1
|
Luo S, Lou F, Yan L, Dong Y, Zhang Y, Liu Y, Ji P, Jin X. Comprehensive analysis of the oral microbiota and metabolome change in patients of burning mouth syndrome with psychiatric symptoms. J Oral Microbiol 2024; 16:2362313. [PMID: 38835338 PMCID: PMC11149574 DOI: 10.1080/20002297.2024.2362313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 05/27/2024] [Indexed: 06/06/2024] Open
Abstract
Background Burning mouth syndrome (BMS) is a chronic idiopathic facial pain with intraoral burning or dysesthesia. BMS patients regularly suffer from anxiety/depression, and the association of psychiatric symptoms with BMS has received considerable attention in recent years. The aims of this study were to investigate the potential interplay between psychiatric symptoms and BMS. Methods Using 16S rRNA sequencing and liquid chromatography-mass spectrometry (LC/MS) to evaluate the oral microbiota and saliva metabolism of 40 BMS patients [including 29 BMS patients with depression or anxiety symptoms (DBMS)] and 40 age matched healthy control (HC). Results The oral microbiota composition in BMS exhibited no significant differences from HC, although DBMS manifested decreased α-diversity relative to HC. Noteworthy was the discernible elevation in the abundance of proinflammatory microorganisms within the oral microbiome of individuals with DBMS. Parallel findings in LC/MS analyses revealed discernible disparities in metabolites between DBMS and HC groups. Principal differential metabolites were notably enriched in amino acid metabolism and lipid metabolism, exhibiting associations with infectious and immunological diseases. Furthermore, the integrated analysis underscores a definitive association between the oral microbiome and metabolism in DBMS. Conclusions This study suggests possible future modalities for better understanding the pathogenesis and personalized treatment plans of BMS.
Collapse
Affiliation(s)
- Shihong Luo
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Department of Oral Implantology, The Affiliated Stomatology Hospital of Southwest Medical University, Luzhou, China
| | - Fangzhi Lou
- College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Li Yan
- College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Yunmei Dong
- College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Yingying Zhang
- College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Yang Liu
- College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Ping Ji
- College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Xin Jin
- College of Stomatology, Chongqing Medical University, Chongqing, China
| |
Collapse
|
2
|
Wang Q, Jin J. Photobiomodulation relieves immediate pain in patients with burning mouth syndrome. Oral Dis 2024. [PMID: 38735764 DOI: 10.1111/odi.14998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 04/30/2024] [Indexed: 05/14/2024]
Affiliation(s)
- Qian Wang
- Department of Stomatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Jianqiu Jin
- Department of Stomatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
3
|
Beecroft EV, Edwards D, Allison JR. Other Secondary Headaches: Odontogenic Pain and Other Painful Orofacial Conditions. Neurol Clin 2024; 42:615-632. [PMID: 38575270 DOI: 10.1016/j.ncl.2023.12.013] [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] [Indexed: 04/06/2024]
Abstract
This article discusses extremely common odontogenic pain conditions, which may occasionally present to the neurology clinic mimicking headache, and other uncommon orofacial pain conditions, which may do the same. Typical presentations, investigative strategies, and management are discussed, as well as highlighting key diagnostic criteria and the importance of involving oral or dental specialists where diagnostic uncertainty exists.
Collapse
Affiliation(s)
- Emma V Beecroft
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom; Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom.
| | - David Edwards
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom; Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
| | - James R Allison
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom; Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
| |
Collapse
|
4
|
Zhang Y, Ye S, Zhang Y, Sun H, Zhao X, Shen X, Wu L. Potential salivary and serum biomarkers for burning mouth syndrome and their relationship with anxiety/depression. J Dent Sci 2024; 19:1052-1060. [PMID: 38618099 PMCID: PMC11010615 DOI: 10.1016/j.jds.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/06/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose The pathophysiology of burning mouth syndrome (BMS), although considered a multifactorial etiology including psychological factors, is still not well understood. Hence, this study aimed to investigate the potential usage of salivary and serum biomarkers, including brain-derived neurotrophic factor (BDNF), interferon-gamma (IFN-γ), interleukin-1beta (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-alpha (TNF-α), in diagnosing BMS and their correlations with anxiety/depression. Materials and methods 45 BMS patients and 14 healthy volunteers were enrolled. The patients were divided into BMS with anxiety/depression group and BMS without anxiety/depression group according to the scores of the Zung Self-rating Anxiety Scale (SAS) and Zung Self-rating Depression Scale (SDS). Additionally, concentrations of BDNF, IFN-γ, IL-1β, IL-6, IL-8, and TNF-α in saliva and those in serum among the patients and healthy volunteers were assessed by multiplex assay using Luminex 200TM system and Enzyme-linked immunosorbent assay (ELISA), respectively. Results Among all the serum biomarkers, only BDNF showed a statistically significant decrease in the patients than the healthy volunteers (P < 0.05). Regarding saliva biomarkers, BDNF, IL-1β, and IL-8 all exhibited a statistically significant increase in all the BMS patients versus the healthy volunteers (P < 0.05) but only BDNF was significantly different between patients with anxiety/depression and healthy individuals when considering anxiety/depression. Among BMS patients with anxiety/depression, saliva TNF-α had positive associations with other biomarkers including BDNF, IFN-γ, IL-1β, IL-6, and IL-8 (P < 0.05). Conclusion The increased concentration of saliva BDNF holds strong potential for diagnosing BMS and the elevated level of saliva TNF-α is crucial in identifying BMS patients with anxiety/depression.
Collapse
Affiliation(s)
- Ying Zhang
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology, College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Jiao Tong University, Shanghai, China
| | - Sai Ye
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology, College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Jiao Tong University, Shanghai, China
| | - Yangqing Zhang
- No.2 High School of East China Normal University, Shanghai, China
| | - Hong Sun
- Department of Laboratory Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoxian Zhao
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology, College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Jiao Tong University, Shanghai, China
| | - Xuemin Shen
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology, College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Jiao Tong University, Shanghai, China
| | - Lan Wu
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology, College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
5
|
Lechien JR, Bobin F, Vaira LA. Usefulness of pepsin saliva measurement for the detection of primary burning mouth syndrome related to reflux. Eur Arch Otorhinolaryngol 2024; 281:827-833. [PMID: 37906367 DOI: 10.1007/s00405-023-08317-x] [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: 10/05/2023] [Accepted: 10/24/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVES To study the diagnostic value of salivary pepsin tests for detecting laryngopharyngeal reflux (LPR) in patients with primary burning mouth syndrome (BMS). METHODS Patients with BMS and asymptomatic individuals were consecutively recruited from September 2018 to June 2023. Patients underwent hypopharyngeal-esophageal impedance pH-monitoring (HEMII-pH) and saliva collections to measure pepsin. Stomatology evaluation was carried out to exclude other causes of BMS. Oral, pharyngeal and laryngeal signs and symptoms were evaluated with Reflux Sign Assessment (RSA) and Reflux Symptom Score (RSS). Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values of pepsin test were calculated considering the highest values of pepsin tests at ≥ 16, ≥ 36, and ≥ 100 ng/mL cutoffs. Receiver operating characteristic curve (ROC) was evaluated. RESULTS Forty-nine patients with both BMS and LPR at the HEMII-pH and 21 asymptomatic individuals were recruited. Pepsin test was 83.7%, 79.6%, and 71.4% sensitive at cutoffs ≥ 16, ≥ 36, and ≥ 100 ng/mL, respectively. The ROC analysis reported that a threshold of ≥ 21.5 ng/mL was associated with sensitivity, specificity, PPV and NPV of 81.6%, 81.0%, 90.1% and 65.4%, respectively. The severity score of burning mouth symptom was significantly associated with the saliva pepsin concentration (rs = 0.263; p = 0.029) and the oral RSA (rs = 0.474; p = 0.007). CONCLUSION Pepsin test is a valuable diagnostic approach for detecting LPR in patients with BMS. Patients with high level of saliva pepsin reported more severe burning mouth symptoms. Future studies are needed to confirm the role of LPR in the primary BMS.
Collapse
Affiliation(s)
- Jérôme R Lechien
- Division of Laryngology and Bronchoesophagology, Department of Otolaryngology-Head and Neck Surgery, EpiCURA Hospital, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Foch Hospital, University Paris Saclay, Paris, France.
- Department of Otolaryngology-Head and Neck Surgery, CHU Saint-Pierre, Brussels, Belgium.
- Department of Otolaryngology, Elsan Hospital, Poitiers, France.
| | - Francois Bobin
- Department of Otolaryngology, Elsan Hospital, Poitiers, France
| | - Luigi A Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
- School of Biomedical Sciences, Biomedical Sciences Department, University of Sassari, Sassari, Italy
| |
Collapse
|
6
|
Thakkar J, Dym H. Management of Burning Mouth Syndrome. Dent Clin North Am 2024; 68:113-119. [PMID: 37951628 DOI: 10.1016/j.cden.2023.07.007] [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] [Indexed: 11/14/2023]
Abstract
This article provides an update for the practicing dentist and/or oral and maxillofacial surgeon on the recognition, identification, and treatment of burning mouth syndrome (BMS). We discuss the most common clinical findings and most common causes of BMS. This article provides a classification flowchart that assists the practitioner in diagnosing and classifying BMS. The article then discusses the pathophysiology and treatment of BMS updated in the literature from the latest studies and reviews. Treatment can vary from topical or systemic medication to behavioral therapy.
Collapse
Affiliation(s)
- Jaykrishna Thakkar
- Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 155 Ashland Place, Brooklyn, NY 11201, USA.
| | - Harry Dym
- Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 155 Ashland Place, Brooklyn, NY 11201, USA
| |
Collapse
|
7
|
Zhao H, Ran S, Gan K, Du Y, Li W. Pain sensitivity and quality of life of patients with burning mouth syndrome: a preliminary study in a Chinese population. BMC Oral Health 2023; 23:951. [PMID: 38041054 PMCID: PMC10693025 DOI: 10.1186/s12903-023-03689-2] [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: 10/11/2023] [Accepted: 11/21/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Burning mouth syndrome (BMS) is an oral-facial pain disorder involving the central and peripheral nervous systems, but the evidence for altered pain sensitivity remains inconclusive. The aim of this study was to investigate pain sensitivity and oral health-related quality of life (OHRQoL) in patients with BMS and to assess the relationship between them. METHODS Fifty Chinese patients with BMS (57.82 ± 11.2 years) and fifty age- and gender-matched healthy subjects (55.64 ± 10.1 years) participated in the study. The Pain Sensitivity Questionnaire (PSQ) was used to assess participants' pain sensitivity. The Oral Health Impact Profile (OHIP-14) was used to evaluate participants' OHRQoL. RESULTS The PSQ total score (p = 0.009), the PSQ minor score (p = 0.003) and the OHIP-14 score (p<0.05) of patients with BMS were significantly higher than those of the healthy subjects. Simple linear regression showed that the PSQ minor score was significantly associated with the OHIP-14 score in patients with BMS (β = 0.338, p = 0.016). CONCLUSION Patients with BMS have higher pain sensitivity than healthy subjects. Reducing pain sensitivity might help to improve the quality of life of patients with BMS.
Collapse
Affiliation(s)
- Hongsen Zhao
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, China.
| | - Shujun Ran
- National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Kang Gan
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, China
| | - Yajing Du
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, China
| | - Wenlu Li
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, China
| |
Collapse
|
8
|
Medeiros CKS, Serrão MDCPN, de Lima AAS, da Silveira ÉJD, de Oliveira PT. Comparative analysis of photobiomodulation therapy and transcutaneous electrical nerve stimulation for burning mouth: a randomized clinical trial. Clin Oral Investig 2023; 27:6157-6165. [PMID: 37656286 DOI: 10.1007/s00784-023-05232-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/18/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVE To compare the effect of photobiomodulation (PBM) and transcutaneous electrical nerve stimulation (TENS) in the treatment of burning mouth. MATERIALS AND METHODS Randomized clinical trial of 25 patients with burning mouth treated by TENS (n=12) and PBM (n=13). The patients were treated weekly for 8 weeks. Two-factor ANOVA was used to determine whether the two interventions promoted significant differences in symptoms (measured with a visual analogue scale), unstimulated salivary flow, xerostomia, and dysgeusia between T0 (baseline), T1 (after the 4th treatment session), T2 (after the 8th treatment session), and T3 (30 days after the end of treatment). RESULTS Intragroup comparison of VAS scores for pain showed a significant difference between T0xT1, T0xT2, and T0xT3 in the TENS group and between T0xT2 and T0xT3 in the PBM group (p˂0.001). Intergroup comparison of VAS scores for pain between T2xT3 showed a better response to PBM than to TENS (p=0.003). Patients of the TENS group showed an increase in salivary flow between T1 and T2 (p=0.052). There were no expressive variations in xerostomia or dysgeusia in the two groups analyzed. CONCLUSION TENS and PBM were effective in reducing the symptoms of burning mouth during and after treatment. The PBM group showed a better response during follow-up. TRIAL REGISTRATION This clinical trial was registered at http://clinicaltrials.gov (Number: NCT05816200). CLINICAL RELEVANCE TENS was found to be a safe and effective therapy for burning mouth. Trial registration number (TRN) and date of registration: This clinical trial was registered at http://clinicaltrials.gov (Number: NCT05816200; date: May 08, 2023).
Collapse
Affiliation(s)
- Cristianne Kalinne Santos Medeiros
- Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil.
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil.
| | | | - Antonio Adilson Soares de Lima
- Department of Stomatology, Graduate School of Dentistry, Federal University of Paraná, Rua Prefeito Lothário Meissner, 632, Campus Jardim Botânico, Curitiba, PR, 80210-170, Brazil
| | - Éricka Janine Dantas da Silveira
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil
| | - Patrícia Teixeira de Oliveira
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil
| |
Collapse
|
9
|
Cieplik F, Hiller KA, Scholz KJ, Schmalz G, Buchalla W, Mittermüller P. General diseases and medications in 687 patients reporting on adverse effects from dental materials. Clin Oral Investig 2023; 27:4447-4457. [PMID: 37212840 PMCID: PMC10415419 DOI: 10.1007/s00784-023-05064-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/07/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVES Examination of patients claiming adverse effects from dental materials can be very challenging. Particularly, systemic aspects must be considered besides dental and orofacial diseases and allergies. Therefore, the aim of this study was to investigate a cohort of 687 patients reporting on adverse effects from dental materials focusing on findings related to known general diseases or conditions or medication-related findings with relevance to their subjective complaints. METHODS Six hundred eighty-seven patients visiting a specialized consultation on claimed adverse effects from dental materials were retrospectively investigated for their subjective complaints, findings related to known general diseases or conditions, medication-related findings, dental and orofacial findings, or allergies with relevance to their subjective complaints. RESULTS The most frequent subjective complaints were burning mouth (44.1%), taste disorders (28.5%), and dry mouth (23.7%). In 58.4% of the patients, dental and orofacial findings relevant to their complaints could be found. Findings related to known general diseases or conditions or medication-related findings were found in 28.7% or 21.0% of the patients, respectively. Regarding medications, findings related to antihypertensives (10.0%) and psychotropic drugs (5.7%) were found most frequently. Relevant diagnosed allergies toward dental materials were found in 11.9%, hyposalivation in 9.6% of the patients. In 15.1% of the patients, no objectifiable causes for the expressed complaints could be found. CONCLUSIONS For patients complaining of adverse effects from dental materials, findings related to known general diseases or conditions and medications should be given particular consideration, while still in some patients, no objectifiable causes for their complaints can be found. CLINICAL RELEVANCE For patients complaining about adverse effects from dental materials, specialized consultations and close collaboration with experts from other medical fields are eligible.
Collapse
Affiliation(s)
- Fabian Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Konstantin J Scholz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Gottfried Schmalz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Pauline Mittermüller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| |
Collapse
|
10
|
Arantes DAC, Toledo ÍCD, de Arruda JAA, Mesquita RA, Castro LAD, Batista AC, Ribeiro-Rotta RF. Evaluation of peripheral nerve fibers and mast cells in burning mouth syndrome. Braz Oral Res 2023; 37:e055. [PMID: 37255075 DOI: 10.1590/1807-3107bor-2023.vol37.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 12/20/2022] [Indexed: 06/01/2023] Open
Abstract
Emerging evidence has revealed a cross-talk in the etiopathogenesis of burning mouth syndrome (BMS) related to peripheral nerve fibers (NF) and neuropeptides secreted by mast cells. Here, we investigated the S-100+ density and PGP 9.5+ integrity of peripheral NF and the tryptase+ mast cell density in the oral mucosa of BMS patients and healthy individuals. A total of 23 oral mucosa specimens (12 BMS and 11 controls) were evaluated. The clinical diagnosis of BMS was based on a careful examination, excluding other local and systemic causes. Samples were taken from an incisional biopsy of the tongue mucosa of individuals with symptomatic BMS, while the margins of the non-neoplastic tongue biopsy served as controls of healthy individuals. Immunohistochemistry was performed to determine the density/mm2 of S-100+, PGP 9.5+ peripheral NF, and tryptase+ mast cells. Similar densities of S-100+, PGP 9.5+ peripheral NF, and tryptase+ mast cells were found in cases of BMS, with a median value of 3.70, 0.70, and 29.24/mm2, respectively, and in the control group, with a median value of 2.60, 0.80, and 26.01/mm2, respectively (p > 0.05). Moreover, the relationship between S100+ and PGP 9.5+ peripheral NF was the same in both groups (p = 0.70). This study demonstrated that there were no alterations in the density and integrity of peripheral NF in the tongue of symptomatic BMS patients. However, the sensitization of peripheral NF in this disease may not depend on mast cell density.
Collapse
Affiliation(s)
- Diego Antonio Costa Arantes
- Universidade Federal de Goiás - UFG, School of Dentistry, Department of Oral Medicine, Goiânia, Goiás, Brazil
| | - Ítalo Cordeiro de Toledo
- Universidade Federal de Goiás - UFG, School of Dentistry, Department of Oral Medicine, Goiânia, Goiás, Brazil
| | - José Alcides Almeida de Arruda
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Departament of Oral Surgery, Pathology and Clinical Dentistry, Belo Horizonte, MG, Brazil
| | - Ricardo Alves Mesquita
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Departament of Oral Surgery, Pathology and Clinical Dentistry, Belo Horizonte, MG, Brazil
| | - Luciano Alberto de Castro
- Universidade Federal de Goiás - UFG, School of Dentistry, Department of Oral Medicine, Goiânia, Goiás, Brazil
| | - Aline Carvalho Batista
- Universidade Federal de Goiás - UFG, School of Dentistry, Department of Oral Medicine, Goiânia, Goiás, Brazil
| | - Rejane Faria Ribeiro-Rotta
- Universidade Federal de Goiás - UFG, School of Dentistry, Department of Oral Medicine, Goiânia, Goiás, Brazil
| |
Collapse
|
11
|
Dugan C, Popescu BO, Țovaru S, Părlătescu I, Musat IA, Dobre M, Ribigan AC, Milanesi E. Neuropsychological assessment of Romanian burning mouth syndrome patients: stress, depression, sleep disturbance, and verbal fluency impairments. Front Psychol 2023; 14:1176147. [PMID: 37255508 PMCID: PMC10225505 DOI: 10.3389/fpsyg.2023.1176147] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/14/2023] [Indexed: 06/01/2023] Open
Abstract
Burning Mouth Syndrome (BMS) is a chronic condition characterized by a burning sensation in the oral mucosa, lasting more than 2 hours daily for more than 3 months, without clinical and/or laboratory evidence. BMS is often comorbid with mood, and psychiatric disorders, and a complex pathophysiology and interaction between impairments in nociceptive processing and psychologic function is occurring. In this work, we aimed to define the neuropsychological profile specific for BMS patients for a better management of this complex disease. We conducted a case-control study comparing 120 BMS patients and 110 non-BMS individuals (CTRL). Sociodemographic data and lifestyle habits, were collected, along with data regarding quality of life (SF-36 scale), stress (PSS), depression and anxiety (MADRS and HADS scales), sleep quality (PSQI scale), and cognitive functions (MoCA, SVF and PVF tests). The statistical analysis revealed a lower general quality of life (p < 0.001), worse sleep quality (p < 0.001) in BMS patients than CTRL. The BMS patients also displayed a higher prevalence of mild depressive symptoms than CTRL applying the MADRS (p < 0.001) and HADS-Depression scales (p = 0.001), whereas no differences in anxiety symptoms were found between the two groups (p = 0.174). Moreover, reduced scores semantic and phonemic verbal fluency tests (p < 0.05) were found, but no change in cognition was observed through MoCA (p = 0.551). Our results highlight that synergy between dentistry and neuropsychiatric assessment is essential for a successful management of BMS.
Collapse
Affiliation(s)
- Cosmin Dugan
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Bogdan Ovidiu Popescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinical Neurosciences, Geriatrics and Gerontology Departments, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Victor Babeș National Institute of Pathology, Bucharest, Romania
| | - Serban Țovaru
- Department of Oral Pathology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Ioanina Părlătescu
- Department of Oral Pathology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Ioana Andreea Musat
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Victor Babeș National Institute of Pathology, Bucharest, Romania
| | - Maria Dobre
- Victor Babeș National Institute of Pathology, Bucharest, Romania
| | - Athena Cristina Ribigan
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Neurology Department, University Emergency Hospital, Bucharest, Romania
| | - Elena Milanesi
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Victor Babeș National Institute of Pathology, Bucharest, Romania
| |
Collapse
|
12
|
Hamon B, Orliaguet M, Misery L, Boisramé S. Burning mouth syndrome and pelvodynia: A literature review. Medicine (Baltimore) 2023; 102:e32648. [PMID: 36701734 PMCID: PMC9857247 DOI: 10.1097/md.0000000000032648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Burning mouth syndrome (BMS) and pelvodynia are chronic pain still poorly understood and the links between them are all the more so. Health professionals therefore have few resources to understand, diagnose and treat these pains. They may consider and treat these ailments individually, which does not represent optimal care management for the patient and leads to overmedication. This article aims to highlight their contiguity from epidemiological, etiological, diagnostic, and therapeutic perspectives. This study was based on articles which were found using databases such as PubMed and Web of Science. No exclusion criteria were used. Fourteen studies were reviewed. This present work shows that the clinical presentations of these syndromes are similar, as exemplified by their strong association with anxiety and depression. The neurophysiological mechanisms involved in these conditions are similar to those in patients. The diagnosis is essentially based on visual examination and an elimination of all other possible causes. In addition, this work promotes the fact that a common therapy can be implemented when BMS and pelvodynia co-occur. However, the literature on the subject is still very limited. This can be deepened by exploring all the effective treatments in BMS and vulvodynia for penoscrotodynia. Finally, for all these pains, there is a therapeutic order to respect starting with a psychological approach, then topical treatments, systemic therapy and surgical. This therapeutic gradient assists practitioner in their patient's pain management. This article also allows health care providers to quickly find an effective systemic treatment for a patient with both BMS and pelvodynia.
Collapse
Affiliation(s)
- Bérenger Hamon
- UFR d’Odontologie, University of Western Brittany, Brest, France
- * Correspondence: B. Hamon, UFR d’Odontologie, University of Western Brittany, Brest 29200, France (e-mail: )
| | - Marie Orliaguet
- Centre Hospitalier Régional Universitaire de Brest, Brest, France
- * Correspondence: B. Hamon, UFR d’Odontologie, University of Western Brittany, Brest 29200, France (e-mail: )
| | - Laurent Misery
- Centre Hospitalier Régional Universitaire de Brest, Brest, France
- * Correspondence: B. Hamon, UFR d’Odontologie, University of Western Brittany, Brest 29200, France (e-mail: )
| | - Sylvie Boisramé
- UFR d’Odontologie, University of Western Brittany, Brest, France
- Centre Hospitalier Régional Universitaire de Brest, Brest, France
- * Correspondence: B. Hamon, UFR d’Odontologie, University of Western Brittany, Brest 29200, France (e-mail: )
| |
Collapse
|
13
|
San Millán-González M, Benito-Orejas JI, Duque-Holguera V, Álvarez-Álvarez M, Losada-Campa J, Saboya-Romero DM. Síndrome de boca ardiente, abordaje otorrinolaringológico. Revisión bibliográfica sistemática. REVISTA ORL 2022. [DOI: 10.14201/orl.30097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Introducción y objetivo: El síndrome de boca ardiente (SBA) es una afección crónica, que cursa con quemazón o dolor de la mucosa bucal, afectando predominantemente a mujeres de edad media. Puede aparecer como cuadro primario o bien de forma secundaria. La fisiopatología de esta entidad es bastante desconocida. Existe un amplio abanico terapéutico, pero por lo general precisa de un abordaje multidisciplinar. Nuestra intención es realizar una puesta al día de la enfermedad para poder hacerla frente en la consulta de otorrinolaringología. Método: Revisión bibliográfica de la literatura. Fecha de publicación limitada de 2012 a 2022. Resultados: El SBA presenta una etiopatogenia de carácter multifactorial. Para su diagnóstico es necesario realizar una exhaustiva anamnesis y exploración. Se diferencian 3 tipos distintos de SBA, siendo el tipo II el más frecuente y el más refractario a la terapia. El adecuado tratamiento se fundamenta en un correcto diagnóstico y debe ser multidisciplinar. Discusión: Es importante resaltar que es una entidad benigna. Los tratamientos son variados y no hay ninguno que destaque sobre el resto, lo que dificulta el manejo de estos pacientes. Aunque la bibliografía sobre este síndrome es abundante, no se han producido en los últimos años, importantes innovaciones en cuanto a la etiología y tratamiento. Conclusiones: La anamnesis y los estudios de laboratorio son fundamentales para descartar casusas secundarias de la enfermedad. La terapia es diversa y debe incluir derivación a salud mental como parte del manejo multidisciplinar.
Collapse
|
14
|
Maarse F, Fennis WMM, Twisk JWR, Korfage A, Santing H, den Hartog L, Muradin MSM, Maningky M, Raghoebar GM, Vissink A, Brand HS, Jager DHJ. Dental implants in dentate primary and secondary Sjögren's syndrome patients: A multicenter prospective cohort study. Clin Oral Implants Res 2022; 33:1157-1170. [PMID: 36136091 PMCID: PMC9827828 DOI: 10.1111/clr.13998] [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: 02/08/2022] [Revised: 07/12/2022] [Accepted: 08/18/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To prospectively assess the clinical performance and patient-reported outcomes of dental implants in dentate patients with primary and secondary Sjögren's syndrome (pSS and sSS, respectively) compared to patients without SS. MATERIALS AND METHODS Thirty-seven implants were placed in 17 patients with pSS/sSS and 26 implants in 17 non-SS patients to replace missing (pre)molars. Clinical performance, marginal bone-level changes, patient satisfaction, and oral health-related quality of life (OHRQoL) were assessed at 1 (T1), 6 (T6), 12 (T12), and 18 (T18) months after placement of the superstructure. Marginal bone-level changes were measured on standardized dental radiographs. Clinical parameters included implant and crown survival, plaque, bleeding and gingival indices, and probing depth. Patient satisfaction and OHRQoL were assessed with validated questionnaires. RESULTS Implant survival at T18 was 100% in the patients with pSS/sSS and 96.2% in the non-SS group. Mean marginal bone loss at T18 did not differ between patients with pSS/sSS and non-SS patients, 1.10 ± 1.04 and 1.04 ± 0.75 mm, respectively (p = .87). Clinical performance was good with no differences between the groups for all outcome measures (p > .05). OHRQoL in patients with pSS/sSS had improved significantly after placement of implant supported crowns at all measuring moments compared to baseline (p < .05). Nevertheless, patient satisfaction and OHRQoL remained significantly higher for patients without SS at all measuring moments (p < .05). CONCLUSION Dental implants can be successfully applied in dentate patients with pSS/sSS and have a positive effect on OHRQoL.
Collapse
Affiliation(s)
- Floor Maarse
- Department of Maxillofacial Surgery and Oral PathologyAmsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Willem M. M. Fennis
- Department of Oral and Maxillofacial Surgery, Prosthodontics and Special Dental CareUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Jos W. R. Twisk
- Department of Epidemiology and Data Science, Amsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Anke Korfage
- Department of Oral and Maxillofacial SurgeryUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | | | - Laurens den Hartog
- Department of Oral and Maxillofacial SurgeryUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Marvick S. M. Muradin
- Department of Oral and Maxillofacial Surgery, Prosthodontics and Special Dental CareUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Melvin S. Maningky
- Department of Maxillofacial Surgery and Oral PathologyAmsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Gerry M. Raghoebar
- Department of Oral and Maxillofacial SurgeryUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial SurgeryUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Henk S. Brand
- Department of Oral BiochemistryAcademic Center for Dentistry Amsterdam (ACTA)AmsterdamThe Netherlands
| | - Derk Hendrik Jan Jager
- Department of Maxillofacial Surgery and Oral PathologyAmsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| |
Collapse
|
15
|
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]
|
16
|
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.
Collapse
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 -
| |
Collapse
|
17
|
Zborowski J, Konopka T. Comparison of Clonazepam and Tongue Protector in the Treatment of Burning Mouth Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158999. [PMID: 35897370 PMCID: PMC9330819 DOI: 10.3390/ijerph19158999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 02/01/2023]
Abstract
Background: BMS is a chronic pain syndrome affecting the oral mucosa. It consists of experiencing a burning or dysesthetic sensation. BMS prevalence varies, with up to 15% among women. An effective treatment is still unattainable. Material and Methods: A total of 60 patients with BMS qualified for a randomised trial, divided in two groups: the clonazepam-treated and tongue protector group. Treatment was provided for 4 weeks in both groups. In the former, the oral dosage of clonazepam 0.5 mg; in the latter, a tongue protector was used. Clinical oral examination was performed, and the presence of taste disorder and pain intensity, on the visual analogues scale, were recorded. Psychological domains were explored with the Beck depression inventory (depression), Athens insomnia scale (insomnia), Eyesenck personality questionnaire-revised (personality traits), and WHO quality of life questionnaire (quality of life). Results: Complete recovery was observed in three patients after clonazepam and one patient after tongue guard treatment. A greater improvement in the VAS scores, from baseline to the control values, was demonstrated in the clonazepam group, and it was statistically significant. In women, the level of depression significantly correlated with all domains of quality of life. Conclusions: BMS is an ongoing multi-specialist challenge. The development of new pathophysiological concepts of BMS offers hope for more effective treatment. Considering the influence of BMS on the quality of life and mental disorders in most patients, further research on the possibilities of therapy seems to be very important.
Collapse
|
18
|
Thermography as a Non-Ionizing Quantitative Tool for Diagnosing Burning Mouth Syndrome: Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158903. [PMID: 35897273 PMCID: PMC9329975 DOI: 10.3390/ijerph19158903] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 01/27/2023]
Abstract
Objectives: Thermography is an imaging technique based on the acquisition and analysis of thermal data. The present study evaluates the use of tongue infrared thermography (IRT) as a tool for the diagnosis of burning mouth syndrome (BMS). Material and methods: An IRT study was carried out in patients diagnosed with BMS according to the criteria of the International Association for the Study of Pain (n = 32) and in healthy controls (n = 35). Burning sensations, dry mouth and taste disturbances were assessed, and three temperature values were recorded for each tongue surface (dorsal, right lateral, left lateral and tip), along with body temperature and environmental temperature. Results: A statistically significant difference was recorded in the temperature of the dorsal surface of the tongue between the BMS group and the controls (p = 0.01). The area under the curve (AUC) was 0.731 (95% CI: 0.402–0.657; p = 0.003). The sensitivity and specificity obtained was 62% and 77%, respectively. Conclusions: Infrared thermography appears to be useful as a complementary tool for the diagnosis of BMS, though further studies are needed in this field.
Collapse
|
19
|
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.
Collapse
|
20
|
Guo Y, Wang B, Gao H, He C, Hua R, Gao L, Du Y, Xu J. Insight into the Role of Psychological Factors in Oral Mucosa Diseases. Int J Mol Sci 2022; 23:ijms23094760. [PMID: 35563151 PMCID: PMC9099906 DOI: 10.3390/ijms23094760] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 04/22/2022] [Accepted: 04/23/2022] [Indexed: 02/04/2023] Open
Abstract
With the development of psychology and medicine, more and more diseases have found their psychological origins and associations, especially ulceration and other mucosal injuries, within the digestive system. However, the association of psychological factors with lesions of the oral mucosa, including oral squamous cell carcinoma (OSCC), burning mouth syndrome (BMS), and recurrent aphthous stomatitis (RAS), have not been fully characterized. In this review, after introducing the association between psychological and nervous factors and diseases, we provide detailed descriptions of the psychology and nerve fibers involved in the pathology of OSCC, BMS, and RAS, pointing out the underlying mechanisms and suggesting the clinical indications.
Collapse
Affiliation(s)
- Yuexin Guo
- Department of Oral Medicine, Basic Medical College, Capital Medical University, Beijing 100069, China; (Y.G.); (Y.D.)
| | - Boya Wang
- Department of Clinical Medicine, Peking University Health Science Center, Beijing 100081, China;
| | - Han Gao
- Department of Physiology and Pathophysiology, Basic Medical College, Capital Medical University, Beijing 100069, China; (H.G.); (C.H.)
| | - Chengwei He
- Department of Physiology and Pathophysiology, Basic Medical College, Capital Medical University, Beijing 100069, China; (H.G.); (C.H.)
| | - Rongxuan Hua
- Department of Clinical Medicine, Basic Medical College, Capital Medical University, Beijing 100069, China;
| | - Lei Gao
- Department of Bioinformatics, College of Bioengineering, Capital Medical University, Beijing 100069, China;
| | - Yixuan Du
- Department of Oral Medicine, Basic Medical College, Capital Medical University, Beijing 100069, China; (Y.G.); (Y.D.)
| | - Jingdong Xu
- Department of Physiology and Pathophysiology, Basic Medical College, Capital Medical University, Beijing 100069, China; (H.G.); (C.H.)
- Correspondence: ; Tel./Fax: +86-10-8391-1469
| |
Collapse
|
21
|
Lee BM, Park JW, Jo JH, Oh B, Chung G. Comparative analysis of the oral microbiome of burning mouth syndrome patients. J Oral Microbiol 2022; 14:2052632. [PMID: 35341209 PMCID: PMC8942548 DOI: 10.1080/20002297.2022.2052632] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Burning mouth syndrome
(BMS) is a chronic pain condition accompanied by unpleasant burning sensations
of the oral mucosa. While multiple factors were proposed for the etiology, evidence
suggested a neuropathic pain origin while others suspected the use of
antibiotics as the underlying cause. Interestingly, several reports demonstrated
the intimate interaction of the nervous system and the microbiome. The current
study aims to elucidate the correlation of the oral microbiome with the pathophysiology
of the primary BMS. Microbiome samples obtained from the unstimulated whole
saliva of 19 primary BMS patients and 22 healthy controls were sequenced and analyzed
of the V3-V4 region of 16S rRNA gene. There was a distinct difference in the
microbial composition between the BMS and the control groups at all taxonomic levels.
Alpha diversity indexes of the oral microbiome were significantly lower in the
BMS group. The samples were readily distinguished by multidimensional scaling
analysis and linear discriminant analysis effect size. Streptococcus, Rothia, Bergeyella, and Granulicatella
genus were dominant in the BMS group, while Prevotella, Haemophilus,
Fusobacterium, Campylobacter,
and Allorevotella genus were more
abundant in the healthy group. Distinct microbiome signatures of BMS patients
suggested a diagnostic value and a potential role in the pathogenesis of BMS.
Collapse
Affiliation(s)
- Byeong-Min Lee
- Department of Oral Physiology and Program in Neurobiology, School of Dentistry, Seoul National University, Seoul, Republic of Korea.,Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Ji Woon Park
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea.,Department of Oral Medicine and Oral Diagnosis, School of Dentistry, Seoul National University, Seoul, Republic of Korea.,Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Jung Hwan Jo
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry, Seoul National University, Seoul, Republic of Korea.,Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Bumjo Oh
- Department of Family Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Gehoon Chung
- Department of Oral Physiology and Program in Neurobiology, School of Dentistry, Seoul National University, Seoul, Republic of Korea.,Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| |
Collapse
|
22
|
Evaluation of the analgesic effect of ɑ-lipoic acid in treating pain disorders: A systematic review and meta-analysis of randomized controlled trials. Pharmacol Res 2022; 177:106075. [PMID: 35026405 DOI: 10.1016/j.phrs.2022.106075] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 11/22/2022]
Abstract
Neuropathic pain is the most prevalent form of chronic pain caused by a disease of the nervous system, such as diabetic polyneuropathy. ɑ-Lipoic acid (ALA) is an antioxidant that has been widely studied for the treatment of pain symptoms in diverse conditions. Therefore, this study aimed to investigate the efficacy of ALA in the treatment of different types of pain through a systematic review and meta-analysis of randomized clinical trials. The study protocol was registered in the International Prospective Registry of Systematic Reviews (CRD42021261971). A search of the databases resulted in 1154 articles, 16 of which were included in the review (9 studies with diabetic polyneuropathy and 7 studies with other painful conditions). Most of the included studies had a low risk of bias. ALA showed efficacy for the treatment of headache, carpal tunnel syndrome and burning mouth syndrome. Meta-analysis was conducted only with the studies using diabetic polyneuropathy. Compared to placebo, ALA treatment decreased the total symptom score (TSS). The subgroup meta-analysis indicated a decrease of stabbing pain, burning, paraesthesia, and numbness in ALA-treated patients compared to placebo. In addition, both routes of administration, intravenous and oral, demonstrated the efficacy to reduce TSS. Therefore, ALA should be used to treat diabetic polyneuropathy pain symptoms. However, the standardization of treatment time and the dose may advance for the approval of ALA for clinical use in diabetic polyneuroneuropathy.
Collapse
|
23
|
Coppola N, Blasi A, Amato M, Ferrigno R, Mignogna MD, Leuci S. Clinical characterization of gingival type of burning mouth syndrome: a cross-sectional study. Med Oral Patol Oral Cir Bucal 2021; 26:e802-e807. [PMID: 34564683 PMCID: PMC8601634 DOI: 10.4317/medoral.24791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 09/06/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The aim of this study is to investigate the prevalence of localized intraoral neuropathic pain in a cluster of patients who reported the involvement of gingival site as only clinical manifestation of dysesthesia, analysing type and distribution of symptoms. MATERIAL AND METHODS Burning mouth syndrome (BMS) patients were enrolled in the study. Patients were screened through laboratory test and a conventional oral examination with periodontal chart. A questionnaire to collect data on symptoms, oral site involved, quality of sleep, anxiety was submitted to all the patients. RESULTS A total of 236 patients were recruited. Seventy-six patients (32.2%) presented generalized type, whereas 160 (67.8%) had localized type. In the localized BMS group, the gingiva was involved in 70 patients and in 33 of these it was the only site involved. In the gingival subgroup, 35 patients reported burning, 29 pain and 24 xerostomia. CONCLUSIONS To best our knowledge, this study is the first that analyses gingival involvement as the only site in BMS and it could encourage further investigations to understand the etiopathogenesis of gingival BMS.
Collapse
Affiliation(s)
- N Coppola
- Department of Neuroscience, Reproductive and Odontostomatological Sciences Oral Medicine Unit, School of Medicine.University of Naples Federico II Via Sergio Pansini 5, 80131 Naples, Italy
| | | | | | | | | | | |
Collapse
|
24
|
Kishore J, Shaikh F, Zubairi AM, Mirza S, Alqutub MN, AlMubarak AM, Abduljabbar T, Vohra F. Evaluation of serum neuron specific enolase levels among patients with primary and secondary burning mouth syndrome. Cephalalgia 2021; 42:119-127. [PMID: 34644195 DOI: 10.1177/03331024211046613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Burning mouth syndrome is a painful condition of the oral cavity with ambiguous pathogenesis and diagnosis. Neuron-specific enolase is increased in several conditions including peripheral neuropathy of diabetes, ophthalmopathies, spinal cord injuries and tumors. Evidence on association of burning mouth syndrome and neuron-specific enolase is limited. AIM This study aims to evaluate neuron-specific enolase levels in primary and secondary burning mouth syndrome patients and compare the levels of neuron-specific enolase with associated conditions in secondary burning mouth syndrome. METHODS One hundred and twenty-eight patients of more than 18 years of age with no gender predilection and having clinical symptoms of burning mouth syndrome and 135 healthy subjects were included. All the patients fulfilled Scala's criteria for the diagnosis of burning mouth syndrome, including "primary" (idiopathic) and "secondary" (resulting from identified precipitating factors) burning mouth syndrome patients. Blood samples were obtained from burning mouth syndrome patients. Serum neuron-specific enolase was evaluated using enzyme-linked immunosorbent assay. To compare means and standard deviations, among primary and secondary burning mouth syndrome, data was analysed with analysis of variance and multiple comparisons test. RESULTS The mean age of the study participants for burning mouth syndrome and healthy subjects was 53.30 and 51.6 years, respectively. Amongst the secondary burning mouth syndrome group, 32 (25%) of the patients had menopause, 15 (11.7%) had diabetes, eight (6.2%) of the patients had nutritional deficiency, seven (5.4%) had combined diabetes, menopause, and depression, six (4.6%) had combined diabetes and depression, four (3.1%) were diagnosed with Sjögren's syndrome. A minor percentage of 2.3% (three) had gastroesophageal reflux disease, while the remaining three (2.3%) patients in the secondary burning mouth syndrome group were on anti-depressants. There was a statistically significant increase in the levels of neuron-specific enolase in primary burning mouth syndrome as compared to the secondary burning mouth syndrome and healthy groups. Among the subgroups of secondary burning mouth syndrome, diabetic individuals showed a significant increase in neuron-specific enolase level when compared with other conditions in the secondary burning mouth syndrome patients.Discussion and conclusion: The raised serum neuron-specific enolase levels in patients suffering from primary burning mouth syndrome highlight a possible neuropathic mechanism. It was also increased in the sub-group of secondary burning mouth syndrome patients having diabetes. Although it cannot be ascertained whether the deranged values in the diabetic group were due to burning mouth syndrome or due to diabetes, the raised quantity of neuron-specific enolase in the primary burning mouth syndrome group is a reliable diagnostic indicator. Future studies on the assessment of neuron-specific enolase levels as a diagnostic tool for onset and management of primary and secondary burning mouth syndrome are recommended.
Collapse
Affiliation(s)
- Jaimala Kishore
- Department of Oral Pathology, 37093Ziauddin University, Ziauddin University, Karachi, Pakistan
| | - Fouzia Shaikh
- Department of Pathology, Ziauddin University, Karachi, Pakistan
| | | | - Sana Mirza
- Department of Oral Pathology, 37093Ziauddin University, Ziauddin University, Karachi, Pakistan
| | - Montaser N Alqutub
- Department of Periodontics and Community Dentistry, 37850King Saud University, 37850King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman M AlMubarak
- Department of Periodontics and Community Dentistry, 37850King Saud University, 37850King Saud University, Riyadh, Saudi Arabia
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Science, College of Dentistry, 37850King Saud University, Riyadh, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, 37850King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
25
|
Su NY, Wang YH, Chang YC. A nationwide register-based study of the prevalence of burning mouth syndrome in Taiwan from 2004 to 2013. J Dent Sci 2021; 16:1074-1079. [PMID: 34484572 PMCID: PMC8403878 DOI: 10.1016/j.jds.2021.06.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 11/29/2022] Open
Abstract
Background/purpose Burning mouth syndrome (BMS) is defined as a chronic burning pain of the oral mucosa with no associated clinical signs or apparent extraneous cause. Limited epidemiologic data have been published. In this study, we probed the nationwide registered database to assess the prevalence of BMS in Taiwan. Materials and methods A retrospective study was conducted to analyze the dental dataset compiled by the Taiwan's National Health Insurance Research Database from 2004 to 2013. The diagnosis of BMS was identified in accordance with the International Classification of Disease, Ninth revision. In addition, sex and age were analyzed by multivariate Poisson regression. Results The prevalence of BMS revealed from 2.24 (per 104) to 3.11 (per 104) over past 10 year period. Female has higher risk of BMS than male (RR: 1.39; 95% CI: 1.37–1.41). The 50–59 years old group, 60–69 years old group, and >70 years old group had 1.55-, 2.06-, and 2.58-fold risk than 40–49 years old group for BMS (p < 0.001), respectively. Conclusion Taken together, this is the first reported nationwide population based prevalence data for BMS in Taiwan. The risk for BMS is highly associated with female and advancing age.
Collapse
Affiliation(s)
- Ni-Yu Su
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan.,Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Chao Chang
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan.,Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| |
Collapse
|
26
|
Du QC, Ge YY, Xiao WL, Wang WF. Dopamine agonist responsive burning mouth syndrome: Report of eight cases. World J Clin Cases 2021; 9:6916-6921. [PMID: 34447842 PMCID: PMC8362543 DOI: 10.12998/wjcc.v9.i23.6916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/04/2021] [Accepted: 06/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Burning mouth syndrome (BMS) is characterized by burning sensation of the oral mucosa. There is a lack of effective treatment. In recent years, a special subtype of BMS has been reported, in which oral burning sensation is alleviated after chewing, speaking, or dopaminergic drug delivery. Currently, there are few reports about the subtype of BMS in China. This study was a retrospective analysis of the clinical data of BMS patients sensitive to dopamine agonist at our hospital, aiming to improve the recognition on this disease.
CASE SUMMARY Eight patients diagnosed with dopamine agonist responsive BMS at the Liaocheng People's Hospital from January 1, 2017 to June 30, 2020 were recruited. The clinical manifestations, treatment, and prognosis were retrospectively analyzed. There were three male and five females in the eight patients. The median age was 56 years (range, 46-65 years). All the eight patients showed burning pain in the mouth. The symptoms were mild in the morning and severe in the evening, and alleviated after chewing, talking, and other oral activities. Four patients were accompanied by restless legs syndrome (RLS). Family history of RLS was positive in two patients. All patients were treated with pramipexol, and symptoms were basically relieved after 2-8 wk.
CONCLUSION Dopamine agonist responsive BMS is a special subtype of BMS, which is alleviated after oral activities. Dopamine receptor agonist is an effective treatment.
Collapse
Affiliation(s)
- Qi-Cui Du
- Department of Stomatology, Liaocheng People's Hospital, Liaocheng 252000, Shandong Province, China
| | - Ying-Ying Ge
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
| | - Wen-Lin Xiao
- Department of Stomatology, Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
| | - Wei-Fei Wang
- Department of Neurology, Liaocheng People's Hospital, Liaocheng 252000, Shandong Province, China
| |
Collapse
|
27
|
Borgnakke WS, Poudel P. Diabetes and Oral Health: Summary of Current Scientific Evidence for Why Transdisciplinary Collaboration Is Needed. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.709831] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This Perspective provides a brief summary of the scientific evidence for the often two-way links between hyperglycemia, including manifest diabetes mellitus (DM), and oral health. It delivers in a nutshell examples of current scientific evidence for the following oral manifestations of hyperglycemia, along with any available evidence for effect in the opposite direction: periodontal diseases, caries/periapical periodontitis, tooth loss, peri-implantitis, dry mouth (xerostomia/hyposalivation), dysbiosis in the oral microbiome, candidiasis, taste disturbances, burning mouth syndrome, cancer, traumatic ulcers, infections of oral wounds, delayed wound healing, melanin pigmentation, fissured tongue, benign migratory glossitis (geographic tongue), temporomandibular disorders, and osteonecrosis of the jaw. Evidence for effects on quality of life will also be reported. This condensed overview delivers the rationale and sets the stage for the urgent need for delivery of oral and general health care in patient-centered transdisciplinary collaboration for early detection and management of both hyperglycemia and oral diseases to improve quality of life.
Collapse
|
28
|
Castillo-Felipe C, Franco-Martínez L, Tvarijonaviciute A, Lopez-Jornet P, Lamy E. Proteomics-Based Identification of Salivary Changes in Patients with Burning Mouth Syndrome. BIOLOGY 2021; 10:392. [PMID: 34062870 PMCID: PMC8147377 DOI: 10.3390/biology10050392] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/19/2021] [Accepted: 04/28/2021] [Indexed: 11/23/2022]
Abstract
Burning mouth syndrome (BMS) is a chronic oral condition characterized by an intraoral burning sensation, taste alterations, and dry mouth sensations. Although a number of factors have been closely related to the appearance of the symptoms, including anxiety, depression, and sleep disturbances, the etiology of BMS remains unclear. Furthermore, currently no objective diagnostic tools exist, making its diagnosis challenging. Therefore, to contribute to the knowledge about BMS etiology and look for objective tools for its diagnosis, the present study was conducted. Thus, the aim of this study was to analyze the proteomic profile of the resting whole saliva of patients with BMS and age and sex-matched controls using two-dimensional electrophoresis. The results showed evidence of changes in saliva at the level of proteins related to important pathways such as stress (sAA), immune system (Ig), and inflammation (leukocyte elastase inhibitor). While some of our findings have been previously described others, such as the deregulation of the coiled-coin domain containing protein 25 in BMS, are presented here for the first time to our knowledge. Thus, saliva provides us with relevant information about BMS pathophysiology and could be considered a suitable biofluid for its study and/or diagnosis.
Collapse
Affiliation(s)
- Candela Castillo-Felipe
- Faculty of Medicine and Odontology, Hospital Morales Meseguer, Clínica Odontológica, 30008 Murcia, Spain;
| | - Lorena Franco-Martínez
- Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, 30100 Murcia, Spain;
| | - Asta Tvarijonaviciute
- Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, 30100 Murcia, Spain;
| | - Pia Lopez-Jornet
- Faculty of Medicine and Odontology, Biomedical Research Institute (IMIB-Arrixaca) Hospital Morales Meseguer, Clínica Odontológica, 30008 Murcia, Spain;
| | - Elsa Lamy
- Mediterranean Institute for Agriculture, Environment and Development (MED), Institute for Advanced Studies and Research, University of Evora, 7006-554 Evora, Portugal;
| |
Collapse
|
29
|
Aitken-Saavedra J, Chaves Tarquinio SB, De Oliveira da Rosa WL, Fernandes da Silva A, Almeida Machado BM, Santos Castro I, Oliveira Wennesheimer A, Morales-Bozo I, Uchoa Vasconcelos AC, Neutzling Gomes AP. Effect of a Homemade Salivary Substitute Prepared Using Chamomile ( Matricaria chamomilla L.) Flower and Flax ( Linum usitatissimum L.) Seed to Relieve Primary Burning Mouth Syndrome: A Preliminary Report. J Altern Complement Med 2021; 26:799-806. [PMID: 32924561 DOI: 10.1089/acm.2019.0478] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Objectives: To evaluate (1) the effect of a salivary substitute prepared using chamomile (Matricaria chamomilla L.) flower and flax (Linum usitatissimum L.) seed to relieve Primary burning mouth syndrome (BMS) symptoms, (2) their effect on the inhibition of matrix metallopeptidase 2 (MMP2) and MMP9 metalloproteinases, and (3) their potential cellular cytotoxic effect. Subjects: 40 women aging >40 years with diagnosis of primary BMS. Settings/Location: Center of Diagnosis of Diseases of the Mouth, Federal University of Pelotas, Brazil. Design: This was an open clinical trial where primary BMS patients used the homemade salivary. At the first appointment, after 30 and 60 days, the authors evaluated the pattern and intensity of BMS and xerostomia symptoms, and then determined and compared the unstimulated salivary flow rate (SFR), viscosity, and salivary pH. MMP2 and MMP9 activities in saliva and cytotoxicity were assessed using different concentrations of chamomile flower and flax seed separately. Interventions: Subjects used the homemade salivary substitute for 3 months and were instructed to rinse their mouth three to four times daily for 1 min. Outcome measures: A numeric rating scale to evaluate the intensity of burning sensation and xerostomia symptoms, salivary flow rate (SFR) to determine salivary volume, dynamic rheology technique for viscosity and a digital meter for salivary pH. MMP2 and MMP9 activities in saliva and cytotoxicity were assessed by zymography and cell viability assay respectively. Results: After treatment, severity of BMS symptoms decreased, the SFR increased, salivary viscosity decreased, and severity of xerostomia sensation (in patients who reported having this symptom) improved (p < 0.05). Chamomile flower and flax seed had no effect on inhibiting MMP2 and MMP9 activities, and neither showed cellular cytotoxic effects. Conclusion: This homemade salivary substitute is an economical, viable, easily manipulated, noncytotoxic, and a practical alternative to relieve BMS symptoms.
Collapse
Affiliation(s)
- Juan Aitken-Saavedra
- Center of Diagnosis of Diseases of the Mouth, Federal University of Pelotas, Pelotas, Brazil.,Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Department of Oral Pathology and Medicine, School of Dentistry, University of Chile, Santiago, Chile
| | | | | | - Adriana Fernandes da Silva
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | | | | | | | - Irene Morales-Bozo
- Institute for Research in Dental Sciences, School of Dentistry, University of Chile, Santiago, Chile
| | | | | |
Collapse
|
30
|
Jin JQ, Cui HM, Han Y, Su S, Liu HW. Multifactor analysis of patients with oral sensory complaints in a case-control study. Chin Med J (Engl) 2020; 133:2822-2828. [PMID: 33273331 PMCID: PMC10631587 DOI: 10.1097/cm9.0000000000001190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND There are an increasing number of patients with oral sensory complaints (OSCs) presenting to our dental clinic. For most dentists, it is difficult to distinguish burning mouth syndrome (BMS) from other oral mucosal diseases that may cause symptoms such as burning mouth. It is beneficial to effectively distinguish OSC patients to reduce misdiagnosis and eliminate burning symptoms as much as possible. METHODS Patients with oral burning sensations in the oral mucosal disease clinic were collected from the Peking University Hospital of Stomatology between September 1, 2014 and December 31, 2018. After excluding oral candidiasis, anemic stomatitis, dental material allergy, and other diseases from patients with oral sensory complaints, basic conditions such as gender, age, education level, job status, hyperglycemia, hypertension, hyperlipidemia, history of brain abnormalities, history of cervical spondylitis, history of thyroid disease, history of thyroid disease and insomnia were obtained. The BMS patients were compared with the control group. The t test and Chi-square test were used for statistical analysis to compare the clinical symptoms of these diseases and explore the risk factors for BMS. RESULTS In this case-control study, 395 patients (321 females and 74 males, mean age 55.26 ± 10.51 years) with oral sensory complaints and 391 healthy controls (281 females and 110 males, mean age 47.11 ± 13.10 years) were enrolled, among which, 8.4% (33/395) had oral candidiasis, 1.3% (5/395) had dental material allergy, 0.8% (3/395) had anemic stomatitis and 0.5% (2/395) had lichen planus. A total of 352 patients were eventually diagnosed with BMS. Anxiety and depression were more severe in BMS patients, as were the incidences of sleep disorders and brain abnormalities. Logistic regression analysis showed that age (odds ratio [OR] = 2.79, 95% confidence interval [CI]: 1.61-4.83, P < 0.001), total cholesterol level (OR = 2.92, 95% CI: 1.32-6.50, P = 0.009) and anxiety score (OR = 1.75, 95% CI: 1.01-2.77, P = 0.017) significantly increased the incidence of BMS. Patients with hyperglycemia (OR = 0.46, 95% CI: 0.23-0.89, P = 0.022), low body mass index (BMI: OR = 0.57, 95% CI: 0.34-0.93, P = 0.026) and low education level (OR = 3.43, 95% CI: 1.91-6.15, P < 0.001) were more likely to suffer from BMS. CONCLUSIONS Oral candidiasis, anemic stomatitis, and dental material allergy with burning symptoms should be excluded from patients with BMS. It is recommended to conduct a questionnaire survey (including anxiety and depression), blood cell analysis, and salivary fungus culture for all patients with an oral burning sensation. It is necessary to conduct a patch test on patients with oral burning sensations and metal restorations.
Collapse
Affiliation(s)
- Jian-Qiu Jin
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing 100081, China
- Department of Stomatology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Hong-Mei Cui
- Department of Stomatology, Suzhou Vocational Health College, Suzhou, Jangsu 215009, China
| | - Ying Han
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Sha Su
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing 100069, China
| | - Hong-Wei Liu
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing 100081, China
| |
Collapse
|
31
|
Kim MJ, Kim J, Kho HS. Treatment outcomes and related clinical characteristics in patients with burning mouth syndrome. Oral Dis 2020; 27:1507-1518. [PMID: 33098162 DOI: 10.1111/odi.13693] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/27/2020] [Accepted: 10/14/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To evaluate the treatment outcomes of medication therapies in patients with burning mouth syndrome (BMS) and to identify the clinical characteristics that may affect the efficacy of prescribed medications. METHODS This is a retrospective study of 769 patients with oral burning sensations. Of these patients, 420 patients diagnosed as the primary BMS received an "Initial Approach" that involved a detailed explanation about its etiopathophysiology, self-care instruction, and use of an oral lubricant. Neuropathic medications were prescribed for 277 patients who did not respond to the initial approach. Clinical characteristics, prescribed medications, and changes in intensity of oral symptoms were reviewed. RESULTS Clonazepam was administered as the first-line medication. Alpha-lipoic acid (ALA), gabapentin, and nortriptyline were commonly administered in combination with clonazepam. More than two-thirds of the patients reported a marked improvement in oral symptoms after treatments with combination of neuropathic medications and ALA. The efficacies of the initial approach and clonazepam had significant positive associations with the initial intensity of oral symptoms and significant negative associations with depression. CONCLUSIONS Clonazepam therapy in combination with appropriate medications was effective for managing patients with BMS. The initial intensity of oral symptoms and psychological status were significantly associated with treatment outcomes.
Collapse
Affiliation(s)
- Moon-Jong Kim
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Jihoon Kim
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Hong-Seop Kho
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea.,Institute on Aging, Seoul National University, Seoul, South Korea
| |
Collapse
|
32
|
Adamo D, Pecoraro G, Coppola N, Calabria E, Aria M, Mignogna M. Vortioxetine versus other antidepressants in the treatment of burning mouth syndrome: An open-label randomized trial. Oral Dis 2020; 27:1022-1041. [PMID: 32790904 DOI: 10.1111/odi.13602] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This randomized open-label trial compared the efficacy and tolerability of vortioxetine (15 mg/daily) with different antidepressants in the treatment of patients with burning mouth syndrome (BMS). METHODS One and hundred fifty BMS patients were randomized into five groups and treated with either vortioxetine, paroxetine (20 mg/daily), sertraline (50 mg/daily), escitalopram (10 mg/daily) or duloxetine (60 mg/daily). The Visual Analogue Scale (VAS), Total Pain Rating Index (T-PRI), Hamilton Rating Scales for Depression (HAM-D) and Anxiety (HAM-A), and Clinical Global Impression Improvement (CGI-I) and Efficacy scales (CGI-E) were performed at baseline and after 2, 4, 6, and 12 months of treatment. Any adverse events (AEs) were tabulated for each group. Descriptive statistics, including the Kruskal-Wallis non-parametric test and the Friedman non-parametric test for median comparisons between different times, were used. RESULTS All the antidepressants (AD) were associated with a significant decrease in the VAS, T-PRI, HAM-A, HAM-D, CGI-I, and CGI-E scores in the long-term (p < .001). However, the response rate of the vortioxetine group showed a significant reduction after six months. The medians, after 6 months, were as follows: VAS 0.0; T-PRI 2.0; HAM-A 7.0; HAM-D 7.0; CGI-I 1.0; and CGI-E 1.0 with a lower incidence of AEs (p < .019). CONCLUSION Vortioxetine was efficacious with a shorter latency of action and fewer AEs compared with other ADs.
Collapse
Affiliation(s)
- Daniela Adamo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| | - Giuseppe Pecoraro
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| | - Noemi Coppola
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| | - Elena Calabria
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| | - Massimo Aria
- Department of Economics and Statistics, University Federico II of Naples, Naples, Italy
| | - Michele Mignogna
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| |
Collapse
|
33
|
Scardina GA, Casella S, Bilello G, Messina P. Photobiomodulation Therapy in the Management of Burning Mouth Syndrome: Morphological Variations in the Capillary Bed. Dent J (Basel) 2020; 8:dj8030099. [PMID: 32882863 PMCID: PMC7559391 DOI: 10.3390/dj8030099] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/10/2020] [Accepted: 08/26/2020] [Indexed: 01/25/2023] Open
Abstract
Burning mouth syndrome (BMS) is an idiopathic condition that manifests itself primarily with the onset of a burning sensation. The aim of this research was to perform photobiomodulation therapy (PBM) using a diode laser on the oral mucosa of BMS patients, followed by an objective evaluation of the morphological changes in the vascular bed underlying the mucosa using polarized light videocapillaroscopy. A group of 40 patients were included in the study. The patients were randomly divided into two groups (using simple randomization) as follows: 20 patients were assigned to the laser group and 20 patients were assigned to the placebo group. Each patient of the laser group received eight irradiations (with 4 Watt of power, wavelength 800 nm, energy 1200 Joules, irradiation time of 300 s, energy density 50 J/cm2, 60 mW continuous wave laser, and irradiance 180 mW/cm2), twice a week, blinded to the type of irradiation administered, for four consecutive weeks. The patients in the placebo group underwent the same sessions as the other patients, the only difference was the non-emission of the laser. An initial check of the vascular bed was performed with a polarized light videocapillaroscope. This was followed by treatment with a therapeutic diode laser and a subsequent check with a videocapillaroscope. We observed that in the group of patients who underwent laser therapy, there was a lasting improvement in symptoms. The capillary oral bed of patients in the placebo group did not show any statistically significant difference (p > 0.05). In the laser group we observed the following: in the buccal mucosa the diameter of the capillary had a reduction of 3 μm; in the upper lip mucosa, there was a reduction of 3 μm; in the lower lip mucosa, there was a reduction of 3 μm; and in the dorsal lingual surface, there was a reduction of 2 μm. An increase in capillary length was also obtained in all irradiated regions in the laser group patients (p < 0.05). PBM induces microcirculatory changes that are still present over a long period of time, such as an improvement in the clinical picture. The improvement in the symptoms has been correlated to the reduction of the capillary diameter. The placebo effect only led to a temporary improvement in symptoms that were unrelated to changes in the microcirculatory pattern.
Collapse
|
34
|
Abstract
Burning mouth syndrome is a chronic condition characterized by an intraoral burning sensation in the absence of a local or systemic cause.
Collapse
Affiliation(s)
- Brittany Klein
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, 1620 Tremont St, Suite 3-02B, Boston, MA 02120, USA
| | - Jaisri R Thoppay
- Center for Integrative Oral Health Inc., 7151, University Boulevard, Unit 110, Winter Park, FL 32792, USA
| | - Scott S De Rossi
- University of North Carolina-Chapel Hill, Adams School of Dentistry, Campus Box 7450, Chapel Hill, NC 27599-7450, USA
| | - Katharine Ciarrocca
- University of North Carolina-Chapel Hill, Adams School of Dentistry, Chapel Hill, NC 27599-7450, USA.
| |
Collapse
|
35
|
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.
Collapse
|
36
|
Abstract
Burning mouth syndrome/glossodynia and trigeminal neuropathic conditions can have serious negative impact on a patient's overall quality of life. These conditions are often hard to diagnose and even harder to fully treat and manage, but it is important for dentists/oral and maxillofacial surgeons to be aware of these conditions and modalities of their treatment. Often the only method for arriving at the proper diagnosis is for patients to undergo traditional approaches for treatment of presenting signs and symptoms, and it is the unexpected failure of interventional therapies that leads ultimately to a proper diagnosis.
Collapse
|
37
|
Lecor PA, Touré B, Moreau N, Braud A, Dieb W, Boucher Y. Could methylene blue be used to manage burning mouth syndrome? A pilot case series. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2020. [DOI: 10.1051/mbcb/2020032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Objective: Burning mouth syndrome is a disabling condition of complex pathophysiology characterized by spontaneous pain felt in the oral mucosa in the absence of evident mucosal lesions which lacks efficient treatments to this day. The purpose of this study was to demonstrate the efficacy of methylene blue in the management of burning mouth syndrome. Methods: The study was conducted at the dental clinic of the Anta Diop University and Newtown dental clinic of Dakar, Senegal. A solution of methylene blue as a mouth-rinse (0.5%) was applied for 5 minutes in five patients satisfying the ICHD-3 diagnostic criteria for burning mouth syndrome. This procedure was repeated every 6 hours 3 times per 24h, during 7 days. Using numeric rating scale, pain severity was assessed as the mean pain felt during the last day of application. Results: After 7 days, the pain was significantly reduced by two-thirds and almost absent at 3 and 6 months follow-up. No secondary effects of the use of methylene blue were observed. Putative mechanisms of action and potential implications for treatment are discussed. Conclusion: Methylene blue is an old compound but a novel topical therapy that could prove beneficial in the management of burning mouth syndrome.
Collapse
|
38
|
Cagna DR, Donovan TE, McKee JR, Eichmiller F, Metz JE, Albouy JP, Marzola R, Murphy KR, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2019; 122:198-269. [PMID: 31405523 DOI: 10.1016/j.prosdent.2019.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 12/13/2022]
Abstract
This comprehensive review of the 2018 dental literature is provided to inform busy dentists about progress in the profession. Developed by the Committee on Scientific Investigation of the American Academy of Restorative Dentistry, each author brings discipline-specific expertise to one of the 8 sections of the report including (1) prosthodontics; (2) periodontics, alveolar bone, and peri-implant tissues; (3) implant dentistry; (4) dental materials and therapeutics; (5) occlusion and temporomandibular disorders; (6) sleep-related breathing disorders; (7) oral medicine and oral and maxillofacial surgery; and (8) dental caries and cariology. The report targets important information that will likely influence day-to-day treatment decisions. Each review is not intended to stand alone but to update interested readers so that they may visit source materials if greater detail is desired. As the profession continues its march toward evidence-based clinical decision-making, an already voluminous library of potentially valuable dental literature continues to grow. It is the intention of this review and its authors to provide assistance in navigating the extensive dental literature published in 2018. It is our hope that readers find this work useful in the clinical management of patients moving forward.
Collapse
Affiliation(s)
- David R Cagna
- Professor, Associate Dean, and Residency Director, Department of Prosthodontics, University of Tennessee Health Sciences Center, College of Dentistry, Memphis, Tenn.
| | - Terence E Donovan
- Professor and Head of Biomaterials, Department of Restorative Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC
| | - James R McKee
- Private practice, Restorative Dentistry, Downers Grove, Ill
| | | | - James E Metz
- Private practice, Restorative Dentistry, Columbus, Ohio
| | - Jean-Pierre Albouy
- Assistant Professor, Department of Restorative Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC
| | | | - Kevin R Murphy
- Associate Clinical Professor, Department of Periodontics, University of Maryland College of Dentistry, Baltimore, MD; Private practice, Periodontics and Prosthodontics, Baltimore, MD
| | | |
Collapse
|
39
|
Abstract
A case-report of burning mouth syndrome is presented. A 27-year-old man complained of burning pain in the tongue and oral mucosa, taste disorder, and sensory impairment. All symptoms appeared after suffering a cold and had a wave-like course during self-medication with antibiotics. The pain has continued for 8 months. Diagnoses of atypical facial pain, glossodynia or secondary facial pain (craniomandibular dysfunction) were made. The effect of treatment in the hospital (carbamazepine, amitriptyline, haloperidol, phenozepam) was not achieved. A microbial test showed a higher number of pathogenic microbes. The final diagnosis was secondary facial pain (burning mouth syndrome) with concomitant lesions of the oral mucosa (Staphylococcus aureus, Candida sp.). The patient received a combined therapy with the pronounced positive effect.
Collapse
Affiliation(s)
- N M Fokina
- Evdokimov Moscow State Medical and Dentistry University, Moscow, Russia
| | | |
Collapse
|
40
|
Kishore J, Shaikh F, Mirza S, Raffat MA, Ikram S, Akram Z. Cytokine levels and their role in the etiopathogenesis of Burning Mouth Syndrome: A systematic review. Cephalalgia 2019; 39:1586-1594. [DOI: 10.1177/0333102419854052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Introduction Burning Mouth Syndrome is characterized by variable symptoms that include pain, burning and paraguesia in an otherwise healthy-appearing oral mucosa. Although the etiopathogenesis of Burning Mouth Syndrome is unknown, some studies provide evidence of subclinical inflammation leading to disrupted cytokine levels. Aim To investigate the expression of cytokines and role in the etiopathogenesis of Burning Mouth Syndrome. Methods Online databases (MEDLINE and EMBASE) were searched from November 1986 to November 2018 for case control/cross-sectional studies comparing the levels of cytokines in patients with Burning Mouth Syndrome and healthy controls. Results A total of eight studies were included in the current review. Four studies were of high and four studies were of moderate quality. Seven studies evaluated IL-6, out of which four showed comparable results, two showed higher levels and one study reported lower levels in Burning Mouth Syndrome patients compared to controls. Four studies assessed IL-2, out of which two reported comparable results whereas one study reported higher levels and one study reported lower levels in Burning Mouth Syndrome patients compared to controls. IL-10 levels were measured in three studies that reported no significant differences in the levels between Burning Mouth Syndrome and healthy controls. Discussion and conclusion The etiopathogenesis of Burning Mouth Syndrome is multifactorial. Studies have provided scientific evidence that inflammation plays a key role in Burning Mouth Syndrome pathogenesis. However, whether up-regulation or down-regulation of specific cytokines contribute to the etiopathogenesis of Burning Mouth Syndrome remains debatable. Further high-quality studies with larger sample size and assessing a wider array of cytokines are warranted in order to obtain strong conclusions.
Collapse
Affiliation(s)
- Jaimala Kishore
- Department of Oral Pathology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
| | - Fouzia Shaikh
- Department of General Pathology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
| | - Sana Mirza
- Department of Oral Pathology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
| | | | - Sana Ikram
- Department of Oral Biology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
| | - Zohaib Akram
- Department of Periodontology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
| |
Collapse
|
41
|
Spanemberg JC, Segura-Egea JJ, Rodríguez-de Rivera-Campillo E, Jané-Salas E, Salum FG, López-López J. Low-level laser therapy in patients with Burning Mouth Syndrome: A double-blind, randomized, controlled clinical trial. J Clin Exp Dent 2019; 11:e162-e169. [PMID: 30805121 PMCID: PMC6383904 DOI: 10.4317/jced.55517] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 01/14/2019] [Indexed: 02/04/2023] Open
Abstract
Background Evaluate the effect of LLLT in the treatment of burning mouth syndrome (BMS). Material and Methods Twenty-one BMS patients were randomly assigned to two groups: 12 in the laser group (LG) and 9 in the control group (CG). Patients in the LG underwent 2-week sessions of LLLT for 4 weeks. The spot tip area of this tool is 0.088cm2, semi-conductor GaAlAs, with a wavelength of 808nm ±5nm (infrared), 200 mW output power, 1.97W/cm2 of power density, 3 J energy per point and application time 15 seconds per point. LLLT was applied punctually, in continuous emissions, on each of the sites where there was a symptom. Symptoms were evaluated with a visual analogue scale (VAS) and patient psychological profiles were assessed using the Hospital Anxiety-Depression Scale. No side effects were recorded. Statistical analysis was carried out via ANOVA and logistic regression analysis. Results The initial VAS score mean was 8.9 for the LG and 8.3 for the CG (p >0.05). After the eighth session the VAS score was 5.5 and 5.8 respectively, and at two months it was 4.7 and 5.1 respectively. Improvement variables were established by dichotomizing the pain scales. We obtained levels of significance for the improvement variable for the LG at the two-month follow-up (p=0.0038) and for the univariate analysis of the treatment. The improvement was marginally significant in the multivariant analysis of: dry mouth, dysgeusia, pain and the treatment (p=0.0538). Conclusions LLLT may be an alternative treatment for the relief of oral burning in patients with BMS. Key words:Burning mouth syndrome, oral pain, laser dentistry, laser therapy, low intensity laser therapy.
Collapse
Affiliation(s)
- Juliana-Cassol Spanemberg
- PhD. Postdoctoral Research Fellow. Specialist in Stomatology and Public Health. Department of Odontoestomatology - Faculty of Medicine and Health Sciences (School of Dentistry)
| | - Juan-Jose Segura-Egea
- PhD, MD, DDS, Doctor Specialist in Stomatology. Department of Stomatology, School of Dentistry, University of Seville, Spain
| | | | - Enric Jané-Salas
- MD, DDS, PhD. Doctor, Specialist in Stomatology. Professor of Oral Pathology, School of Dentistry, University of Barcelona, Spain / Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Spain
| | - Fernanda-Gonçalves Salum
- PhD, Senior Lecturer, School of Dentistry, Oral Medicine Division, São Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Jose López-López
- Facultative Director and Clinical Head of the Surgical Medical Area of the Odontological Hospital University of Barcelona
| |
Collapse
|
42
|
Thoppay J, Desai B. Oral burning: local and systemic connection for a patient-centric approach. EPMA J 2019; 10:1-11. [PMID: 30984309 DOI: 10.1007/s13167-018-0157-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 12/20/2018] [Indexed: 12/24/2022]
Abstract
Burning symptoms in the oral cavity are caused by a range of systemic and local factors, in addition to the neuropathic pain disorder burning mouth syndrome (BMS). Patients may state oral burning as a standalone symptom or may report as a secondary symptom in association with other factors, most commonly with oral dryness, oral mucosal lesions, or certain systemic conditions. There is a level of uncertainty in the presentation of this condition which creates a diagnostic challenge from both the patient's perspective and the practitioner evaluating these individuals. The diagnoses are complicated due to the lack of a clear definition of BMS and clinical guidelines to distinguish BMS from other conditions that are responsible for oral burning symptoms. A clinician should be able to differentiate oral burning from burning mouth syndrome. This integrative review discusses on local and systemic etiologies of oral burning based on current evidence that needs to be excluded for a diagnosis of BMS. It also provides an algorithm for diagnostic workup and therapeutic management to medical providers for patients experiencing oral burning symptoms. This comprehensive system provides a systematic stepwise workup in diagnosing and managing patients presenting with a complaint of oral burning that optimally meets a predictive, preventive, and personalized medicine (PPPM) approach.
Collapse
Affiliation(s)
- Jaisri Thoppay
- 1Oral Medicine, Orofacial Pain and Geriatric Programs, Virginia Commonwealth University, Richmond, VA USA
| | - Bhavik Desai
- 2Oral Health and Diagnostic Sciences, Oral Medicine Section, Dental College of Georgia at Augusta University, Augusta, GA USA
| |
Collapse
|