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Calabria E, Canfora F, Leuci S, Coppola N, Pecoraro G, Giudice A, Antonelli A, Aria M, D'Aniello L, Mignogna MD, Adamo D. Gender differences in pain perception among burning mouth syndrome patients: a cross-sectional study of 242 men and 242 women. Sci Rep 2024; 14:3340. [PMID: 38336850 PMCID: PMC10858236 DOI: 10.1038/s41598-024-53074-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/27/2024] [Indexed: 02/12/2024] Open
Abstract
Several orofacial painful conditions are influenced by gender-related factors, but no studies are available with regard to Burning Mouth Syndrome (BMS). The present study aimed at investigating gender differences among BMS patients and their influence on pain perception. 242 BMS males (BMSm) and 242 BMS females (BMSf) matched for age were consecutively enrolled. Sociodemographic and clinical characteristics were recorded and the numeric rating scale (NRS), the Total Pain Rating Index (T-PRI), the Hamilton rating scale for anxiety and depression (HAM-A, HAM-D), the Pittsburgh sleep quality index (PSQI) and the Epworth sleepiness scale (ESS) were administered. The BMSm presented statistically significant higher levels of education and rate of employment compared to the BMSf (p-values: 0.001**). Moreover, the BMSm were greater consumers of alcohol and had a higher BMI than the BMSf (p-values: < 0.001**, 0.034*). With respect to systemic comorbidities, cardiovascular diseases were statistically more prevalent among the BMSm, while hypothyroidism was more frequent in the BMSf (p-vales: < 0.001**). No differences were noted between the two groups in terms of oral symptoms and in the median scores of NRS, T-PRI, HAM-A, HAM-D, PSQI and ESS. Interestingly, the multivariate regression analysis revealed that, while anxiety, high BMI, poor sleep and high level of T-PRI were correlated to the intensity of pain (NRS) in both groups, low education was additional predictor of pain in BMSf. Further, depression, alcohol and intensity of pain were factors positively associated to the quality of pain (T-PRI) in the BMSm, whereas low education, non-married status and NRS were correlated to the T-PRI, in the BMSf. Surprisingly, smoking was inversely correlated to the intensity of pain and quality of pain respectively in BMSf and BMSm. Sociodemographic and risk factors were found to differently influence pain perception in BMSm and BMSf. Therefore, clinicians should take into account gender differences in the assessment of BMS patients to better tailor the overall pain management.
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Affiliation(s)
- Elena Calabria
- Department of Health Sciences, School of Dentistry, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Federica Canfora
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Pansini N°5, 80131, Naples, Italy.
| | - Stefania Leuci
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Pansini N°5, 80131, Naples, Italy
| | - Noemi Coppola
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Pansini N°5, 80131, Naples, Italy
| | - Giuseppe Pecoraro
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Pansini N°5, 80131, Naples, Italy
| | - Amerigo Giudice
- Department of Health Sciences, School of Dentistry, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Alessandro Antonelli
- Department of Health Sciences, School of Dentistry, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Massimo Aria
- Department of Economics and Statistics, University of Naples Federico II, Naples, Italy
| | - Luca D'Aniello
- Department of Social Sciences, University of Naples Federico II, Naples, Italy
| | - Michele Davide Mignogna
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Pansini N°5, 80131, Naples, Italy
| | - Daniela Adamo
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Pansini N°5, 80131, Naples, Italy
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Porporatti AL, Schroder ÂGD, Lebel A, Moreau N, Misery L, Alajbeg I, Braud A, Boucher Y. Is burning mouth syndrome associated with stress? A meta-analysis. J Oral Rehabil 2023; 50:1279-1315. [PMID: 37332081 DOI: 10.1111/joor.13536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 04/04/2023] [Accepted: 06/10/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Some studies have shown burning mouth syndrome (BMS) as comorbid psychosocial and psychiatric disorders, and as well, pointed at stress as a major risk factor. OBJECTIVE The aim of this meta-analysis was to answer the following question: 'Is there an association between BMS and stress, compared to healthy controls?' METHODS Two reviewers searched for the effect of stress in BMS and published on five main databases and three from the grey literature. Various questionnaires and biomarkers were analysed. Of the 2489 selected articles, 30 met the inclusion criteria. Studies englobed questionnaires, such as Perceived Stress Questionnaire, Lipp Stress Symptoms Inventory, Holmes-Rahe scale, Depression, Anxiety, and Stress Scale (DASS-21), Recent Experience Test; and various biomarkers, such as cortisol, opiorphin, IgA, α-amylase and interleukins. RESULTS In all studies with questionnaires, stress was significantly increased in the BMS group vs. control. Patients with BMS presented 25.73% higher cortisol levels, 28.17% higher IgA levels and 40.62% higher α-amylase levels than controls. Meta-analysis found that BMS subjects presented 3.01 nmoL/L [0.53; 5.50] higher cortisol levels, 84.35 kU/L [15.00; 153.71] higher α-amylase levels, 29.25 mg/mL [9.86; 48.64] higher IgA levels and 258.59 pg/mL [59.24; 457.94] higher IL-8 levels than control. No differences were found for opiorphin concentration in ng/mL [-0.96; 2.53]. For interleukins, no differences were founded for IL-1 β, IL-2, IL-4, IL-6, IL-8, IL-10 and TNF-α. CONCLUSION Based on the available evidence, this meta-analysis suggests more stress factors in questionnaire-based studies, and higher levels of cortisol, α-amylase, IgA and IL-8 biomarkers in BMS subjects than controls.
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Affiliation(s)
- André Luís Porporatti
- Laboratoire de Neurobiologie Oro-Faciale (EA 7543), Université Paris Cité, France and GHPS Assistance Publique Hôpitaux de Paris, Paris, France
| | | | - Ashley Lebel
- Laboratoire de Neurobiologie OroFaciale, Université Paris Cité, France and GHPS Assistance Publique Hôpitaux de Paris, Paris, France
| | - Nathan Moreau
- Laboratoire de Neurobiologie Oro-Faciale (EA 7543), Université Paris Cité and Hôpital Bretonneau (AP-HP), Paris, France
| | | | | | - Adeline Braud
- Laboratoire de Neurobiologie Oro-Faciale (EA 7543), Université Paris Cité, France and GHPS Assistance Publique Hôpitaux de Paris, Paris, France
| | - Yves Boucher
- Laboratoire de Neurobiologie Oro-Faciale (EA 7543), Université Paris Cité, France and GHPS Assistance Publique Hôpitaux de Paris, Paris, France
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Glavina A, Lugović-Mihić L, Martinović D, Cigić L, Tandara L, Lukenda M, Biočina-Lukenda D, Šupe-Domić D. Association between Salivary Cortisol and α-Amylase with the Psychological Profile of Patients with Oral Lichen Planus and Burning Mouth Syndrome: A Case-Control Study. Biomedicines 2023; 11:2182. [PMID: 37626679 PMCID: PMC10452894 DOI: 10.3390/biomedicines11082182] [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: 07/07/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
The aim of our study was to assess the relationship between the concentration/activity of salivary stress biomarkers (cortisol, α-amylase) and the psychological profile of patients with oral lichen planus (OLP) and primary burning mouth syndrome (BMS). A total of 160 subjects participated in this case-control study: 60 patients with OLP; 60 patients with primary BMS; and 40 control subjects. Unstimulated whole saliva (UWS) was collected between 9 and 10 a.m. Salivary biomarkers were analyzed by enzyme-linked immunosorbent assays (ELISAs). Psychological assessment was evaluated with the Depression, Anxiety, and Stress Scale (DASS-21). The patients with primary BMS had higher salivary cortisol concentrations and α-amylase activity (0.52 vs. 0.44 µg/dL; 160,531 vs. 145,804 U/L; one-way analysis of variance (ANOVA) with post hoc Scheffe test) compared with patients with OLP. The patients with primary BMS had statistically significant higher scores for depression, anxiety, and stress compared with patients with OLP and control subjects (p < 0.001, Kruskal-Wallis test). There was a strong positive correlation between anxiety and depression, stress and depression, and stress and anxiety in patients with OLP and BMS (p < 0.001 and p < 0.001, respectively; Spearman's correlation). There was a good positive correlation between symptom intensity (pain/burning) and psychological profile (depression, anxiety, stress) in patients with primary BMS (r = 0.373, p = 0.003; r = 0.515, p < 0.001; r = 0.365, p = 0.004, respectively; Spearman's correlation). This case-control study is the first to compare the psychoendocrinological profile of patients with two different oral diseases. The patients with BMS showed a higher concentration/activity of salivary stress biomarkers (cortisol, α-amylase) and a stronger association with mental disorders compared with patients with OLP. However, an interdisciplinary psychoneuroimmunological approach is equally important in both patient groups (OLP and BMS), regardless of whether mental disorders are the cause or the consequence.
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Affiliation(s)
- Ana Glavina
- Dental Clinic Split, 21000 Split, Croatia; (A.G.); (D.B.-L.)
- Department of Oral Medicine and Periodontology, Study of Dental Medicine, School of Medicine, University of Split, 21000 Split, Croatia;
| | - Liborija Lugović-Mihić
- Department of Dermatovenereology, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia;
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Dinko Martinović
- Department of Maxillofacial Surgery, University Hospital of Split, 21000 Split, Croatia;
- Department of Pathophysiology, School of Medicine, University of Split, 21000 Split, Croatia
| | - Livia Cigić
- Department of Oral Medicine and Periodontology, Study of Dental Medicine, School of Medicine, University of Split, 21000 Split, Croatia;
- Department of Dental Medicine, University Hospital of Split, 21000 Split, Croatia
| | - Leida Tandara
- Department of Medical Laboratory Diagnostics, University Hospital of Split, 21000 Split, Croatia;
| | - Marino Lukenda
- Study in English, School of Medicine, University of Split, 21000 Split, Croatia;
| | - Dolores Biočina-Lukenda
- Dental Clinic Split, 21000 Split, Croatia; (A.G.); (D.B.-L.)
- Department of Oral Medicine and Periodontology, Study of Dental Medicine, School of Medicine, University of Split, 21000 Split, Croatia;
| | - Daniela Šupe-Domić
- Department of Medical Laboratory Diagnostics, University Hospital of Split, 21000 Split, Croatia;
- Department of Health Studies, University of Split, 21000 Split, Croatia
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Wyns A, Hendrix J, Lahousse A, De Bruyne E, Nijs J, Godderis L, Polli A. The Biology of Stress Intolerance in Patients with Chronic Pain—State of the Art and Future Directions. J Clin Med 2023; 12:jcm12062245. [PMID: 36983246 PMCID: PMC10057496 DOI: 10.3390/jcm12062245] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/16/2023] Open
Abstract
Stress has been consistently linked to negative impacts on physical and mental health. More specifically, patients with chronic pain experience stress intolerance, which is an exacerbation or occurrence of symptoms in response to any type of stress. The pathophysiological mechanisms underlying this phenomenon remain unsolved. In this state-of-the-art paper, we summarised the role of the autonomic nervous system (ANS) and hypothalamus-pituitary-adrenal (HPA) axis, the two major stress response systems in stress intolerance. We provided insights into such mechanisms based on evidence from clinical studies in both patients with chronic pain, showing dysregulated stress systems, and healthy controls supported by preclinical studies, highlighting the link between these systems and symptoms of stress intolerance. Furthermore, we explored the possible regulating role for (epi)genetic mechanisms influencing the ANS and HPA axis. The link between stress and chronic pain has become an important area of research as it has the potential to inform the development of interventions to improve the quality of life for individuals living with chronic pain. As stress has become a prevalent concern in modern society, understanding the connection between stress, HPA axis, ANS, and chronic health conditions such as chronic pain is crucial to improve public health and well-being.
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Affiliation(s)
- Arne Wyns
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (A.W.); (A.L.); (J.N.); (A.P.)
| | - Jolien Hendrix
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (A.W.); (A.L.); (J.N.); (A.P.)
- Department of Public Health and Primary Care, Centre for Environment & Health, KU Leuven, Kapucijnenvoer 35, 3000 Leuven, Belgium;
- Flanders Research Foundation-FWO, 1090 Brussels, Belgium
- Correspondence:
| | - Astrid Lahousse
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (A.W.); (A.L.); (J.N.); (A.P.)
- Flanders Research Foundation-FWO, 1090 Brussels, Belgium
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital, 1090 Brussels, Belgium
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy (KIMA), Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - Elke De Bruyne
- Department of Hematology and Immunology-Myeloma Center Brussels, Vrije Universiteit Brussel, 1090 Brussels, Belgium;
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (A.W.); (A.L.); (J.N.); (A.P.)
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital, 1090 Brussels, Belgium
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Lode Godderis
- Department of Public Health and Primary Care, Centre for Environment & Health, KU Leuven, Kapucijnenvoer 35, 3000 Leuven, Belgium;
- External Service for Prevention and Protection at Work, IDEWE, 3001 Heverlee, Belgium
| | - Andrea Polli
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (A.W.); (A.L.); (J.N.); (A.P.)
- Department of Public Health and Primary Care, Centre for Environment & Health, KU Leuven, Kapucijnenvoer 35, 3000 Leuven, Belgium;
- Flanders Research Foundation-FWO, 1090 Brussels, Belgium
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Moreau C, El Habnouni C, Lecron JC, Morel F, Delwail A, Le Gall-Ianotto C, Le Garrec R, Misery L, Piver E, Vaillant L, Lefevre A, Emond P, Blasco H, Samimi M. Salivary metabolome indicates a shift in tyrosine metabolism in patients with burning mouth syndrome: a prospective case-control study. Pain 2023; 164:e144-e156. [PMID: 35916738 DOI: 10.1097/j.pain.0000000000002733] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 05/31/2022] [Indexed: 11/25/2022]
Abstract
ABSTRACT The pathophysiology of primary burning mouth syndrome (BMS) remains controversial. Targeted analyses or "omics" approach of saliva provide diagnostic or pathophysiological biomarkers. This pilot study's primary objective was to explore the pathophysiology of BMS through a comparative analysis of the salivary metabolome among 26 BMS female cases and 25 age- and sex-matched control subjects. Secondary objectives included comparative analyses of inflammatory cytokines, neuroinflammatory markers, and steroid hormones among cases and control subjects, and among BMS patients according to their clinical characteristics. Salivary metabolome, neuroinflammatory markers, cytokines, and steroids were, respectively, analysed by liquid chromatography coupled with mass spectrometry, ELISA and protease activity assay, and multiparametric Luminex method. Among the 166 detected metabolites, univariate analysis did not find any discriminant metabolite between groups. Supervised multivariate analysis divided patients into 2 groups with an accuracy of 60% but did not allow significant discrimination (permutation test, P = 0.35). Among the metabolites contributing to the model, 3 belonging to the tyrosine pathway ( l -dopa, l -tyrosine, and tyramine) were involved in the discrimination between cases and control subjects, and among BMS patients according to their levels of pain. Among the detectable molecules, levels of cytokines, steroid hormones, and neuroinflammatory markers did not differ between cases and control subjects and were not associated with characteristics of BMS patients. These results do not support the involvement of steroid hormones, inflammatory cytokines, or inflammatory neurogenic mediators in the pathophysiology of pain in BMS, whereas the observed shift in tyrosine metabolism may indicate an adaptative response to chronic pain or an impaired dopaminergic transmission.
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Affiliation(s)
- Charlotte Moreau
- University François Rabelais, Tours, France
- Department of Dermatology, University Hospital of Tours, Tours Cedex, France
| | - Chakib El Habnouni
- University François Rabelais, Tours, France
- Department of Dermatology, University Hospital of Tours, Tours Cedex, France
| | - Jean-Claude Lecron
- Laboratory Inflammation, Tissus Epithéliaux et Cytokines, Poitiers University and Immunology/inflammation Laboratory, Poitiers University Hospital, Poitiers, France
| | - Franck Morel
- Laboratory Inflammation, Tissus Epithéliaux et Cytokines, Poitiers University and Immunology/inflammation Laboratory, Poitiers University Hospital, Poitiers, France
| | - Adriana Delwail
- ImageUP, Plate-forme d'Imagerie and Laboratoire Signalisation et Transport Ioniques Membranaires ERL CNRS 7003/EA 7349, Poitiers University, Poitiers, France
| | | | - Raphaele Le Garrec
- Univ Brest, LIEN (Laboratoire Interactions Epithelium Neurones), Brest, France
| | - Laurent Misery
- Univ Brest, LIEN (Laboratoire Interactions Epithelium Neurones), Brest, France
| | - Eric Piver
- Department of Biochemistry and Molecular Biology, University Hospital of Tours, Tours Cedex, France
- Inserm UMR 1259-Morphogenèse et antigénicité du VIH et des virus des hépatites (MAVIVH)
| | - Loïc Vaillant
- University François Rabelais, Tours, France
- Department of Dermatology, University Hospital of Tours, Tours Cedex, France
| | | | - Patrick Emond
- UMR 1253 iBrain, Université de Tours, Inserm, Tours, France
- Department of In Vitro Nuclear Medicine, University Hospital of Tours, Tours Cedex, France
| | - Hélène Blasco
- Department of Biochemistry and Molecular Biology, University Hospital of Tours, Tours Cedex, France
- UMR 1253 iBrain, Université de Tours, Inserm, Tours, France
| | - Mahtab Samimi
- University François Rabelais, Tours, France
- Department of Dermatology, University Hospital of Tours, Tours Cedex, France
- BIP, 1282 INRA University of Tours, Tours, France
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6
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Ye L, Dai Q, Hou F, Wu C, Qiu X, Yuan P, Chen F, Meng Y, Feng X, Jiang L. Salivary metabolomics of burning mouth syndrome: A cross-sectional study. Arch Oral Biol 2022; 144:105552. [DOI: 10.1016/j.archoralbio.2022.105552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/09/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022]
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7
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Aitken-Saavedra J, Tarquinio SB, Kinalski M, Haubman D, Martins MW, Vasconcelos AC. Salivary characteristics in burning mouth syndrome: a systematic review. Minerva Dent Oral Sci 2022; 71:233-241. [PMID: 35920290 DOI: 10.23736/s2724-6329.22.04647-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Compare through case-control studies, the salivary characteristics of patients with and without BMS. EVIDENCE ACQUISITION Searches in Embase, PubMed, Web of Science, Scopus, Cochrane, and BIREME were conducted for the identification of case-controls studies reported. EVIDENCE SYNTHESIS Thirty-three studies were included, of which 26 articles evaluated OSB, 17 SRF, and 7 SE. Nineteen organic biomarkers showed higher levels in BMS patients, the two most indicated being α-amylase and cortisol. Ten organic biomarkers, including Tumor Necrosis Factor-alpha (TNF-α) and IL-6, showed lower levels in BMS patients. Regarding salivary flow rate (SFR), five articles indicated that BMS patients have less unstimulated SFR (uSRF)Two articles indicate that stimulated SFR (sSRF) is lower in BMS patients nevertheless, but eight did not show differences. Sialochemical analysis revealed that sodium (Na), chloride (Cl), potassium (K), sodium (Na), and calcium (Ca), showed higher levels in BMS patients according to three studies, but two studies did not establish any differences. Two study established that BMS patients have lower Mg salivary levels. CONCLUSIONS Qualitative salivary characteristics suggest that BMS has neuropathic, inflammatory, emotional, immune, and hormonal involvements. BMS can be associated with changes in salivary biomarkers of inflammation and oxidative stress, is related to anxiety and degree of pain.
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Affiliation(s)
- Juan Aitken-Saavedra
- Department of Oral Pathology and Medicine, Faculty of Dentistry, University of Chile, Santiago, Chile
- School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Sandra B Tarquinio
- Diagnostic Center for Oral Diseases, Federal University of Pelotas, Pelotas, Brazil
| | - Matheus Kinalski
- Faculty of Dentistry, Community University of Chapecó, Chapecó, Brazil
| | - Daniela Haubman
- School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | | | - Ana C Vasconcelos
- Diagnostic Center for Oral Diseases, Federal University of Pelotas, Pelotas, Brazil -
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Response to Treatment with Melatonin and Clonazepam versus Placebo in Patients with Burning Mouth Syndrome. J Clin Med 2022; 11:jcm11092516. [PMID: 35566642 PMCID: PMC9101769 DOI: 10.3390/jcm11092516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/19/2022] [Accepted: 04/27/2022] [Indexed: 12/23/2022] Open
Abstract
Objective: to evaluate the efficacy of melatonin and clonazepam versus placebo in patients with burning mouth syndrome (BMS). Methods: a prospective double-blind study was carried out in patients with BMS and randomized to three groups: melatonin (1 mg once a day), clonazepam (0.5 mg/twice a day), or a placebo once a day, for 8 weeks. The clinical changes were evaluated, including xerostomia, the Oral Health Impact Profile 14 (OHIP-14) score, Pittsburg Sleep Quality Index, and the Hospital Anxiety and Depression Scale (HADS). Oxygen saturation and heart rate were recorded, with an analysis of salivary biomarkers in the forms of oxytocin, ferritin, adenosine deaminase (ADA), total proteins, and alpha-amylase. Results: a total of 64 patients were analyzed. A significant decrease in burning sensation was recorded with melatonin (7.8 ± 1.54 pre-treatment, 5.78 ± 2.54 post-treatment; p < 0.001) and clonazepam (8.75 ± 1.2 pre-treatment, 5.5 ± 3.6 post-treatment (p < 0.01). With regard to quality of life (OHIP-14), significant improvements were observed before and after the administration of melatonin (p < 0.001) and clonazepam (p = 0.001). On the other hand, with regard to the changes in salivary biomarkers following treatment, negative correlations were found between oxytocin and drainage (r = −0.410; p = 0.009) and between the HADS-D score and ferritin (r = −0.312; p = 0.05). While salivary amylase showed positive correlation with heart rate (r = 0.346; p = 0.029) and oxygen saturation (r = 0.419; p = 0.007). Conclusions: melatonin and clonazepam were shown to be effective at reducing the burning sensation and improving quality of life. Both drugs were found to be safe, with no major adverse effects in patients with BMS. Melatonin may be regarded as an alternative treatment for patients with BMS, though further studies are needed to confirm its effectiveness.
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Hong G, Chen Z, Han JM, Wang WQ, Gao P, Sasaki K. Effect of amylase activity on mechanical properties of dental composite resin. Dent Mater J 2020; 40:348-355. [PMID: 33087633 DOI: 10.4012/dmj.2020-079] [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: 11/23/2022]
Abstract
The purpose of this study was to investigate the effect of amylase activity on the mechanical properties of three dental composite resin (Filtek Z350; Filtek Z250 and Polofil Supra). The specimens were immersed in amylase solution at four different activities (25, 50, 100 and 200 KIU/L) with an artificial saliva solution (AS) as a control. The flexural strength (FS) and elastic modulus (EM) were determined in a three-point bending test after immersion for periods up to 12 months. In addition, surface roughness and surface morphology also determined. The FS of Filtek Z350 reaching the lowest level of 67.86 MPa after AS immersion for one year. There was a general trend for FS to decrease following immersion in AS for all the tested materials. However, the amylase groups did not undergo a significant decrease in FS and EM, and there was a slight increase in FS and EM for Polofil Supra.
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Affiliation(s)
- Guang Hong
- Division for Globalization Initiative, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University
| | - Zhen Chen
- Department of Operative Dentistry and Endodontology, School of Stomatology, Tianjin Medical University.,Division of Advanced Prosthetic Dentistry, Graduate School of Dentistry, Tohoku University
| | - Jian-Min Han
- Dental Materials Laboratory, National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology
| | - Wei-Qi Wang
- Division of Advanced Prosthetic Dentistry, Graduate School of Dentistry, Tohoku University
| | - Ping Gao
- Department of Prosthetic Dentistry, School of Stomatology, Tianjin Medical University
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Graduate School of Dentistry, Tohoku University
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Salivary Hormones and Quality of Life in Female Postmenopausal Burning Mouth Patients-A Pilot Case-Control Study. Dent J (Basel) 2020; 8:dj8040111. [PMID: 33019769 PMCID: PMC7711961 DOI: 10.3390/dj8040111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 12/03/2022] Open
Abstract
The objective of our study was to investigate salivary levels of estradiol, progesterone and dehydroepiandrosterone (DHEA), and quality of life, in female postmenopausal women with burning mouth syndrome. The study included new patients diagnosed with burning mouth syndrome and excluded local and systemic causes. Unstimulated saliva samples were taken in the morning from 9 AM and 11 AM and immediately frozen for hormone analysis. The patients filled out a self-perceived quality of life questionnaire Oral Health Impact Profile-14 and determined the intensity of mucosal symptoms according to the visual-analog scale grading 0 to 10. A total of 40 patients were included. The study group had significantly lower levels of salivary estradiol. No difference was observed in levels of progesterone and DHEA between the groups. The levels of salivary hormones did not exhibit a significant correlation according to the Spearman correlation test with a self-perceived quality of life questionnaire (OHIP-14) in the study group or in the control group. Further research on a larger number of patients is needed to verify these results. This information might help to enable more precise and efficient treatment.
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Škrinjar I, Lončar Brzak B, Vidranski V, Vučićević Boras V, Rogulj AA, Pavelić B. Salivary Cortisol Levels and Burning Symptoms in Patients with Burning Mouth Syndrome before and after Low Level Laser Therapy: a Double Blind Controlled Randomized Clinical Trial. Acta Stomatol Croat 2020; 54:44-50. [PMID: 32523156 PMCID: PMC7233125 DOI: 10.15644/asc54/1/5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objectives Burning mouth syndrome (BMS) is a disorder which is described as burning sensation of the oral mucosa without pathological changes. Most of the patients have some underlying stressful conditions. Stress induces an increase in secretion of different endocrine glands resulting in higher levels of glucocorticoids. One of the options for treatment of BMS includes low level laser therapy (LLLT). The aim of this research was to determine salivary cortisol levels and intensity of burning symptoms in BMS patients before and after LLLT. Materials and Methods Twenty-three participants were allocated by randomization in two groups: 12 patients in the study group and 11 patients in the placebo group. Cortisol levels in all patients were analyzed from the sample of saliva collected without stimulation. In both groups, the LLLT was performed once a day for ten consecutive days (excluding weekend) with Ga-Al-As light-emitting diode type of laser, with a wavelength of 685nm. In the control group, LLLT was done with inactive laser probe which was only emitting audio signal. The intensity of burning symptoms was measured by a visual analogue scale (VAS). The VAS and unstimulated saliva were measured at baseline and on the last day of the LLLT. A quantitative analysis of saliva was performed using competitive commercial ELISA-kit. Results VAS scores and salivary cortisol levels were significantly lower in both groups after LLLT. Conclusions LLLT can be useful in patients with BMS for reducing burning symptoms and salivary cortisol level. Future studies on a larger number of patients should clarify whether the positive results are an outcome of laser effectiveness or of placebo effect.
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Affiliation(s)
- Ivana Škrinjar
- Department of Oral Medicine, University Hospital Center Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| | - Božana Lončar Brzak
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| | - Valentina Vidranski
- Department of Oncology and Nuclear Medicine, University Clinical Hospital Sisters of Mercy, Vinogradska cesta 29, 10000 Zagreb, Croatia
| | - Vanja Vučićević Boras
- Department of Oral Medicine, School of Dental Medicine University of Zagreb and University Clinical Hospital Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| | - Ana Andabak Rogulj
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| | - Božidar Pavelić
- Department of Restorative Dentistry, School of Dental Medicine, University of Zagreb and University Hospital Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
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12
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Kang JH, Kho HS. Blood contamination in salivary diagnostics: current methods and their limitations. Clin Chem Lab Med 2020; 57:1115-1124. [PMID: 30511922 DOI: 10.1515/cclm-2018-0739] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 10/31/2018] [Indexed: 01/15/2023]
Abstract
The use of saliva samples in clinical studies has increased. However, the diagnostic value of whole saliva is compromised in the presence of blood contamination, owing to the higher levels of analytes in blood compared with those in saliva. The aim of this study was to review the existing methods and their limitations for measuring the levels of blood contamination in saliva. A literature search was performed using Web of Science, SCOPUS, and PubMed databases and 49 articles dealing with salivary diagnostics and measurements of blood contamination were included. Five methods for measuring the degree of blood components in saliva were discussed, including "visual inspection", use of "strip for urinalysis", and detection of plasma proteins such as "hemoglobin", "albumin", and "transferrin". Each method has its limitations, and transferrin has been regarded as the most reliable and valid marker for blood contamination in saliva. However, transferrin in whole saliva may not be solely a product of blood, and its level in whole saliva can be influenced by several factors such as age, gonadal hormones, salivary flow rate, chewing performance, and oral microorganisms. In conclusion, when quantitatively analyzing whole saliva samples, the influence of blood contamination should be considered.
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Affiliation(s)
- Jeong-Hyun Kang
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, Korea (ROK).,Clinic of Oral Medicine and Orofacial Pain, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea (ROK)
| | - Hong-Seop Kho
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, Korea (ROK).,Institute on Aging, Seoul National University, Seoul, Korea (ROK), Phone: +82-2-2072-3989, Fax: +82-2-744-9135
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13
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Imamura Y, Okada-Ogawa A, Noma N, Shinozaki T, Watanabe K, Kohashi R, Shinoda M, Wada A, Abe O, Iwata K. A perspective from experimental studies of burning mouth syndrome. J Oral Sci 2020; 62:165-169. [PMID: 32161235 DOI: 10.2334/josnusd.19-0459] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Burning mouth syndrome (BMS) is one of the most frequently seen idiopathic pain conditions in a dental setting. Peri- and postmenopausal women are most frequently affected, and patients who experience BMS complain of persistent burning pain mainly at the tip and the bilateral border of the tongue. Recent studies have assessed whether BMS is a neuropathic pain condition, based on morphologic changes in biopsied tongue specimens, and whether there are abnormal pain responses in patients with this disease. Somatosensory studies have reported some abnormal findings in sensory and pain detection thresholds with inconsistency; however, the most distinct finding was exaggerated responses to painful stimuli. Imaging and electrophysiologic studies have suggested the possibility of dysregulation of the pain-modulating system in the central nervous system, which may explain the enhanced pain responses despite the lack of typical responses toward quantitative sensory tests. Basic studies have suggested the possible involvement of neuroprotective steroids, although the underlying mechanisms of this condition have not been elucidated. Experimental studies are looking for preferable supportive therapies for BMS patients despite the obscure pathogenesis.
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Affiliation(s)
- Yoshiki Imamura
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry.,Division of Clinical Research, Dental Research Institute, Nihon University School of Dentistry
| | - Akiko Okada-Ogawa
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry.,Division of Clinical Research, Dental Research Institute, Nihon University School of Dentistry
| | - Noboru Noma
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry.,Division of Clinical Research, Dental Research Institute, Nihon University School of Dentistry
| | - Takahiro Shinozaki
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry.,Division of Clinical Research, Dental Research Institute, Nihon University School of Dentistry
| | - Kosuke Watanabe
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry
| | - Ryutaro Kohashi
- Department of Dental Radiology, Nihon University School of Dentistry
| | - Masamichi Shinoda
- Department of Physiology, Nihon University School of Dentistry.,Division of Functional Morphology, Dental Research Institute, Nihon University School of Dentistry
| | - Akihiko Wada
- Department of Radiology, Juntendo University Faculty of Medicine
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo
| | - Koichi Iwata
- Department of Physiology, Nihon University School of Dentistry.,Division of Functional Morphology, Dental Research Institute, Nihon University School of Dentistry
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14
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Salivary Biomarkers and Their Correlation with Pain and Stress in Patients with Burning Mouth Syndrome. J Clin Med 2020; 9:jcm9040929. [PMID: 32231113 PMCID: PMC7230786 DOI: 10.3390/jcm9040929] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 03/17/2020] [Accepted: 03/25/2020] [Indexed: 12/16/2022] Open
Abstract
Objective: To evaluate a panel of salivary analytes involving biomarkers of inflammation, stress, immune system and antioxidant status in patients with burning mouth syndrome (BMS) and to study their relationship with clinical variables. Materials and Methods: A total of 51 patients with BMS and 31 controls were consecutively enrolled in the study, with the recording of oral habits, the severity of pain using a visual analogue scale (VAS), the Hospital Anxiety and Depression (HAD) score and the Oral Health Impact Profile-14 (OHIP14) score. Resting whole saliva was collected with the drainage technique, followed by the measurement of 11 biomarkers. Results: The salivary flow was higher in patients with BMS. Among all the biomarkers studied, significantly higher levels of alpha-amylase, immunoglobulin A (IgA), and macrophage inflammatory protein-4 (MIP4) and lower levels of uric acid and ferric reducing activity of plasma (FRAP) were observed in the saliva of patients with BMS as compared to the controls (p < 0.05 in all cases). Positive correlations were found between pain, oral quality of life and anxiety scores and salivary biomarkers. Conclusions: BMS is associated with changes in salivary biomarkers of inflammation, oxidative stress and stress, being related to the degree of pain and anxiety.
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15
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Pereira SR, Tello Velasquez J, Duggan S, Ivanisevic B, McKenna JP, McCreary C, Downer EJ. Recent advances in the understanding of the aetiology and therapeutic strategies in burning mouth syndrome: Focus on the actions of cannabinoids. Eur J Neurosci 2020; 55:1032-1050. [DOI: 10.1111/ejn.14712] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/06/2020] [Accepted: 02/20/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Sónia R. Pereira
- Discipline of Physiology School of Medicine Trinity Biomedical Sciences Institute Trinity College Dublin Dublin 2 Ireland
| | - Johana Tello Velasquez
- Discipline of Physiology School of Medicine Trinity Biomedical Sciences Institute Trinity College Dublin Dublin 2 Ireland
| | - Sarah Duggan
- Discipline of Physiology School of Medicine Trinity Biomedical Sciences Institute Trinity College Dublin Dublin 2 Ireland
| | - Bojana Ivanisevic
- Cork University Dental School and Hospital University College Cork Cork Ireland
| | - Joseph P. McKenna
- Cork University Dental School and Hospital University College Cork Cork Ireland
| | - Christine McCreary
- Cork University Dental School and Hospital University College Cork Cork Ireland
| | - Eric J. Downer
- Discipline of Physiology School of Medicine Trinity Biomedical Sciences Institute Trinity College Dublin Dublin 2 Ireland
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16
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Imamura Y, Shinozaki T, Okada-Ogawa A, Noma N, Shinoda M, Iwata K, Wada A, Abe O, Wang K, Svensson P. An updated review on pathophysiology and management of burning mouth syndrome with endocrinological, psychological and neuropathic perspectives. J Oral Rehabil 2019; 46:574-587. [PMID: 30892737 DOI: 10.1111/joor.12795] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/19/2019] [Accepted: 03/12/2019] [Indexed: 12/17/2022]
Abstract
Burning mouth syndrome (BMS) is a chronic oro-facial pain disorder of unknown cause. It is more common in peri- and post-menopausal women, and sex hormone dysregulation is believed to be an important causative factor. Psychosocial events often trigger or exacerbate symptoms, and persons with BMS appear to be predisposed towards anxiety and depression. Atrophy of small nerve fibres in the tongue epithelium has been reported, and potential neuropathic mechanisms for BMS are now widely investigated. Historically, BMS was thought to comprise endocrinological, psychosocial and neuropathic components. Neuroprotective steroids and glial cell line-derived neurotrophic factor family ligands may have pivotal roles in the peripheral mechanisms associated with atrophy of small nerve fibres. Denervation of chorda tympani nerve fibres that innervate fungiform buds leads to alternative trigeminal innervation, which results in dysgeusia and burning pain when eating hot foods. With regard to the central mechanism of BMS, depletion of neuroprotective steroids alters the brain network-related mood and pain modulation. Peripheral mechanistic studies support the use of topical clonazepam and capsaicin for the management of BMS, and some evidence supports the use of cognitive behavioural therapy. Hormone replacement therapy may address the causes of BMS, although adverse effects prevent its use as a first-line treatment. Selective serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors (SNRIs) may have important benefits, and well-designed controlled studies are expected. Other treatment options to be investigated include brain stimulation and TSPO (translocator protein 18 kDa) ligands.
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Affiliation(s)
- Yoshiki Imamura
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan.,Nihon University School of Dentistry Dental Research Center, Chiyoda-ku, Tokyo, Japan
| | - Takahiro Shinozaki
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan.,Nihon University School of Dentistry Dental Research Center, Chiyoda-ku, Tokyo, Japan
| | - Akiko Okada-Ogawa
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan.,Nihon University School of Dentistry Dental Research Center, Chiyoda-ku, Tokyo, Japan
| | - Noboru Noma
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan.,Nihon University School of Dentistry Dental Research Center, Chiyoda-ku, Tokyo, Japan
| | - Masahiro Shinoda
- Nihon University School of Dentistry Dental Research Center, Chiyoda-ku, Tokyo, Japan.,Department of Physiology, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan
| | - Koichi Iwata
- Nihon University School of Dentistry Dental Research Center, Chiyoda-ku, Tokyo, Japan.,Department of Physiology, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan
| | - Akihiko Wada
- Department of Radiology, Faculty of Medicine, Juntendo University, Bunkyo-ku, Tokyo, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Kelun Wang
- Department of Health Science and Technology, Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
| | - Peter Svensson
- Department of Dentistry and Oral Health, Section for Orofacial Pain and Jaw Function, Aarhus University, Aarhus, Denmark
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17
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Cabras T, Manconi B, Castagnola M, Sanna MT, Arba M, Acharya S, Ekström J, Carlén A, Messana I. Proteomics of the acid-soluble fraction of whole and major gland saliva in burning mouth syndrome patients. Arch Oral Biol 2018; 98:148-155. [PMID: 30496935 DOI: 10.1016/j.archoralbio.2018.11.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 11/15/2018] [Accepted: 11/19/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE In the present study the salivary proteome of burning mouth syndrome patients and healthy subjects was characterized by a top-down proteomic approach and compared to highlight possible qualitative and quantitative differences that may give suggestions about the causes of this pathology which are still unknown. MATERIALS AND METHODS Resting and stimulated whole saliva, stimulated parotid and submandibular/sublingual saliva samples were collected from burning mouth syndrome patients (n = 16) and age- and gender-matched healthy subjects (n = 14). An equal volume of 0.2% trifluoroacetic acid was added to each sample immediately after collection and the supernatants were analysed by liquid chromatography coupled to electrospray-ionisation mass spectrometry. Proteins and peptides were quantified using a label-free approach measuring the extracted ion current peak areas of the main salivary proteins and peptides. RESULTS The quantitation of the main salivary proteins and peptides revealed a higher concentration of cystatin SN in resting saliva of burning mouth syndrome patients with respect to healthy controls and no other conspicuous changes. CONCLUSIONS The reported data showed that the salivary protein profile was not affected, in composition and relative abundance, by the burning mouth syndrome, except for the cystatin SN, a protein up-regulated in several pathological conditions, that might be considered potentially indicative of the disease.
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Affiliation(s)
- Tiziana Cabras
- Department of Life and Environmental Sciences, Biomedical Section, University of Cagliari, 09042, Monserrato, CA, Italy.
| | - Barbara Manconi
- Department of Life and Environmental Sciences, Biomedical Section, University of Cagliari, 09042, Monserrato, CA, Italy
| | - Massimo Castagnola
- Institute of Chemistry of the Molecular Recognition - CNR, L.go F. Vito 1, 00168, Rome, Italy; Institute of Biochemistry and Clinical Biochemistry, Università Cattolica del Sacro Cuore and/or Department of Laboratory Diagnostic and Infectious Diseases, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, L.go F. Vito 1, 00168, Rome, Italy
| | - Maria Teresa Sanna
- Department of Life and Environmental Sciences, Biomedical Section, University of Cagliari, 09042, Monserrato, CA, Italy
| | - Morena Arba
- Department of Life and Environmental Sciences, Biomedical Section, University of Cagliari, 09042, Monserrato, CA, Italy
| | - Shikha Acharya
- Department of Oral Microbiology and Immunology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Box 431, SE-405 30 Göteborg, Sweden
| | - Jörgen Ekström
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Box 431, SE-405 30 Göteborg, Sweden
| | - Anette Carlén
- Department of Oral Microbiology and Immunology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Box 431, SE-405 30 Göteborg, Sweden
| | - Irene Messana
- Institute of Chemistry of the Molecular Recognition - CNR, L.go F. Vito 1, 00168, Rome, Italy
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18
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Lorenzo-Pouso AI, Pérez-Sayáns M, Bravo SB, López-Jornet P, García-Vence M, Alonso-Sampedro M, Carballo J, García-García A. Protein-Based Salivary Profiles as Novel Biomarkers for Oral Diseases. DISEASE MARKERS 2018; 2018:6141845. [PMID: 30524521 PMCID: PMC6247606 DOI: 10.1155/2018/6141845] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 09/26/2018] [Accepted: 10/04/2018] [Indexed: 12/11/2022]
Abstract
The Global Burden of Oral Diseases affects 3.5 billion people worldwide, representing the number of people affected by the burden of untreated dental caries, severe periodontal disease, and edentulism. Thus, much more efforts in terms of diagnostics and treatments must be provided in the fight of these outcomes. In this sense, recently, the study of saliva as biological matrix has been identified as a new landmark initiative in the search of novel and useful biomarkers to prevent and diagnose these conditions. Specifically, saliva is a rich reservoir of different proteins and peptides and accessible due to recent advances in molecular biology and specially in targeted and unbiased proteomics technologies. Nonetheless, emerging barriers are an obstacle to the study of the salivary proteome in an effective way. This review aims at giving an overall perspective of salivary biomarkers identified in several oral diseases by means of molecular biology approaches.
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Affiliation(s)
- Alejandro I. Lorenzo-Pouso
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, Spain
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, Spain
| | - Susana B. Bravo
- Proteomic Unit, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, Spain
| | - Pía López-Jornet
- Department of Oral Medicine, Faculty of Medicine, Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Espinardo, Murcia, Spain
| | - María García-Vence
- Proteomic Unit, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, Spain
| | - Manuela Alonso-Sampedro
- Department of Internal Medicine and Clinical Epidemiology, Santiago de Compostela University Hospital Complex (CHUS), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Galicia, Spain
| | - Javier Carballo
- Department of Food Technology, Faculty of Sciences, University of Vigo-Ourense Campus, Ourense, Spain
| | - Abel García-García
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, Spain
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19
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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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Abstract
OBJECTIVE The aim of this study was to investigate possible relationships among hematologic factors, psychological dimensions, the presence of self-reported sleep problems, and clinical characteristics in patients with burning mouth syndrome (BMS). METHODS Twenty-five postmenopausal female patients with primary BMS (aged 55.2 ± 9.6 years) were included. All participants underwent clinical and psychological evaluations and blood sampling. The patients were subdivided according to the absence or presence of the self-reported sleep problems. RESULTS Pain intensity of BMS patients with sleep problems was significantly higher than those without sleep problems, and the severity of oral complaints was correlated with the presence of depression, anxiety, hostility, phobia, and psychosis. Estradiol levels were significantly lower, and FSH and LH levels were higher in BMS patients with sleep problems than those without sleep problems. DISCUSSION BMS patients with sleep problems may suffer inharmonious psychoneuroendocrinological interactions that might worsen oral BMS symptoms.
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Affiliation(s)
- Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital , Seoul, Korea
| | - Suk Chon
- Department of Endocrinology and Metabolism, Kyung Hee University College of Medicine, Kyung Hee University Hospital , Seoul, Korea
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21
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Acharya S, Hägglin C, Jontell M, Wenneberg B, Ekström J, Carlén A. Saliva on the oral mucosa and whole saliva in women diagnosed with burning mouth syndrome. Oral Dis 2018; 24:1468-1476. [DOI: 10.1111/odi.12918] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 05/04/2018] [Accepted: 05/29/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Shikha Acharya
- Department of Oral Microbiology and Immunology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Catharina Hägglin
- Department of Behavioural and Community Dentistry; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Centre of Gerodontology; Public Dental Service; Västra Götaland Sweden
| | - Mats Jontell
- Department of Oral Medicine and Pathology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Bengt Wenneberg
- Department of Orofacial Pain; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Jörgen Ekström
- Department of Pharmacology; Institute of Neuroscience and Physiology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Anette Carlén
- Department of Oral Microbiology and Immunology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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22
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Kim MJ, Kim J, Kho HS. Comparison between burning mouth syndrome patients with and without psychological problems. Int J Oral Maxillofac Surg 2018; 47:879-887. [DOI: 10.1016/j.ijom.2018.02.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 12/12/2017] [Accepted: 02/05/2018] [Indexed: 12/19/2022]
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23
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Bullon P, Pavillard LE, de la Torre-Torres R. Inflammasome and Oral Diseases. EXPERIENTIA SUPPLEMENTUM (2012) 2018; 108:153-176. [PMID: 30536171 DOI: 10.1007/978-3-319-89390-7_7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
One of the main steps in the development of the life in the earth is multicellularity. It enables cell differentiation and the development of morphological structures within an organism and is an essential factor in how to recognize friendly cells that are part of the multicellular organism and which foreign organisms can be harmful. Recognition includes devices such as the major histocompatibility complex (MHC), and the pattern recognition receptors (PRRs). PRRs are a group of proteins expressed by cells of the innate immune system that identify two classes of products: pathogen-associated molecular patterns (PAMPs), related to microbial pathogens, and damage-associated molecular patterns (DAMPs), associated with cell components that are released during cell damage or death. All these activate the inflammasome, which is a multiprotein oligomer that includes caspase 1, PYCARD, NALP, and caspase 5 (also known as caspase 11 or ICH-3). It is responsible for activation of inflammatory processes and has been shown to induce cell pyroptosis, a programmed cell death distinct from apoptosis, and promotes the maturation of the inflammatory cytokines interleukin 1β (IL-1β) and interleukin 18 (IL-18). We review whether inflammasome is related to diseases that can occur in the oral cavity. The mouth is always a possible environment for the development of pathological conditions because of the wide variety of microorganisms. Small variations in the equilibrium of the oral flora can cause disorders that could affect the organism in a systemic form. We provide data on periodontal disease, candidiasis, herpes virus, oral cancer, caries, and other oral diseases. There are very few papers that study this issue; therefore, we need more investigation and publications about inflammatory molecular processes, and more specifically, related to the inflammasome complex.
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Affiliation(s)
- Pedro Bullon
- Departament Periodontology, Facultad de Odontología, Universidad de Sevilla, Sevilla, Spain.
| | - Luis E Pavillard
- Departament Periodontology, Facultad de Odontología, Universidad de Sevilla, Sevilla, Spain
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Kang JH, Kim YY, Chang JY, Kho HS. Relationships between oral MUC1 expression and salivary hormones in burning mouth syndrome. Arch Oral Biol 2017; 78:58-64. [DOI: 10.1016/j.archoralbio.2017.01.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 01/23/2017] [Accepted: 01/31/2017] [Indexed: 12/23/2022]
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Hassona Y, Scully C. Salivary changes in oral mucosal diseases. Periodontol 2000 2017; 70:111-27. [PMID: 26662486 DOI: 10.1111/prd.12102] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2015] [Indexed: 12/17/2022]
Abstract
Saliva is a unique biological fluid that can be easily collected and analyzed with low cost and low morbidity. Therefore, there is a growing attention for using salivary biomarkers in the diagnosis and monitoring of disease progress and response to treatment. Salivary changes have been described in relation to oral mucosal diseases. This article discusses the causes and consequences of salivary hypofunction and presents a review of the literature related to changes in salivary parameters in various oral mucosal diseases and in systemic diseases with possible oral mucosal involvement.
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Salivary Alpha-Amylase Enzyme, Psychological Disorders, and Life Quality in Patients with Recurrent Aphthous Stomatitis. Int J Dent 2017; 2017:5269856. [PMID: 28408928 PMCID: PMC5376436 DOI: 10.1155/2017/5269856] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 02/22/2017] [Accepted: 03/05/2017] [Indexed: 12/17/2022] Open
Abstract
Objective. The aim of this study was to evaluate stress, anxiety, and salivary alpha-amylase (SAA) activity in patients with recurrent aphthous stomatitis (RAS). The impact of this disease on the life quality was also evaluated. Design. Twenty-two patients with RAS and controls, matched by sex and age, were selected. Stress and anxiety were assessed using Lipp's Inventory of Stress Symptoms and Beck Anxiety Inventory. Life quality was assessed through the World Health Organization Quality of Life-bref (WHOQOL-BREF) and the Oral Health Impact Profile-14 (OHIP-14). Saliva samples were collected in the morning and afternoon and the SAA activity was analyzed by enzymatic kinetic method. Results. No significant difference was observed between the groups regarding the SAA activity (p = 0.306). Patients with RAS had higher scores of anxiety (p = 0.016). The scores of WHOQOL-BREF were significantly lower in patients with RAS. The values obtained through OHIP-14 were significantly higher in these patients (p = 0.002). Conclusion. RAS negatively affects the life quality. Patients with the disease have higher levels of anxiety, suggesting its association with the etiopathogenesis of RAS.
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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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Nosratzehi T, Salimi S, Parvaee A. Comparison of Salivary Cortisol and α-amylase Levels and Psychological Profiles in Patients with Burning Mouth Syndrome. SPECIAL CARE IN DENTISTRY 2017; 37:120-125. [PMID: 28112423 DOI: 10.1111/scd.12214] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of the study was to compare salivary cortisol and α-amylase levels and psychological profiles in patients with burning mouth syndrome (BMS) and healthy subjects. METHODS AND MATERIALS Spitting method was used to collect unstimulated salivary. Salivary cortisol and α-amylase levels were determined using ELISA and the Caraway starch-iodine technique. SLC-90 questionnaire was used to determine the psychological profiles. RESULTS The difference between mean of salivary cortisol levels in patients with BMS and in healthy subjects was not significant (4.50 ± 3.68 ng/mL vs. 3.69 ± 3.07 ng/mL, p = 0.377). The difference between mean of α-amylase levels in the BMS patients and healthy subjects was significant (351.68 ± 142.5 and 146.22 ± 130.4, p = 0.001). Note that, 83.4% and 18% of the patients in the case and control groups had psychological problems (p = 0.001). CONCLUSION The results showed higher salivary levels of cortisol and α-amylase in patients with BMS compared to healthy individuals. Psychological problem was prevalent in patients.
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Affiliation(s)
- Tahereh Nosratzehi
- Assistant Professor, Oral and Dental Disease Research Center, Department of Oral Medicine, Faculty of Dentistry, Zahedan University of Medical Science, Zahedan, Iran
| | - Saeedeh Salimi
- Associate Professor, Cellular and Molecular Research Center, Department of Clinical Biochemistry, Faculty of Medicine, Zahedan University of Medical Science, Zahedan, Iran
| | - Azadeh Parvaee
- Dentist, Zahedan University of Medical Science, Zahedan, Iran
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Salarić I, Sabalić M, Alajbeg I. Opiorphin in burning mouth syndrome patients: a case-control study. Clin Oral Investig 2016; 21:2363-2370. [PMID: 28013436 DOI: 10.1007/s00784-016-2031-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 12/07/2016] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Opiorphin is a pentapeptide isolated from human saliva that suppresses pain from chemically induced inflammation and acute physical pain. Burning mouth syndrome (BMS) is a chronic condition of a burning sensation in the mouth, where no underlying dental or medical cause can be identified. We aimed to measure the level of opiorphin in whole unstimulated (UWS) and stimulated (SWS) saliva of patients with BMS. MATERIALS AND METHODS Originally developed and validated LC-MS/MS method was used for opiorphin quantification. Samples were obtained from 29 BMS patients and 29 age- and sex-matched controls. RESULTS The average concentration of opiorphin in UWS and SWS in the BMS group was 8.13 ± 6.45 and 5.82 ± 3.59 ng/ml, respectively. Opiorphin in BMS patients' UWS was significantly higher, compared to the control group (t = 2.5898; p = 0.0122). SWS opiorphin levels were higher, but not significantly, in BMS patients than in controls. CONCLUSIONS Our results indicate that higher quantities of salivary opiorphin in BMS may be a consequence of chronic pain, but we cannot exclude that they occur as a result of emotional and behavioral imbalances possibly associated with BMS. To our knowledge, this is the first original article measuring opiorphin in a pain disorder. CLINICAL RELEVANCE Opiorphin may be a measurable biomarker for chronic pain, which could help in objectifying otherwise exclusively a subjective experience. Increased opiorphin could serve as a universal objective indicator of painful conditions. Since opiorphin may also reflect emotional and socio-relational imbalances occurring with BMS, it could as well represent a biomarker for BMS. Knowledge on opiorphin's involvement in pain pathways could contribute to developing new clinical diagnostic methods for BMS.
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Affiliation(s)
- Ivan Salarić
- Department of Oral and Maxillofacial Surgery, University of Zagreb School of Dental Medicine University Hospital Dubrava, Av. Gojka Šuška 6, 10000, Zagreb, Croatia
| | - Maja Sabalić
- Department of Craniofacial Development and Stem Cell Biology, Guy's Hospital, King's College London, Great Maze Pond, London, SE1 9RT, UK
| | - Ivan Alajbeg
- Department of Oral Medicine, University of Zagreb School of Dental Medicine and University Hospital Centre Zagreb, Gundulićeva 5, 10000, Zagreb, Croatia.
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Woda A, Picard P, Dutheil F. Dysfunctional stress responses in chronic pain. Psychoneuroendocrinology 2016; 71:127-35. [PMID: 27262345 DOI: 10.1016/j.psyneuen.2016.05.017] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 04/06/2016] [Accepted: 05/18/2016] [Indexed: 11/26/2022]
Abstract
Many dysfunctional and chronic pain conditions overlap. This review describes the different modes of chronic deregulation of the adaptive response to stress which may be a common factor for these conditions. Several types of dysfunction can be identified within the hypothalamo-pituitary-adrenal axis: basal hypercortisolism, hyper-reactivity, basal hypocortisolism and hypo-reactivity. Neuroactive steroid synthesis is another component of the adaptive response to stress. Dehydroepiandrosterone (DHEA) and its sulfated form DHEA-S, and progesterone and its derivatives are synthetized in cutaneous, nervous, and adipose cells. They are neuroactive factors that act locally. They may have a role in the localization of the symptoms and their levels can vary both in the central nervous system and in the periphery. Persistent changes in neuroactive steroid levels or precursors can induce localized neurodegeneration. The autonomic nervous system is another component of the stress response. Its dysfunction in chronic stress responses can be expressed by decreased basal parasympathethic activity, increased basal sympathetic activity or sympathetic hyporeactivity to a stressful stimulus. The immune and genetic systems also participate. The helper-T cells Th1 secrete pro-inflammatory cytokines such as IL-1-β, IL-2, IL-6, IL-8, IL-12, IFN-γ, and TNF-α, whereas Th2 secrete anti-inflammatory cytokines: IL-4, IL-10, IGF-10, IL-13. Chronic deregulation of the Th1/Th2 balance can occur in favor of anti- or pro-inflammatory direction, locally or systemically. Individual vulnerability to stress can be due to environmental factors but can also be genetically influenced. Genetic polymorphisms and epigenetics are the main keys to understanding the influence of genetics on the response of individuals to constraints.
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Affiliation(s)
- Alain Woda
- Dental faculty, EA 3847, CROC, 11 Boulevard Charles-de-Gaulle, Clermont-Ferrand, France; University Hospital of Clermont-Ferrand (CHU), Odontology department, Clermont-Ferrand, France
| | - Pascale Picard
- Pain center, University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France
| | - Frédéric Dutheil
- Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France; University Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Clermont-Ferrand, France; Australian Catholic University, Faculty of Health, Melbourne, Victoria, Australia; CNRS, UMR 6024, Physiological and Psychosocial Stress, LAPSCO, University Clermont Auvergne, Clermont-Ferrand, France.
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das Neves de Araújo Lima E, Barbosa NG, dos Santos ACS, AraújoMouraLemos TM, de Souza CM, Trevilatto PC, da Silveira EJD, de Medeiros AMC. Comparative Analysis of Psychological, Hormonal, and Genetic Factors Between Burning Mouth Syndrome and Secondary Oral Burning. PAIN MEDICINE 2016; 17:1602-11. [DOI: 10.1093/pm/pnv087] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 11/27/2015] [Indexed: 11/14/2022]
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Davies SJC, Underhill HC, Abdel-Karim A, Christmas DM, Bolea-Alamanac BM, Potokar J, Herrod J, Prime SS. Individual oral symptoms in burning mouth syndrome may be associated differentially with depression and anxiety. Acta Odontol Scand 2015; 74:155-60. [PMID: 26494262 DOI: 10.3109/00016357.2015.1100324] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Burning mouth syndrome (BMS) is an idiopathic disease characterized by the feeling of burning in the oral cavity. Ten per cent of patients presenting to oral medicine clinics have BMS. Anxiety and depression are common co-morbidities in BMS, but it is not known if they are associated with specific BMS symptoms. OBJECTIVE In an exploratory analysis, this study examined the association of generalized anxiety and depression with individual BMS symptoms. METHODS Forty-one patients were recruited from a dental outpatient clinic (30 with BMS and 11 with other oral conditions), evaluating specific BMS symptoms and their intensity. Anxiety and depression symptoms were assessed using a standardized measure (Clinical Interview Schedule-Revised). RESULTS Taste change (p = 0.007), fear of serious illness (p = 0.011), metallic taste (p = 0.018) and sensation of a film on the gums (p = 0.047) were associated with an excess of psychiatric symptoms. More specifically, metallic taste (coefficient = 0.497, 95% CI = 0.149-0.845; p = 0.006) and sensation of film on gums (coefficient = 0.625, 95% CI = 0.148-1.103; p = 0.012) were associated significantly with higher scores for depressive symptoms; taste change (coefficient = 0.269, 95% CI = 0.077-0.461; p = 0.007), bad breath (coefficient = 0.273, 95% CI = 0.065-0.482; p = 0.012) and fear of serious illness (coefficient = 0.242, 95% CI = 0.036-0.448; p = 0.023) were associated with higher anxiety scores. CONCLUSION Specific BMS symptoms are associated differentially with generalized anxiety and depression. Dental practitioners should ascertain which BMS symptoms are predominant and be mindful of the association of certain symptoms with anxiety or depression and, where necessary, consider medical consultation.
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Affiliation(s)
- Simon J C Davies
- a School of Social and Community Medicine , University of Bristol , Bristol , UK
- b Centre for Addiction and Mental Health , and University of Toronto , Toronto , Canada
| | - Helen C Underhill
- c School of Oral & Dental Sciences , University of Bristol , Bristol , UK
| | - Amina Abdel-Karim
- c School of Oral & Dental Sciences , University of Bristol , Bristol , UK
| | - David M Christmas
- a School of Social and Community Medicine , University of Bristol , Bristol , UK
| | | | - John Potokar
- a School of Social and Community Medicine , University of Bristol , Bristol , UK
| | - Johanna Herrod
- d The Rosa Burden Centre for Neuropsychiatry , Southmead Hospital , Bristol , UK
| | - Stephen S Prime
- c School of Oral & Dental Sciences , University of Bristol , Bristol , UK
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Kozloski MJ, Schumm LP, McClintock MK. The utility and dynamics of salivary sex hormone measurements in the National Social Life, Health, and Aging Project, Wave 2. J Gerontol B Psychol Sci Soc Sci 2014; 69 Suppl 2:S215-28. [PMID: 25360023 PMCID: PMC4303088 DOI: 10.1093/geronb/gbu123] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 08/13/2014] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES Sex hormones affect physical, mental, and social health, yet their role in mediating social effects on aging is understudied. To facilitate such analyses with the National Social Life, Health & Aging Project Wave 2, we summarize the conceptual background, collection protocols, laboratory assays, and data analysis strategies for biologically active (free) levels of testosterone, estradiol, progesterone, and dehydroepiandrosterone (DHEA). METHOD Saliva from passive drool was collected from returning Wave 1 respondents and non-respondents as well as their partners during an in-home interview. Specimens were frozen and sent to Dresden LabService GmbH for duplicate assays of biologically active steroids using identical assay kits from National Social Life, Health, and Aging Project (NSHAP) Wave 1 (SaliCap, Catalog No. RE69995). Overall, 2,772 testosterone, 2,504 estradiol, 2,714 progesterone, and 2,800 DHEA measurements are publically available for Wave 2 analyses. Through a series of weighted linear regressions, all 4 steroids are compared by gender and age and to Wave 1 measurements. RESULTS Men had higher levels of both free testosterone and progesterone than women; women and men had the same levels of estradiol and DHEA. Both free testosterone and DHEA decreased with age. We also found significant wave effects for all 4 sex hormones. CONCLUSION NSHAP Waves 1 and 2 are the first U.S. probability sample studies to measure these 4 salivary sex hormones simultaneously, providing individual profiles 5 years apart. Wave 2 data demonstrate differences by gender and trends by age that are similar to those found in other saliva-based and serum-based studies of free steroid levels. The differences between waves arising from the change in assay laboratory need to be adjusted in future longitudinal analyses using NSHAP Wave 1 and Wave 2 steroid data.
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Affiliation(s)
- Michael J Kozloski
- Department of Sociology, Center on Demography and Economics of Aging, Institute for Mind and Biology,
| | | | - Martha K McClintock
- Center on Demography and Economics of Aging, Institute for Mind and Biology, Department of Comparative Human Development, and Department of Psychology, University of Chicago, Illinois
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Kim Y, Kim HI, Kho HS. Characteristics of men and premenopausal women with burning mouth symptoms: a case-control study. Headache 2014; 54:888-98. [PMID: 24628375 DOI: 10.1111/head.12338] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To identify possible clinical differences between male, premenopausal, and postmenopausal female patients with burning mouth symptoms. BACKGROUND Burning mouth symptoms are known to occur predominantly in postmenopausal women. In some rare cases, however, such symptoms may also appear in men and younger premenopausal women. There is no information on the characteristics of male and premenopausal female patients with burning mouth symptoms. METHODS A total of 22 male patients (no age limit) and 19 relatively younger premenopausal female patients (age: ≤45 years) with a burning sensation in the mouth without any visible signs of oral mucosal diseases were included in the experimental groups. Sixty burning mouth patients (postmenopausal females, age: ≥50 years) without oral mucosal diseases were included as a typical older postmenopausal group for comparison. All individuals in the 3 groups were subjected to clinical evaluations including an interview, a comprehensive questionnaire, a simplified psychological evaluation (Symptom Checklist-90-Revision [SCL-90-R]), blood tests, and a measurement of salivary flow rate. RESULTS The male group reported taste problems less commonly (40.9%, P = .009) and less severely (median visual analog scale [VAS] = 0.00, P = .004) than the postmenopausal group (73.3%, median VAS = 4.50). The younger premenopausal group complained of paresthesia more commonly (68.4%, P = .006) and more severely (median VAS = 0.50, P = .007) than the postmenopausal group (30.0%, median VAS = 0.00). The male group (81.8%) reported discomfort of the tongue less commonly than the postmenopausal group (100.0%, P = .004). The percentage of patients with a symptom triad of oral mucosal pain, dysguesia, and xerostomia was significantly higher in the premenopausal (73.7%, P = .005) and postmenopausal (60.0%, P = .012) groups than the male group (27.3%). The flow rate of unstimulated whole saliva was significantly higher in the premenopausal group (0.27 ± 0.18 mL/min) than the postmenopausal group (0.17 ± 0.16 mL/min, P = .006). None of the 9 symptom dimensions of the SCL-90-R were significantly different among the 3 groups. The percentage of patients with abnormal blood tests and taking medications due to comorbid diseases was the lowest in the premenopausal group. CONCLUSIONS Male and premenopausal female patients with burning mouth symptoms showed different characteristics compared with typical postmenopausal female patients.
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Affiliation(s)
- Yongdae Kim
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
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Kho HS, Chang JY, Kim YY, Kim Y. MUC1 and toll-like receptor-2 expression in burning mouth syndrome and oral lichen planus. Arch Oral Biol 2013; 58:837-42. [DOI: 10.1016/j.archoralbio.2013.01.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 12/29/2012] [Accepted: 01/15/2013] [Indexed: 12/16/2022]
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