Burning Mouth Syndrome Research Articles

Oral Findings, Salivary Copper, Magnesium, and Leptin in Type II Diabetic Patients in Relation to Oral Candida Species.

Type 2 diabetes is a condition in which the body becomes resistant to the effects of insulin, leading to reduced insulin production in the pancreas. It has genetic- and family-related risk factors that cannot be changed, along with modifiable lifestyle factors. The precise genetic causes of type 2 diabetes are still unknown. However, individuals can potentially slow or stop the progression of the condition by making dietary adjustments and increasing physical activity levels. Material and Methods. Forty-five type II diabetic patients in the study included participants between 40 and 60 years old, with a minimum duration of one year, as well as 45 healthy control subjects who were matched in terms of age and sex, and had no underlying systemic diseases. Oral examination is done for the symptoms including burning sensation, candidiasis, and a reduction in the production of saliva. The rate of saliva flow (in milliliters per minute) was measured in samples of saliva that were not stimulated. The salivary trace elements and levels of adipocytokines were evaluated using colorimetric and Ethylenediaminetetraacetic acid (ELISA) testing. The quantification of Candida colony numbers, an enrichment and culture approach, was used to achieve a concentration of 100,000 colony-forming units per milliliter (CFU/ml). The ShowNovo WG1 halimeter was used to measure volatile sulfur compounds in breath. The salivary glucose oxidase assay was conducted using a colorimetric technique, while the determination of trace elements was also performed using a colorimetric assay method. The diabetic group exhibited a significant increase in the number of Candida spp colonies due to elevated levels of glucose in the saliva (p > 0.05). However, the variables being examined, such as body mass index (BMI), burning mouth syndrome (BMS), salivary flow rate (SFR), salivary leptin, salivary copper, and salivary magnesium, did not exhibit any significant variations in quantities between the diabetic and healthy groups (p > 0.05). The data collected in this research aid in the creation of a preventative program for oral fungal infections in individuals with type 2 diabetes. The program utilizes saliva and its constituents.

Alteration of Dopamine Receptors as a Possible Etiology in Burning Mouth Syndrome

Burning mouth syndrome continues to be a diagnostic and therapeutic challenge today. New horizons in etiology and management have opened the door for a new therapeutic option that we will mention in this article.

Prevalence of orofacial and head pain: an umbrella review of systematic reviews

Head pain (HP) and orofacial pain (OFP) are the most prevalent types of pain worldwide, encompassing cranial, oral and facial pain. The aim of this umbrella review was to answer the following questions: “What is the overall prevalence of HP/OFP and the different prevalences of HP/OFP conditions in adults and children?”. We searched for studies investigating the prevalence of HP/OFP in four major databases and two databases from the grey literature, based on the following PECOS inclusion criteria:(P)opulation: Adults and children; (E)xposure: Orofacial or head pain conditions such as (1) dental, periodontal and gingival, (2) temporomandibular disorders (TMD), (3) neuropathic conditions, (4) headaches, and (5) idiopathic pain conditions; (C)omparison: None; (O)utcome: Prevalence; (S)tudies: Systematic reviews and/or meta-analyses. We identified 2275 studies and after selection through eligibility criteria, 24 systematic reviews were included. The prevalence of pain in adults for different subgroups ranged from 1.12% for Burning Mouth Syndrome to 80.80% for cancer therapy-related orofacial pain. In children, it ranged from 0.20% for temporomandibular joint osteoarthrosis to 83% for all types of headache. This umbrella review based on available evidence provides integrated data illustrating the highly variable prevalence of head pain and orofacial pain both in adults and children. Considering the high specificity of head pain/orofacial pain, specific public health programs should be developed to address such highly prevalent conditions.

Method and Indication of Tongue Acupuncture Treatment: A Narrative Review

Tongue acupuncture is not only a body acupuncture treatment for the tongue but also a new microacupuncture treatment. Tongue acupuncture is a very promising treatment from a diagnostic and therapeutic point of view. According to several studies, Guan’s tongue acupuncture and tri-tongue acupuncture are frequently used. Tongue acupuncture can be used for dysphagia, dysarthria, aphasia, insomnia, autism spectrum disorder, burning mouth syndrome, and cerebral palsy.

Potential Biomarkers for an Evidence-Based Diagnosis of Burning Mouth Syndrome

Potential Biomarkers for an Evidence-Based Diagnosis of Burning Mouth Syndrome

Effectiveness of herbal medicine as an alternative therapy for burning mouth syndrome: a systematic review

Background: Burning mouth syndrome (BMS) is characterized by a burning sensation or dysesthesia of the oral mucosa without accompanying abnormal clinical or laboratory findings. Management of BMS is very important to reduce pain, support nutrition and improve patients’ quality of life. Various studies on BMS therapy have been carried out, one of which is by using alternative materials derived from nature known as herbal ingredients. The objective of this systematic review is to review the effectiveness of herbal medicine to reduce pain in BMS patients. Methods: This systematic review was conducted using the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines. Article searches were conducted through Pubmed, Scopus, Science Direct, Cochrane, and Springer Link published from 2012 to 2022 with specific keywords. The search for articles was limited to human studies and randomized controlled trial (RCT), papers written in English and availability of full text. The risk assessment of bias uses the Modified Jadad Scale. Results: Seven articles with good eligibility that meet the inclusion criteria were analyzed. The herbal medicine reviewed were capsaicin (two articles), Aloe vera, catuama, capsaicin, virgin olive oil, chamomile and crocin (one article for each herbal medicine). All of the herbal medicine reviewed were proven to reduce pain in BMS patients, but capsaicin and catuama showed significant differences with the comparison group. Minimal side effects were also observed with capsaicin and catuama. Conclusion: Herbal medicinal ingredients have been proven to be effective, useful and safe alternative therapies for BMS patients.

Clinical Features and Variations of Pain Expressions in 834 Burning Mouth Syndrome Patients With or Without Psychiatric Comorbidities.

Introduction Burning mouth syndrome (BMS) is characterized as chronic burning pain or unpleasant discomfort in the oral region without any corresponding clinical abnormalities. The aim of this study is to investigate the difference in clinical features and the variations of pain expressions between BMS patients with and without psychiatric comorbidities. Methodology The patients with BMS who first visited between April 2016 and March 2020 were involved and the clinical data including the presence of psychiatric comorbidities and scores of self-rating depression scale (SDS), pain catastrophizing scale (PCS), and pain quality from short-form McGill pain questionnaire (SF-MPQ) were collected retrospectively. Results In 834 patients with BMS (700 females, 63.9 ± 13.1 years old), 371 patients (44.5%) had psychiatric comorbidities. There was no significant between-group difference in demographic data. However, significantly higher scores were observed in SDS (p < 0.001) and PCS (p < 0.001) in the patients with psychiatric comorbidities. Moreover, the patients with psychiatric comorbidities showed significantly stronger pain intensity (p < 0.001) besides higher scores of each descriptor in SF-MPQ. In addition, they had chosen more descriptors in SF-MPQ (p < 0.001); furthermore, the number of selected pain descriptors showed a stronger correlation with PCS than with SDS regardless of the presence of psychiatric comorbidities. Conclusion BMS patients may complain of various pain expressions regardless of the psychiatric comorbidities; however, more severe complaints relating to high pain catastrophizing are more likely in patients with psychiatric comorbidities. These results suggested that underlying anxiety exacerbated the variety of pain expressions in BMS patients with psychiatric comorbidities.

Oral Findings and Gustatory Function of Postmenopausal Indonesian Women with Low Levels of Reproductive Hormones

Menopause is always associated with various problems in the mouth. This study aims to determine oral findings and taste function in postmenopausal women in Indonesia. Descriptive cross-sectional sample of 18 postmenopausal women aged between 53 and 89 years living in nursing homes. Data were collected through demographic questionnaires, oral examination, measuring total saliva volume, assessing saliva pH, checking estradiol and progesterone levels in the blood. Taste tests were carried out the next day with liquids of three different concentrations of four different taste qualities including sweet, salty, sour and bitter. Research results: average age of participants was 75.4+8.6 years, and average DMFT 16.06+2.59. Significant reductions were seen in pH and saliva flow rate, while the most common oral complaints were xerostomia (22%) and pain in the temporomandibular joint (11.1%). Mean estradiol levels were 1.5 + 4.4 pg/mL and progesterone 0.05 + 0.06 ng/mL. Burning Mouth Syndrome and Oral Candidiasis were not found. The majority reported a higher level of taste sensitivity, especially to solutions with the highest concentration, namely bitter taste. This research shows that subjects experienced changes in oral health due to hormonal changes, side effects of medication, and the aging process. Decreased taste function, especially sensitivity to salty, sweet and sour tastes.

Assessment of Clinical Characteristics and Pharmacotherapy in Burning Mouth Syndrome Patients

Assessment of Clinical Characteristics and Pharmacotherapy in Burning Mouth Syndrome Patients

Topical gabapentin solution for the management of burning mouth syndrome: A retrospective study

Objective The aim of this retrospective study was to evaluate the effectiveness and safety of topical gabapentin solution (250 mg/mL) for the management of burning mouth syndrome (BMS). Study design A retrospective chart review was conducted of all patients diagnosed with BMS and managed with gabapentin 250 mg/mL solution (swish and spit) between January 2021 and October 2022. Patient-reported outcomes included changes in burning score ranked on a 10-point numeric rating scale (NRS) and reported adverse drug reactions (ADR). Wilcoxon signed-rank test was used to assess differences in the oral burning score ranked on a NRS (0–10) between the baseline visit and the second visit. Results A total of 19 patients (68.4% females) with BMS were included and evaluated for follow-up at a median of 86 days (range: 29–195). Overall, patients reported a median 2-point burning decrease on a 0–10 NRS between the baseline visit and the second visit (p &lt; 0.01). ADRs were reported by 3 patients (15.8%). Conclusion Although this was a small retrospective study, BMS management with topical gabapentin (250 mg/mL) appears to be effective and well-tolerated. Future randomized prospective studies are needed to verify these preliminary findings.

Occlusal tactile acuity in patients with burning mouth syndrome: A case-control study

ObjectivesOcclusal Tactile Acuity (OTA) is the ability to detect small thicknesses between occluding teeth. Individuals diagnosed with Burning Mouth Syndrome (BMS) often refer an uncomfortable sensation associated with their occlusion. The aim of the current study was to measure the OTA in BMS patients, and to compare it with that of age and gender matched pain free controls. Materials and methods25 BMS patients and 25 controls were enrolled. The OTA was tested with 10 different thicknesses: 9 aluminium foils (8 –72 µm with a constant increment of 8 µm) and 1 sham test (without foil), each thickness being tested 10 times in random order (100 tests in total). ResultsSignificantly increased OTA was observed in the BMS group, compared to the controls group, for the foil thicknesses between 8 µm and 48 µm. Furthermore, BMS patients showed substantial impairment in the detection of the sham test, even if this finding did not reach statistically significance (P = 0.743). ConclusionsBMS patients presented increased ability to detect small thicknesses between antagonist teeth during intercuspation. These findings might explain the high somatosensory distortion referred by those patients, in absence of objective clinical findings.

Pain sensitivity and quality of life of patients with burning mouth syndrome: a preliminary study in a Chinese population

BackgroundBurning 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.MethodsFifty 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.ResultsThe 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).ConclusionPatients with BMS have higher pain sensitivity than healthy subjects. Reducing pain sensitivity might help to improve the quality of life of patients with BMS.

Management of burning mouth syndrome

In this review, we discuss some practical strategies that can be useful for clinicians in the interdisciplinary and individualised management of patients with burning mouth syndrome. Burning mouth syndrome (stomatodynia, glossodynia) is a chronic, idiopathic pain syndrome accompanied by a sensation of pain or burning, scalding, pinching, numbness or stinging without clinical changes in oral cavity mucosa in the absence of abnormalities in additional tests. In addition to the above symptoms, burning mouth syndrome is characterised by a sensation of oral dryness (xerostomia), distortion of the sense of taste (dysgeusia), and food hypersensitivity. Patients may further report mood swings, anxiety, insomnia, personality disorder, chronic fatigue, headache or carcinophobia. Burning mouth syndrome has a clear predisposition to perimenopausal females, and significantly affects not only the quality of life of patients but also that of their families. The aetiopathogenesis of the disease is not fully understood, and treatment predominantly focuses on symptomatic relief. Topical therapies involve benzydamine, clonazepam, capsaicin, lidocaine, lactoperoxidase, and sucralfate. Antidepressants, antiepileptics, atypical neuroleptics, and benzodiazepines have been used in systemic pharmacological management of burning mouth syndrome. Burning mouth syndrome therapy should be a combination of pharmacological and neuromodulating effects with psychological support for both patients and their families. The therapeutic strategy should be highly personalised, interdisciplinary, and holistic.

Analysis of the Effect of Mindfulness Meditation on Patients with Burning Mouth Syndrome

Objective: To explore the effect of mindfulness meditation on patients with burning mouth syndrome. Methods: 60 patients with burning mouth syndrome in our hospital who were treated from January 2021 to December 2022 were selected for this study. The patients were divided into two groups of thirty cases each using the randomized numerical table method. The observation underwent psychological intervention and mindfulness meditation training, while the control group only received symptomatic care. The condition of the patients of both groups was observed and compared. Results: Upon receiving treatment, the patients in the observation group had lower Hamilton Anxiety (HAM-A) scores, and Hamilton Depression (HAMD) scores compared to the control group (P &lt; 0.05). The visual analog scale (VAS) scores of the observation group were also lower than those of the control group (P &lt; 0.05). Moreover, the efficacy of the nursing intervention in the observation group was higher than that of the control group (P &lt; 0.05). Conclusion: Psychological intervention and mindfulness meditation training can effectively improve the clinical symptoms of patients with burning mouth syndrome. Therefore, this treatment method should be popularized.

Non-Communicable Diseases and Associated Risk Factors in Burning Mouth Syndrome Patients.

Background and Objectives: Noncommunicable diseases (NCDs) are a group of non-transmissible conditions that tend to be of long duration and are the result of a combination of genetic, physiological, environmental, and behavioral factors. Although an association between oral disorders and NCDs has been suggested, the relationship between Burning Mouth Syndrome (BMS) and NCDs and their associated risk factors has not been deeply investigated. In this study, we aim to identify associations between BMS and NCDs in the Romanian population. Materials and Methods: Ninety-nine BMS patients and 88 age-matched controls (aged 50 and over) were clinically evaluated for the presence of eight noncommunicable diseases (NCDs) and their most common risk factors, including hypertension, dyslipidemia, smoking, and obesity. Results: The results of our study showed that the BMS in the Romanian population seems to be significantly associated with cardiovascular diseases (CVDs) (p < 0.001) and two of their risk factors, hypertension (p < 0.001) and dyslipidemia (p < 0.001). Moreover, evaluating the Framingham Risk Score (FRS) in the individuals not affected by CVDs (73 CTRL and 38 BMS), we found that 13.2% of BMS patients reported a moderate risk of developing CVDs in ten years, compared to the controls, all of whom presented a low risk (p = 0.002). Conclusions: Our findings suggest that a multidisciplinary clinical approach, which also includes a cardiovascular evaluation, is essential for the successful management of BMS. Moreover, these data highlighted the importance of introducing an integrated strategy for the prevention and care of NCDs in BMS patients.

Oxidative stress–mediated proapoptosis signaling: A novel theory on the mechanism underlying the pathogenesis of burning mouth syndrome

BackgroundBurning mouth syndrome (BMS) is a chronic oral pain disorder characterized by a generalized burning sensation in the oral mucosa without apparent medical or dental causes. Despite various hypotheses proposed to explain BMS pathogenesis, a clear understanding of the cellular-level events and associated histologic and molecular findings is lacking. Advancing our understanding of BMS pathogenesis could facilitate the development of more targeted therapeutic interventions. Types of Studies ReviewedThe authors conducted an extensive literature search and review of cellular mechanisms, focusing on evidence-based data that support a comprehensive hypothesis for BMS pathogenesis. The authors explored novel and detailed mechanisms that may account for the characteristic features of BMS. ResultsThe authors proposed that BMS symptoms arise from the uncontrolled activation of proapoptotic transmembrane calcium permeable channels expressed in intraoral mucosal nerve fibers. Elevated levels of reactive oxygen species or dysfunctional antiapoptosis pathways may lead to uncontrolled oxidative stress–mediated apoptosis signaling, resulting in upregulation of transmembrane transient receptor potential vanilloid type 1 and P2X 3 calcium channels in nociceptive fibers. Activation of these channels can cause nerve terminal depolarization, leading to generation of action potentials that are centrally interpreted as pain. Conclusions and Practical ImplicationsThe authors present a novel hypothesis for BMS pathogenesis, highlighting the role of proapoptotic transmembrane calcium permeable channels and oxidative stress–mediated apoptosis signaling in the development of BMS symptoms. Understanding these underlying mechanisms could provide new insights into the development of targeted therapeutic interventions for BMS. Additional research is warranted to validate this hypothesis and explore potential avenues for effective management of BMS.

Loneliness during the COVID-19 Pandemic in Patients with Burning Mouth Syndrome: A Multicentric Case-Control Italian Study

Background. Lockdown restrictions during the COVID-19 pandemic exerted a strong impact on people’s quality of life and increased loneliness. This study evaluates the effect of the pandemic on loneliness in patients with burning mouth syndrome (BMS) compared with the general population. Methods. 100 BMS patients versus 100 healthy controls (HC) were recruited in five Italian centers. The 12-Item General Health Questionnaire (GHQ-12), the Depression Anxiety Stress Scales-21 (DASS-21), the Insomnia Severity Index (ISI), the short-form UCLA Loneliness Scale-8 (ULS-8), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Suicidal Ideation Attribute Scale (SIDAS) were administered. Results. BMS patients and HC showed high scores (16 [14-20.25] and 16 [14-18]) in the ULS-8. Statistically significant differences have been found considering the BMS patients lived with fewer relatives during the lockdown compared with the HC (2 [2-3] and 3 [2-4]; p : 0.012) with a lower level of satisfaction in relationships with relatives (4 [1.75-5] and 5 [4-5]; p &lt; 0.001 ) and also in the DASS-21 total scores between the BMS patients and HC (16 [10-24.2] and 10 [4-17]; p &lt; 0.001 ). The multivariate logistic regression revealed that age, education, DASS-21, and MSPSS were the most predictive variables and could explain 34.68% of the variance in the ULS-8 score ( p &lt; 0.001 ) in the BMS group. However, only the DASS-21 was significant in the HC group, explaining 10.11% of the variance of the ULS-8 ( p : 0.033). Conclusions. Both the patients and controls experienced deep loneliness during the pandemic. However, in the BMS group, loneliness was significantly correlated with age, a higher level of education and stress, and a lower level of satisfaction in relationships with relatives and social support perceived compared with the controls.

Oral Manifestations in Diabetes Mellitus and Management Considerations: A Review

Diabetes mellitus is a chronic metabolic disorder defined as an increase in sugar levels in the bloodstream brought onby either insufficient insulin secretion, resistance to insulin's effects, or both. All age groups are affected by the chronic conditionknown as diabetes mellitus. It is among the world's major causes of mortality and morbidity. Xerostomia, dental caries,periodontal disease, gingivitis, candidiasis, other oral infections, burning mouth syndrome, taste dysfunction, oral mucosalalterations, delayed wound healing, and localized osteitis are common oral manifestations of diabetes mellitus. Majorcomplications impacting a patient's quality of life include oral complications in diabetic individuals. Long-term oral problems inthese patients’ harm blood glucose regulation, making oral complications care and prevention important. The dental professionalshould be familiar with DM's oral manifestations to identify this disease complication. This article not only discusses the oralmanifestations but also discusses management considerations in diabetic patients which will help future dental professionals indental practice. This article aims to spread knowledge and awareness about the potential oral manifestations of diabetes mellitusand treatment considerations.Keywords: , , , , ,

Comparison of Clinical Characteristics between Primary and Secondary Burning Mouth Syndrome

Comparison of Clinical Characteristics between Primary and Secondary Burning Mouth Syndrome

Usefulness of pepsin saliva measurement for the detection of primary burning mouth syndrome related to reflux.

To study the diagnostic value of salivary pepsin tests for detecting laryngopharyngeal reflux (LPR) in patients with primary burning mouth syndrome (BMS). 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 ≥ 100ng/mL cutoffs. Receiver operating characteristic curve (ROC) was evaluated. 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 ≥ 100ng/mL, respectively. The ROC analysis reported that a threshold of ≥ 21.5ng/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). 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.