Burning Mouth Research Articles

Oro-facial mucocutaneous manifestations of Coronavirus Disease-2019 (COVID-19): A systematic review.

We reviewed the prevalence, the likely aetiopathogenesis, and the management of oro-facial mucocutaneous manifestations of Coronavirus Disease-2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus -2 (SARS-CoV-2). English language manuscripts searched using standard databases yielded 26 articles that met the inclusion criteria. In total, 169 cases (75 females; 94 males) from 15 countries with a spectrum of COVID-19 severities were reviewed. Gustatory perturbations were prevalent in over 70%. Mucocutaneous manifestations were reported predominantly on the tongue, palate, buccal mucosa, gingivae, and lips and included ulcers, blisters, erosions, papillary hyperplasia, macules, glossitis, and mucositis. Ulcerative lesions, present in over 50 percent, were the most common oral manifestation. Lesions resembling candidal infections, with burning mouth, were prevalent in 19%. Petechiae and angina bullosa were generally seen, subsequent to COVID-19 therapies, in 11%. Ulcerated, necrotic gingivae were documented in severely ill with poor oral hygiene. These manifestations, present across the COVID-19 disease spectrum, were commonly associated with the immunosuppressed state and/ or the concurrent antimicrobial/steroidal therapies. In summary, a wide variety of orofacial mucocutaneous lesions manifest in COVID-19. They are likely to be secondary to the disease-associated immune impairment and/or pharmaco-therapy rather than a direct result of SARS-CoV-2 infection per se.

Botulinum toxin A in dentistry and orofacial surgery: an evidence-based review - part 1: therapeutic applications.

Objective An evidence-based review on the safety and efficacy of botulinum toxin type-A (BoNTA) in orofacial conditions, focusing on the therapeutic applications and role of BoNTA as an adjuvant treatment.Data source and selection Data was collected using PubMed (Medline), Cochrane Library of Systematic Reviews and Cochrane Central Register of Controlled Trials electronic databases. Having satisfied the search parameters, 32 studies for therapeutic applications and 26 for BoNTA as an adjunctive treatment were included. The quality of relevant studies was assessed using the Best Evidence Topics (BETs) Critical Appraisal Tool.Data extraction The highest level of evidence (LOE) behind BoNTA safety and efficacy was for wound healing and scar management in the orofacial surgery context, where BoNTA was presented as an adjunctive modality. Level-I evidence was controversial for temporomandibular disorders and bruxism. However, it showed promising results for painful temporomandibular disorders of myogenic origin refractory to conservative therapies, and to decrease muscle contraction intensity in sleeping bruxism. There was only one level-II study for persistent recurrent aphthous stomatitis. Data showed limited level-III evidence for orofacial pain conditions (temporomandibular joint recurrent dislocation and pain, burning mouth syndrome or atypical odontalgia), oral cancer complications, or as an adjuvant to maxillofacial and orthognathic surgeries. Benefits of BoNTA in prosthodontics had weak level-IV evidence. No evidence was found among the periodontology field.Conclusion There is growing evidence to support the safety and efficacy of BoNTA in the investigated orofacial pathological conditions, with high levels of satisfaction from the patient and clinician perspective. However, there are some inconsistencies and limited high-quality evidence available. Well-designed controlled clinical trials are necessary to evaluate long-term safety, efficacy and cost-effectiveness before BoNTA is widely adopted with irrefutable evidence-based clinical guidelines.

Gastroesophageal reflux disease and oral health: A narrative review

Gastroesophageal reflux disease (GERD) is a clinical condition in which stomach contents leak backward into the esophagus. It affects millions of people worldwide and has a detrimental effect on quality of life. Heartburn and acid regurgitation are typical GERD symptoms, while atypical manifestations include noncardiac chest pain, cough and laryngitis. The oral and maxillofacial manifestations of GERD may include dental erosion, xerostomia, mucositis, aphthous like ulcerations, sour taste, burning mouth, hyperesthesia, bruxism, and/or temporomandibular disorder (TMD). This narrative review provides oral health care professionals with an update to medical aspects of GERD, recognition and management of oral and maxillofacial manifestations of the condition and provision of appropriate dental care for this patient population.

Characteristics of Oral Mucosal Lesions and Their Association With Socioeconomic Status and Systemic Health: A Cross-Sectional Study of Consecutively Collected Oral Medicine Clinic Data in a Remote Rural Area of China.

ObjectivesEpidemiological data of oral mucosal lesions (OMLs) are required to develop practical oral care policies. However, limited data are available for rural areas in China. We aimed to estimate the spectrum and frequency of OMLs and to identify their associated socioeconomic status (SES) and systemic health in a remote rural area in Yunnan, China.MethodsWe screened patients for OMLs in an oral medicine clinic in rural Yunnan, China, from August 2020 to February 2021. OMLs were documented. SES, including the highest education level achieved and the previous month's household income, as well as the patient's systemic health, including a history of smoking, alcohol use, and chronic disease, were obtained from the Medical History/Health Questionnaire Form and patient medical records.ResultsA total of 146 patients were found to have OMLs. The most frequent OML was aphthous ulcer (n = 41, 28.1%), followed by burning mouth syndrome (BMS) (n = 16, 11.0%), viral ulcer (n = 14, 9.6%), and oral lichen planus (OLP) (n = 9, 6.2%). In these patients, the most common chronic diseases were sleep apnea (n = 35, 24.0%), hypertension (n = 23, 15.8%), bronchitis (n = 16, 11.0%), reflux (including gastroesophageal reflux disease) (n = 12, 8.2%), and arthritis (n = 11, 7.5%). On adjusted regression, the patients without chronic diseases had a lower risk of BMS than those with chronic diseases [odds ratio (OR), 0.2; 95% confidence interval (CI), 0.03–0.9]. Age was an independent protective factor for viral ulcers (OR, 1.0; 95% CI, 0.9–1.0). Patients with low-income levels had a lower risk of OLP than those with high-income levels (OR, 0.2; 95% CI, 0.05–0.9).ConclusionsOur oral medicine clinic data in remote Yunnan, China, showed the most frequent OML was aphthous ulcer, which was followed by BMS, viral ulcer, and OLP. Oral care policies should be prioritized among patients with aphthous ulcer. Preventive strategy of BMS should be targeted to people with chronic disease for health equalities. Therefore, an individualized strategy for interventions of OMLs might be optimal, based on the specific epidemiologic characteristics in rural settings.

A CASE STUDY OF GINGIVAL ACTINOMYCOSIS REPORTED TO KCD PESHAWAR

Background: Actinomycosis caused by saprophytic Actinomycess species123 is an infectious disease that frequentlycauses chronic granulomatous and suppurative lesions. Although the most common type of Actinomycosis is cervicalfascial, intraoral, and periodontal types rarely occur in a localized fashion4. Early and adequate differential diagnosisof Actinomycosis before therapeutic attempts and management steps are of great importance due to the opportunisticcharacteristic of actinomycotic infection.The present case report is about a patient with chronic periodontitis and a diffuse and atypical actinomycotic lesion,which was limited to the gingival region. The diagnosis was based on histopathological examination, the case’s history,and the lesion’s clinical nature.The patient responded to daily administration of Amoxicycllin 500mg TDS and Chlorhexidine mouthwash 0.2%rinse (following toothbrushing) performed with oral hygiene reinforcement and periodontal debridement monthly. Completeimprovement of the lesion was observed after 5 months.Study Design: A Case Reprot StudyDuration And Place Of Study: department at Khyber College of Dentistry Peshawar in March 2014 with achief complaint of burning mouth, pain in eating, ulceration, and bleeding.Keywords: Gingival actinomycosis, Actinomyces species, sulfur granules, antibiotic therapy, oral hygiene, periodontitis,KCD Peshawar

The risk factors associated with geographic tongue in a southwestern Chinese population

The goal of this study was to look into age, genetics,sex, oral mucosa diseases, and systemic diseases as potential risk factors for the geographic tongue (GT) in a Chinese population. This retrospective cross-sectional study used the demographic and medical data of 3400 patients between March 2021 and August 2021 from the Department of Oral Medicine at West China Hospital of Stomatology. Binary logistic regression was conducted to analyze the association of GT and age, fissured tongue (FT), burning mouth syndrome (BMS), oral lichen planus (OLP), gastrointestinal disorders, and hematologic disorders and to acquire the adjusted odds ratio (AOR). GT occurred in 3.6% of patients, with 15 out of 123 (12.2%) patients with GT having a family history. Binary logistic regression found age <30 years (AOR: 4.4; [95% CI: 2.8-6.9]), FT (28.8 [17.1-48.4]), BMS (0.3 [0.1-0.6]), OLP (0.2 [0.0-0.5]), and gastrointestinal disorders (4.3 [2.7-6.7]) were significantly associated with GT, and GT was unrelated to recurrent aphthous ulcer (RAU) or systemic diseases such as cardiovascular diseases. In the Chinese population, GT was more prevalent in patients with <30 years of age, FT, and gastrointestinal disorders, and it was less prevalent in BMS and OLP.

ОСОБЕННОСТИ КЛИНИЧЕСКИХ ПРОЯВЛЕНИЙ ОСНОВНЫХ СТОМАТОЛОГИЧЕСКИХ ЗАБОЛЕВАНИЙ У ПАЦИЕНТОВ С САХАРНЫМ ДИАБЕТОМ 2 ТИПА (ОБЗОР ЛИТЕРАТУРЫ)

Subject. The article is a literary review devoted to the peculiarities of clinical manifestations of major dental diseases in patients with impaired carbohydrate metabolism, type 2 diabetes mellitus.&#x0D; Methodology. The data of Russian and foreign literature were studied using scientific search library databases: PubMed, Elibrary, Cochrane. Literature analysis was carried out on 59 sources over the past 5 years (42 domestic authors and 17 foreign ones). The analysis of the literature data allows us to consider type 2 diabetes mellitus as highly common somatic diseases leading to the development of various symptoms, syndromes and diseases of the hard tissues of the teeth, periodontal and oral mucosa.&#x0D; Results. Among the wide range of possible complications and symptoms are - impaired taste sensitivity, the presence of xerostomia, burning mouth syndrome, glossalgia, lichen planus, leukoplakia, candidiasis, chronic inflammatory diseases of periodontal tissues, complicated and uncomplicated caries of hard dental tissues. Diagnostic and therapeutic and preventive measures in this case should be aimed at their early diagnosis and prevention.&#x0D; Conclusions. Against the background of manifestations of DM2, there is a significant prevalence of major dental diseases, which most often depends not only on the duration of the course and severity of DM2, but also on the state of carbohydrate metabolism compensation, age and gender. Undoubtedly, the principle of continuity of interested specialties, including dentists, endocrinologists, gastroenterologists and other specialists, has great prospects both in the diagnosis and prevention of pathology of the oral mucosa.

Relationship between subjective taste sensations and taste strip test in patients with taste disorders with and without burning mouth syndrome

Background/purposeBoth subjective and objective evaluations are required to assess taste function. Evaluation of taste function has important clinical significances in patients with burning mouth syndrome (BMS) due to pain-taste interactions. The purpose of this study was to investigate the relationship between subjective and objective taste evaluations in patients with taste disorders based on the presence of BMS. Materials and methodsFifty–one patients with taste disturbances were included. The patients completed questionnaires on subjective taste sensations. The taste strip test was performed to examine objective taste function. The patients were divided into two groups: subjects with BMS (n = 24, 3 males and 21 females) and without BMS (n = 27, 8 males and 19 females). ResultsSignificant differences were not observed in age, age distribution, and gender distribution between the groups. There were no significant differences in self-reported taste abilities based on the presence of BMS. However, the taste strip test showed higher correct answer rates for bitterness (P = 0.027) in the patients with BMS. In addition, a significant difference (P = 0.034) was observed in the distribution of objective types of taste disorders between the groups. A significant correlation between the subjective and objective evaluation results was observed only in patients with BMS. ConclusionIn patients with taste disorders, patients with BMS had significant correlations between subjective and objective evaluations and different distributions in the types of taste disorders compared with those without BMS. The presence or absence of BMS should be evaluated in the diagnosis and management of taste disorders.

Evaluation and comparison of oral &amp; periodontal health status in post-menopausal females with and without xerostomia

Background &amp; Objective - Menopause is the permanent cessation of menstrual periods, whether occurs naturally or induced by surgery, chemotherapy, or radiation. It is accompanied by hormonal changes, predominantly decrease in estrogen and androgen levels. Females experience varying oral symptoms that may result from endocrine disturbances, multiple vitamin and mineral deficiencies and psychological dynamics during their menopausal years. Main oral symptoms associated during menopause include xerostomia, burning mouth and altered taste perception. Xerostomia leads to change in salivary pH thereby increasing the risk for oral diseases including periodontal diseases. Saliva contributes to maintenance of the oral pH by neutralizing acids from food and beverages, as well as from bacterial activity, thereby reducing the risk of periodontal disease. After menopause, reduced salivary flow rate and low pH may make females prone to oral health problems. Hence, the main goal of this study is toevaluate and compare the periodontal health status in post-menopausal females with and without xerostomia. Methodology-A total of 204 post-menopausal have been observed and their oral &amp; periodontal status data was analyzed &amp; interpreted.Result &amp; Conclusion- Post-menopausal females with xerostomia were observed to have poor oral hygiene and severe periodontitis in comparison to non- xerostomia group.

BURNING MOUTH DISEASE, MODERN TREATMENT AND CLINICAL MANAGEMENT: A NARRATIVE REVIEW

PURPOSE: The purpose of this review was to investigate the current and modern therapy approach of BMD (burning mouth disease) also referred as BMS (burning mouth syndrome), in order to have a better comprehension for the best and most successful way of treatment and management for this pathology. A literature research was carried outMATERIALS &amp; METHODS: mainly using online sources, Pubmed database, and paper sources (specialized books). articles published over the last years have been rstly examined. Systematic reviews, narrative reviews, mini reviews and meta-analysis were primarily selected. If a subject matter appeared to have few or no such sources, articles based on case reports were also considered. Finally, 20 sources have been considered eligible for theRESULTS: purpose of the review, 19 scientic articles and 1 specialized book were selected. Clonazepam, capsaicin and Vortioxetine areCONCLUSIONS: currently the most widely used and known drugs even if further studies are needed especially in the case of Vortioxetine and selective serotonin reuptake inhibitors.

Assessment between Aloe Vera Gel and Intralesional Hydrocortisone in the Management of Stage II Oral Submucous Fibrosis

Objective: To assess the effect of aloe vera gel and intralesional hydrocortisone in the management of stage II oral submucous fibrosis patients in terms of mouth opening and burning sensation. Subject and Methods: A total of 38 patients were equally divided into two groups; i.e Group A was treated with herbal antioxidant aloe vera gel, while Group B was treated with traditional intralesional hydrocortisone. Patients of stage II OSMF were diagnosed clinically on the basis of presenting symptoms. Mouth opening and burning sensations were recorded at start of treatment and postoperatively for 3 months period. All findings were recorded on proforma. Results: In both groups males were in majority as compared to females. Total of 13 males and 6 females, 14 males and 5 females were reported in Group A and B respectively (P Value 0.5190. Mean age of patients in group A was 25.19 ± 6.33, while in group B it was 28.93 ± 5.82. Significant improvement in mouth opening and burning sensation was found equally in both groups. Conclusion: Aloe vera gel applied topically and intralesional hydrocortisone are equally effective in reducing the symptoms of stage II OSMF patients. Keywords: Oral Submucous Fibrosis, Aloe Vera, Intralesional Hydrocortisone, Mouth Opening, Burning Sensation

Response to Treatment with Melatonin and Clonazepam versus Placebo in Patients with Burning Mouth Syndrome.

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.

Insight into the Role of Psychological Factors in Oral Mucosa Diseases.

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.

A systematic review of the efficacy and safety of topical cyclosporine in dermatology.

Cyclosporine-A (Cyc-A) was initially prescribed as systemic therapy for patients receiving solid organ transplants or in patients with graft versus host disease (GVHD). Topical Cyc-A is an ideal form of cyclosporine in the treatment of mucocutaneous disorders as it causes fewer systemic side effects and has more stable results than steroids; however, poor absorption through the skin makes the development of new formulations necessary to improve skin permeability. The aim of this study was to evaluate the efficacy and safety of topical Cyc-A in different dermatological conditions. A thorough systematic review was performed on PubMed/Medline, Embase, Scopus, and Web of Science databases as well as Google Scholar, and relevant studies from 2000 until January 3, 2022, were selected. The study was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA). Topical Cyc-A was observed to be an effective medication in the treatment of oral lichen planus, psoriasis, burning mouth syndrome, Pyoderma Gangrenosum, and Zoon's balanitis. Adverse side effects such as dysphagia, burning sensation, lips swelling, and gastrointestinal upset were reported following Cyc-A mouthwash use, whereas mild erythema, dryness, and fissuring of the skin were observed following the Cyc-A lipogel application. Topical Cyc-A was found to be a good alternative to traditional treatment regimens for immune-mediated mucocutaneous conditions. Cyc-A can be considered as a safe and efficient option in cases of long-term treatment as it does not have the same adverse effects of long-term steroids.

MUCIN 1 (MUC1) LEVELS AND GLYCOSYLATION PATTERNS IN SALIVA OF PATIENTS WITH BURNING MOUTH SYNDROME (BMS): A CASE-CONTROL STUDY

<h3>Objectives</h3> Mechanisms underlying burning mouth syndrome (BMS) remain unclear. Evidence of changes in oral mucosal epithelial cells has been found in patients with BMS. This case-control study aimed to investigate whether BMS cases have evidence of impaired mucosal barrier function compared with controls without BMS, focusing on the role of salivary mucins as a first line of defense for oral epithelial cells. <h3>Study Design</h3> A total of 50 women (22 BMS cases and 28 healthy controls) age 50 years or older were included in this study. Participants attended a clinical visit including assessment of BMS symptoms, salivary sample collection, oral examination, swab for candida detection, and DNA collection using the DNA•SAL device. Total protein concentration was measured using the bicinchoninic acid assay. MUC1 protein concentration in saliva samples was quantified by sandwich enzyme-linked immunosorbent assay (Invitrogen). Salivary glycosylation was assessed by protein-normalized dot blot against 3 lectins (Maackia Amurensis Lectin II; WGA: wheat germ agglutinin; UEA: ulex europeus agglutinin (MAL-II), WGA, and UEA). H antigen, the precursor of ABO antigens, secretor status was predicted by performing Sanger DNA sequencing of the FUT2 gene. <h3>Results</h3> The average salivary protein concentration was 1.30 mg/mL in BMS cases vs 0.94 mg/mL in controls (<i>P</i> = .15). Mann-Whitney <i>U</i> test showed a trend toward lower levels of MUC1 in BMS cases (n = 20, sum of ranks = 392.50) compared with controls (n = 24, sum of ranks = 597.50; <i>P</i> = .17). UEA, MALII, and WGA reactivities were each quantitatively lower in cases compared with controls but varied widely (<i>P</i> = NS). The percentage of nonsecretors was 23% among cases vs 38% among controls (<i>P</i> = .28). Genotype-predicted secretors had significantly higher UEA reactivity compared with nonsecretors (<i>P</i> < .001). <h3>Conclusions</h3> Our study overall found trends consistent with higher salivary protein concentration, lower salivary MUC1 levels, and salivary hypoglycosylation in BMS cases compared with controls, although no findings were statistically significant. Study limitations include subject heterogeneity and sample size. As expected, UEA levels were significantly higher in secretors compared with nonsecretors. Other aspects of the oral epithelial barrier, including the quantity of other mucins and glycosylation, remain to be examined.

Retrospective Series of Burning Mouth Syndrome Patients Treated with a Protective Mouthguard: An Effective Non-Pharmacologic Treatment Modality

<h3>Background</h3> Burning mouth syndrome (BMS) is a relatively common condition defined as a relentless, idiopathic burning sensation of the oral mucosa after exclusion of other underlying causes of burning. Currently effective treatment is limited mostly to pharmacologic interventions. The use of non-pharmacologic therapy, specifically the use of protective mouthguards has not been well studied. This study evaluates effectiveness of mouthguards in patients treated for BMS at University of Florida College of Dentistry (UFCD). <h3>Material and Methods</h3> Following IRB approval, the clinical database was retrospectively searched for patients diagnosed with BMS and treated with mouthguard between 2014-2019. Inclusion criteria included a minimum of 6-month follow-up and patients were excluded if treatment records were incomplete. Demographics, clinical data, medical history, and other treatment modalities were recorded and analyzed. <h3>Results</h3> A total of 16 cases were included and a mean age of 67 years (range of 50-82) and a female: male ratio of 4.3:1 was identified. The average duration of burning symptoms prior to the first visit was 43 months. The location of symptoms involved tongue only (n=11, 69%); tongue, palate, and lips (n=2, 12.5%); tongue and palate (n=2, 12.5%); and tongue and lips (n=1, 6%). The most common concurrent medical conditions were hypothyroidism (n=7, 43.7%), hypertension (n=6, 37.5%), and diabetes (n=3, 18.7%). Study patients took a median of 6.5 concurrent medications. Six patients (37.5%) had symptomatic relief with mouthguard ther- apy in conjunction to concurrent standard BMS pharmacologic therapy, 37.5% of patients (n=6) had symptomatic relief with the mouthguard alone, and 25% of patients (n=4) reported no relief from the mouthguard. <h3>Conclusion</h3> In this study a total of 75% of BMS patients reported improvement of subjective symptoms with the use of a pro- tective mouthguard, demonstrating the potential effectiveness of mouthguard as a non-pharmacologic therapeutic modality for BMS patients.

Food Intake, Oral Hygiene Practices, Self-reported Oral Problems, and Knowledge of Oral Diseases among Pregnant and Non-pregnant Women Attending Community Health Center, Child Care Center, and Tertiary Care Hospital in Urban Ajmer

Aim: The aim of this study was to determine food intake, the level of knowledge of oral diseases, practices regarding oral hygiene, and self-reported oral problems among pregnant and non-pregnant women attending community health center, child care center, and tertiary care hospital in urban Ajmer. Materials and Methods: This was a quantitative, questionnaire-based, and cross-sectional study, in which 300 respondents of 20–35 years of age. Data were analyzed using the Statistical Package for the Social Sciences. Results: Participants in the knowledge of oral diseases were 26% gingivitis signs including gum swelling (5.7%) and bleeding (9.7%). Of all the participants, 21.3% practiced tooth brushing twice/day, 65.7% used toothpowder, and dental floss (17.7). Self-reported oral problems included reddish gums (8%), painful gums (10.7%), burning mouth (15.7%), dry mouth (28%), and bad breath (7%). Conclusion: Majority of women studied no basic knowledge of oral diseases and only few knew the causes. All respondents performed tooth cleaning however, majority did not know the appropriate practices, and only few had oral problems. Integration of oral health care to general health promotion and oral therapy given to pregnant women at high risk is recommended to prevent adverse pregnancy outcomes.

Topical Herbal Therapeutic Formulation used in the Management of Oral Potentially Malignant Disorders – A Systematic Review

Background: Oral potentially malignant disorders (OPMDs) are divided into two groups precancerous lesions, a benign lesion with morphologically altered tissue, which has a greater than normal risk of transforming into malignancy, and precancerous conditions, a disease or patient's habit that does not necessarily alter the appearance of local tissues but is associated with a greater or normal risk of precancerous lesion or cancer development in that tissue. Aim: This systematic review aims to evaluate the effectiveness of topical herbal therapeutics in the management of potentially malignant oral disorders. Objective: Primary objective was to evaluate the efficiency of tulsi, aloe vera, and turmeric in the management of OPMDs, and the secondary objective was to determine the herbal therapeutic response in patients with oral leukoplakia oral sub, mucous fibrosis, and lichen planus. Data Sources and Search Methods: The search was done using the MeSH [medical subject headings] terms and keyword search in the electronic databases, namely Pub Med and Google Scholar. The studies included in this systematic review were identified by a comprehensive search from the electronic search engines like Pub Med Advanced search (from April up to January 2021) and Google scholar. The search yielded 39 articles out of which 11 articles were only included based on the inclusion criteria. Data Collection and Analysis: All the studies included were based on the data extraction and analysis of the studies for quality. The outcome measure evaluated the reduction in burning sensation, mouth opening, and clinical resolution of the lesion. Results: A total of 39 articles were included in this systematic review from electronic searches using Pub Med advanced search and Google scholar. Conclusion: For management of oral submucous fibrosis topical aloe vera gel showed 90% of complete clinical response, oral lichen planus topical tulsi and turmeric gel showed 90% complete clinical response, and only two studies were conducted on oral leukoplakia which had a high risk of bias; hence, this systematic review does not yield to a piece of conclusive evidence for the management of oral leukoplakia using topical herbal therapeutics.

Heart Rate Variability Analysis According to Clinical Characteristics in Patients with Burning Mouth Syndrome

Objectives: This study aimed to identify the characteristics of the heart rate variability (HRV) index in patients with burning mouth syndrome (BMS) and to evaluate the predictive value of HRV for Korean medical treatment responsiveness to tongue pain in BMS.Methods: Among BMS patients who visited the Oral Diseases Clinic of Kyung Hee University Korean Medicine Hospital from January 1, 2018, to May 31, 2021, we reviewed the clinical records of 217 women aged 50 years and over. HRV and unstimulated saliva flow rate (USFR) measurements were carried out, and all patients were asked to indicate their degree of tongue pain using the visual analog scale (VAS). The subjects were classified into subgroups according to the presence or absence of hyposalivation and VAS improvement, and each subgroup was compared using the HRV index. Logistic regression analysis was conducted to confirm whether cause–effect relationships were present between statistically significant values.Results: BMS patients had lower LF and HF than healthy people. Subgroup analysis demonstrated that there were some statistically significant differences in the HRV index according to salivation rate and degree of pain. In addition, as the LF/HF ratio increased, the pain improvement rate decreased after treatment.Conclusion: The autonomic nerve activity of BMS patients was lower than that of healthy people; however, autonomic balance was not impaired. In addition, tongue pain in BMS patients responded more favorably to Korean medical treatment when patients fell within a normal range of the LF/HF ratio, suggesting that autonomic imbalance could be used as one of the predictable factors in clinical practice.

Comparative analysis of the oral microbiome of burning mouth syndrome patients

ABSTRACT Burning mouth syndrome(BMS) is a chronic pain condition accompanied by unpleasant burning sensationsof the oral mucosa. While multiple factors were proposed for the etiology, evidencesuggested a neuropathic pain origin while others suspected the use ofantibiotics as the underlying cause. Interestingly, several reports demonstratedthe intimate interaction of the nervous system and the microbiome. The currentstudy aims to elucidate the correlation of the oral microbiome with the pathophysiologyof the primary BMS. Microbiome samples obtained from the unstimulated wholesaliva of 19 primary BMS patients and 22 healthy controls were sequenced and analyzedof the V3-V4 region of 16S rRNA gene. There was a distinct difference in themicrobial composition between the BMS and the control groups at all taxonomic levels.Alpha diversity indexes of the oral microbiome were significantly lower in theBMS group. The samples were readily distinguished by multidimensional scalinganalysis and linear discriminant analysis effect size. Streptococcus, Rothia, Bergeyella, and Granulicatellagenus were dominant in the BMS group, while Prevotella, Haemophilus,Fusobacterium, Campylobacter,and Allorevotella genus were moreabundant in the healthy group. Distinct microbiome signatures of BMS patientssuggested a diagnostic value and a potential role in the pathogenesis of BMS.