Abstract
Introduction : Idiopathic burning mouth syndrome (iBMS) is a chronic oral pain syndrome mainly characterized by a burning sensation in the oral mucosa and an etiopathogenesis that remains unclear, with therapeutic options that are disappointing. Any clinical observation providing insight into the disorder can therefore be of interest. Among metabolic factors, deficiencies of vitamins have been pointed out, but only a few studies have focused on the role of vitamin B6 (vitB6) in this syndrome. In this report, we aimed to highlight the involvement of increased but not decreased vitB6 serum levels in a subgroup of BMS Patients. Patients and Methods : Medical files of patients who attended the chronic orofacial pain consultation, in the dental departement of the Groupe Hospitalier Pitie-Salpetriere (GHPS) in Paris (France) between 09/03/2008 and 12/19/2015 were retrieved from the hospital database and analyzed. This retrospective study was approved by the board of the dental department and authorization for use of patient data was obtained from the National Personal Data Protection Committee (Commission Nationale de l’Informatique et des Libertes (CNIL)) (#1913570). Results : Seven per- or postmenopausal female patients out of 42 diagnosed with iBMS (17%) displayed an increase in their serum levels of vitB6, one to six times the upper normal limits. There was a statistically significant correlation between pain and vitB6 levels. Moreover, in two patients, the reversal of vitB6 levels to normal values resulted in significant decreases in pain severity. Conclusion : These clinical observations report for the first time a potential implication of elevated vitB6 serum levels in the burning sensation which might be specific to a subgroup of iBMS patients.
Highlights
Idiopathic burning mouth syndrome, called primary BMS or idiopathic stomatodynia, is mainly characterized by a spontaneous continuous burning pain felt in the tongue or in the oral mucosa in the absence of clinically apparent mucosal alterations, often accompanied by taste dysfunction and xerostomia [1]
It is opposed to secondary BMS for which a local or systemic cause can be identified [2] with clinical examination and routine tests, including cell count, candida identification, dosage of thyroid-stimulating hormone (TSH), iron, vitamins, etc. [2, 3]
Among the 42 patients diagnosed with Idiopathic burning mouth syndrome (iBMS), seven (16.6%) had elevated vitamin B6 (vitB6) levels
Summary
Idiopathic burning mouth syndrome (iBMS), called primary BMS or idiopathic stomatodynia, is mainly characterized by a spontaneous continuous burning pain felt in the tongue or in the oral mucosa in the absence of clinically apparent mucosal alterations, often accompanied by taste dysfunction and xerostomia [1]. The disorder seems multifactorial and the mechanisms so far remain unclear, insights into the pathophysiology have recently been achieved. Psychophysical, pharmacological, electrophysiological, and imaging data suggest neuropathic mechanisms, including both peripheral and central changes and autonomic system alterations. The main clinical characteristics [1, 2], pathophysiological mechanisms [4,5,6,7] and therapeutic options [8] of BMS have been reviewed [7]
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