1016/j.tripleo.2006.11.009] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2006] [Accepted: 11/06/2006] [Indexed: 11/23/2022]
Abstract
Primary burning mouth syndrome (BMS) is a chronic, idiopathic intraoral mucosal pain condition that is not accompanied by clinical lesions or systemic disease. There is some uncertainty whether this condition should be referred to as a disease, a disorder, or a syndrome but there are insufficient data to justify any change in taxonomy at present. BMS occurs most often among women and is often accompanied by xerostomia and taste disturbances. More recently a neuropathological basis has been proposed so that BMS may be regarded as an oral dysesthesia or painful neuropathy. However, our incomplete understanding of the epidemiology, etiology, pathophysiology, and lack of diagnostic criteria are barriers to critical investigation and selection of effective treatments. There is only limited evidence to guide clinicians in the management of patients with BMS. Treatable secondary causes should be investigated before diagnosing primary BMS. Topical clonazepam and cognitive therapy have been proven efficacious in some patients. Emerging evidence supports the effectiveness of the antioxidant, alpha lipoic acid, with further studies of this agent being warranted. Additional research into mechanisms, diagnostic criteria, and randomized controlled interventional studies are needed.
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Affiliation(s)
- Lauren L Patton
- Department of Dental Ecology, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7450, USA.
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49
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Cavalcanti DR, Birman EG, Migliari DA, Silveira FRXD. Burning mouth syndrome: clinical profile of Brazilian patients and oral carriage of candida species. Braz Dent J 2007; 18:341-5. [DOI: 10.1590/s0103-64402007000400013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2007] [Accepted: 05/23/2007] [Indexed: 11/22/2022] Open
Abstract
Burning mouth syndrome (BMS) is a complex disease of unknown cause. It is characterized by a burning sensation in the oral mucosa, notwithstanding its clinical normal aspect. BMS is particularly seen in postmenopausal women. The purpose of this study was to investigate this syndrome on a clinical basis and, in addition, to analyze its possible relation to the frequency of Candida species. Thirty-one patients (28 women and 3 men; 13 Caucasians and 18 non-Caucasians; mean age = 61.3, range 30-85 years) were evaluated. Most patients (80.6%) were under long-term medication, antihypertensive, ansiolitic and antidepressant drugs being the most used. Burning mouth complaint was associated with other secondary oral complaints in 83.8% of the cases. Tongue was the most commonly affected site (70.9%), followed by the vermillion border of the lower lip (38.7%) and hard palate (32.2%). The association of the burning sensation with oral cancer (cancer phobia) was reported by 67.7% of the patients. Haematologic examination (hematocrit, haemoglobin and fasting blood glucose level) revealed 2 cases each of anemia and type 2 diabetes. Local factors, tooth extractions and dentures wearing, were associated with the onset of symptoms in 35.5% of the cases. Daily activities were changed as a consequence of BMS in 29% of the patients. Among the species of the genus Candida, C. albicans was the most frequent in BMS patients (9 - 29.03%) and controls (12 - 38.70%), followed respectively by C. parapsilosis (2 - 6.45% and 0 - 0%); C. tropicalis (1 - 3.22% and 2 - 6.45%); C. krusei and C. kefyr (1 - 3.22% and 0 - 0%). Therefore, such difference did not reach valuable results. In conclusion, these data were similar to those reported in other studies. The highlights of the present findings were the possible relation of BMS with chronic drug use, depression, menopause and cancer phobia. No association was found between BMS and the prevalence of Candida species.
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50
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Albuquerque RJC, de Leeuw R, Carlson CR, Okeson JP, Miller CS, Andersen AH. Cerebral activation during thermal stimulation of patients who have burning mouth disorder: An fMRI study. Pain 2006; 122:223-234. [PMID: 16632202 DOI: 10.1016/j.pain.2006.01.020] [Citation(s) in RCA: 115] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2005] [Revised: 01/05/2006] [Accepted: 01/17/2006] [Indexed: 10/24/2022]
Abstract
The pathophysiology of burning mouth disorder (BMD) is not clearly understood, but central neuropathic mechanisms are thought to be involved. The aim of this study was to gain insight into the pathophysiology associated with BMD by using functional magnetic resonance imaging (fMRI). Areas of brain activation following thermal stimulation of the trigeminal nerve of eight female patients with BMD (mean age 49.1+/-10.1) were mapped using fMRI and compared with those of eight matched pain-free volunteers (mean age 50.3+/-12.3). Qualitative and quantitative differences in brain activation patterns between the two study groups were demonstrated. BMD patients displayed greater fractional signal changes in the right anterior cingulate cortex (BA 32/24) and bilateral precuneus than did controls (p<0.005). The control group showed larger fractional signal changes in the bilateral thalamus, right middle frontal gyrus, right pre-central gyrus, left lingual gyrus, and cerebellum than did the BMD patients (p<0.005). In addition, BMD patients had less volumetric activation throughout the entire brain compared to the control group. Overall, BMD patients displayed brain activation patterns similar to those of patients with other neuropathic pain conditions and appear to process thermal painful stimulation to the trigeminal nerve qualitatively and quantitatively different than pain-free individuals. These findings suggest that brain hypoactivity may be an important feature in the pathophysiology of BMD.
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Affiliation(s)
- Romulo J C Albuquerque
- University of Kentucky, Department of Oral Health Science, USA University of Kentucky, Department of Anatomy and Neurobiology, USA University of Kentucky, Department of Psychology, USA
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