• Title, Summary, Keyword: Burning mouth syndrome

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Treatment Outcomes of Venlafaxine and Duloxetine in Refractory Burning Mouth Syndrome Patients

  • Kim, Moon-Jong;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.44 no.3
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    • pp.83-91
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    • 2019
  • Purpose: Venlafaxine and duloxetine have been shown to be effective in the treatment of neuropathic pain disorders. However, knowledge about the efficacy of venlafaxine and duloxetine on burning mouth syndrome (BMS) is still insufficient. The purpose of this study was to investigate the efficacy of venlafaxine and duloxetine on refractory BMS patients. Methods: Twelve refractory BMS patients who were prescribed venlafaxine or duloxetine were included in this study. These patients did not respond to previous administration of clonazepam, alpha-lipoic acid, gabapentin, and nortriptyline. All participants were the primary type of BMS patients who had no local and systemic factors related to the oral burning sensation. The intensities of oral symptoms following venlafaxine or duloxetine administration were compared with those before administration and at baseline. Results: Venlafaxine and duloxetine were prescribed to four and nine patients, respectively. One patient was prescribed both medications in turn. Among them, only two patients showed improvement of oral symptoms without side effects. In the other ten patients, symptoms failed to improve. Six of them reported that the drug was ineffective, and four of them stopped taking the medications on their own due to intolerable side effects, such as insomnia, constipation, drowsiness, dizziness, and xerostomia. Conclusions: Venlafaxine and duloxetine may only relieve oral symptoms in a minority of refractory BMS patients. Further large-scale studies are needed to determine the potential clinical factors that could predict the efficacy of venlafaxine and duloxetine.

Case Report : Treatment of Burning mouth Syndrome Using a Removable Anti-Nociceptive Appliance (가철성 유해자극차단장치를 이용한 구강작열감증후군의 치료 증례)

  • Roh, Byung-Yoon;Ahn, Jong-Mo;Yoon, Chang-Lyuk;Ryu, Ji-Won
    • Journal of Oral Medicine and Pain
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    • v.37 no.1
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    • pp.1-7
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    • 2012
  • Burning mouth syndrome(BMS) refers to a chronic orofacial pain disorder usually unaccompanied by mucosal lesions or other clinical signs. Tongue(anterior and lateral border) is found to be the most common site for the burning sensations in the oral cavity, and various oral sites may be affected including hard palate and lips. The etiology of this disorder remains poorly understood, but the various factors might be related with the pathogenesis of the BMS. These factors have been devided into local, systemic and psychological. Recently, there have been increasing reports that the pain of BMS may be neuropathic in origin. The complex and multifactorial etiology of BMS necessitates multidisciplinary approach for the management of these patients. Recently, several studies have reported that oral parafunctional habits could be related the pathogenesis of BMS, and tried to control the symptom of BMS with various methods. We reported the cases who had the symptom of burning mouth syndrome with removable anti-nociceptive appliance in the lower dentition.

Correlation between Dysgeusia and Spleen qi Deficiency Patterns in Patients with Burning Mouth Syndrome (구강작열감증후군 환자의 미각 이상과 비기허증(脾氣虛證)의 상관관계)

  • Lee, Jung-eun;Park, Jae-woo;Kim, Jin-sung
    • The Journal of Internal Korean Medicine
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    • v.38 no.4
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    • pp.455-467
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    • 2017
  • Objectives: This study evaluated the correlation between taste function and spleen qi deficiency in patients with burning mouth syndrome (BMS) and compared subgroups of BMS (i.e., dysgeusia and non-dysgeusia subgroups). Methods: This study included 60 participants categorized into two groups: a BMS group and healthy control (HC) group. Taste threshold was measured within six levels using solutions of four basic taste qualities. Subjects' Oral Health Impact Profiles (OHIPs-14) and Spleen qi Deficiency Questionnaire (SQDQ) scores were analyzed. Results: Taste thresholds for sweet (sucrose) and salty (NaCl) tastes were significantly lower in the BMS group than in the HC group, but sour (citric acid) and bitter (quinine HCl) tastes showed no significant differences between groups. In the dysgeusia and non-dysgeusia subgroups, no significant differences in the four basic taste thresholds were found. SQDQ scores were significantly higher in the BMS group compared to the HC and in the dysgeusia group compared to the non-dysgeusia group. OHIPs-14 and SQDQ scores for the BMS group were significantly and positively correlated. Conclusions: Spleen qi deficiency is related to taste function and can be used to treat BMS patients with taste dysfunction.

Psychological Aspects of Burning Mouth Syndrome

  • Kim, Cheul
    • Journal of Oral Medicine and Pain
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    • v.40 no.1
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    • pp.3-9
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    • 2015
  • The etiopathogenesis of burning mouth syndrome (BMS) seems to be complex and many patients probably involves interactions among local, systemic, and/or psychological factors in the pathophysiologic mechanism. Although there are controversies over whether the psychological factor is a cause or a result of BMS, several studies have supported strong relationships between psychological factors and chronic pain. It has been suggested that somatic complaints from unfavorable life experiences may influence both individual personality and mood changes; however, initiation of BMS symptoms is not necessarily correlated with stressful life events despite their elevated psychological stress. If the psychological distress is not a causal factor of BMS, it seems that BMS patients may be particularly vulnerable to psychological problems, primarily depression, anxiety, and hostility due to the characteristic entities of BMS such as chronic persistent pain itself. It seems likely that both physiological and psychological factors play a role in causing, perpetuating and/or exacerbating BMS; therefore, both two components of the patient's symptoms must be addressed. The acceptance of psychological factors by the patient is often an important element of BMS, management. The evaluation of psychological and emotional status of BMS patient enables clinicians to recognize prolonged negative and subclinical factors which can complicate the management of pain or indirectly perpetuate other physical factors. This evaluation improves the doctor-patient relationships, motivation, and compliance through a correct understanding of the clinical problem. Appropriate emotional and psychological evaluation may be required prior to developing a treatment plan in order to gain the successful treatment outcome.

Sleep Quality Evaluation Using Self-Reported Questionnaires in Patients with Burning Mouth Syndrome

  • Jin, Jung-Yong;Lee, Kyung-Eun;Suh, Bong-Jik
    • Journal of Oral Medicine and Pain
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    • v.41 no.4
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    • pp.188-194
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    • 2016
  • Purpose: Burning mouth syndrome (BMS) is ambiguous and enigmatic oral condition. Sleep disturbance is one of the most prevalent complaints of patients with chronic pain. The aim of this study was to estimate general sleep characteristics and propensity in patients with BMS. Methods: A total of thirty BMS patients and thirty healthy control subjects were investigated. Self-reported measures of sleep quality were conducted using two widely used methods; the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Data were analyzed with one-way ANOVA, chi-square, Fisher's exact test, Kruskal-Wallis test, Holm method with 95% confidence interval and p<0.05 significant level. Results: BMS patients showed more poor sleepers than those in control subjects in both ESS and PSQI test. BMS patients also showed statistically significant poorer sleep quality compared with control subjects in both test. When BMS group were divided into three groups on the basis of numeric rating scale, the higher score subjects had, the more mean rank they had in the PSQI. Conclusions: BMS patients showed up poor sleep characteristics and propensity than control group, and they also showed the more severe the pain was, the worse the sleep quality was.

Patient Expectations of Visiting Department of Oral Medicine for Burning Mouth Syndrome: Relationship between Expectations and Clinical and Psychological Characteristics

  • Kim, Hye-Kyoung;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.44 no.4
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    • pp.147-153
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    • 2019
  • Purpose: The aims of this study were to investigate the expectation of patients with burning mouth syndrome (BMS) and assess the relationship between patient expectations and clinical and psychological characteristics. Methods: Eligibility was retrospectively assessed on 93 patients with BMS. A total of five questionnaires on patients' expectation for a visit, pain, sleep quality (Pittsburgh Sleep Quality Index), cognition (Pain Catastrophizing Scale) and psychological distress (Symptom Checklist-90 revised) were measured. Results: Sixty-five patients were included in this study. The top 3 priorities of expectation for a treatment visit to the Department of Oral Medicine were as following; "I want my pain to be free"; "I want to understand why it hurts"; "I want to communicate better with doctors about pain". Patients with priority of pain relief showed poor sleep quality than patients who are more interested in the disease related information. Conclusions: To improve treatment outcomes of BMS, clinicians should improve their own understanding of patients who are suffering from BMS. Inquiring about the patient expectations may be one of them, and it would contribute to the enhancement of patients' overall well-being.

Antidiuretic Hormone Levels in Men with Burning Mouth Syndrome: A Pilot Study

  • Lee, Yeon-Hee;Hwang, Mi-Jin;Chon, Suk;Auh, Q-Schick
    • Journal of Oral Medicine and Pain
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    • v.42 no.4
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    • pp.116-124
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    • 2017
  • Purpose: Burning mouth syndrome (BMS) is a disabling pain that mostly occurs in elderly women, but rarely in men. It is characterized by an unremitting oral burning sensation and pain without detectable oral mucosal changes. We investigated the clinical and hematologic features of middle-aged men with BMS, and compared the results to those of men with oral mucositis. Methods: Five men with BMS ($48.60{\pm}6.19years$) and five age-matched controls with oral mucositis ($49.80{\pm}15.26years$) underwent clinical and psychological evaluations and blood tests. Psychological status was evaluated using the Symptom Checklist-90-Revised. Cortisol, estradiol, progesterone, testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), adrenocorticotropic hormone (ACTH), and antidiuretic hormone (ADH) levels and erythrocyte sedimentation rate (ESR) were determined from the blood samples. Results: ADH level was significantly lower in men with BMS than in the controls. ADH levels correlated with testosterone (p<0.01), and ACTH levels strongly correlated with ESR (p<0.05). Progesterone level positively correlated with FSH and LH levels. Pain intensity on a visual analogue scale correlated with estradiol level only in men with BMS. Among psychological factors, the obsessive-compulsive disorder, interpersonal-sensitivity, and anxiety scores were higher in men with BMS than in the controls (p<0.05). However, no correlations were observed between the psychological and hematologic factors in both groups. The BMS symptoms presented only on the tongue, with the lateral border being the most prevalent area. Conclusions: Men with BMS may experience dysregulated endocrinologic or psychoneuroendocrinologic interactions, which might affect oral BMS symptoms, aggravating the severity of the burning sensation.

A literature review on burning mouth syndrome (구강작열감 증후군에 대한 논문 고찰)

  • Choi, Sung-Hyeon;Lee, Bin-Na;Lim, Hae-Soon;Oh, Won-Mann;Kim, Jae-Hyung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.3
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    • pp.123-131
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    • 2019
  • Burning mouth syndrome (BMS) is defined as the xerostomia, burning sensation and various discomfort of tongue and oral mucosa. BMS can occur in both men and women, but is more frequent in middle-aged menopausal women. Because exact cause can't be identified clearly and it is hard to make diagnosis in clinic, the purpose of the treatment have been to relieve symptoms. Etiology of BMS is divided into local, systemic, and psychological factors. ${\alpha}$-lipoic acid, clonazepam, supplemental therapy and cognitive behavior therapy can be prescribed for BMS. Nowdays, many experts focus attention on effect of combination therapy. It is necessary to solve the symptoms of the patients by combination of pharmacological approach and psychotherapy with cognitive behavior therapy considering the factors in various aspects.

Retrospective Review of Effectiveness of Various Pharmacological Agents in Treating Burning Mouth Syndrome

  • Im, Yeong-Gwan;Kim, Byung-Gook;Kim, Jae-Hyung
    • Journal of Oral Medicine and Pain
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    • v.41 no.1
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    • pp.21-25
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    • 2016
  • Purpose: Burning mouth syndrome (BMS) is a chronic pain condition involving the oral and perioral regions, often characterized by a burning sensation and pain in elderly patients. In this study, we investigated the effectiveness of pharmacological agents for the treatment of BMS patients through a retrospective chart review. Methods: We enrolled 61 BMS subjects (57 females, 4 males; $66.4{\pm}10.9$ years of age) from among consecutive patients treated pharmacologically from January 2014 to June 2015 at Chonnam National University Dental Hospital. Patients with secondary BMS associated with local factors were excluded. The treatment period, number of pharmacological agents tried, and effectiveness of the drugs administered to each subject were analyzed. Results: The mean treatment period for the management of BMS was 2.5 months. More than three agents were tried to control BMS symptoms in 17 subjects (27.9%); two agents were used in 10 subjects (16.4%), and a single agent in 24 subjects (39.3%). Clonazepam was prescribed most frequently and was effective at relieving symptoms in 30 of 39 subjects (76.9%). Paroxetine was moderately effective, relieving symptoms in 7 of 17 subjects (41.2%). Some of the subjects benefited from tricyclic antidepressants, gabapentin, and lipoic acid. A topical local anesthetic used to supplement other systemic agents had ameliorating effects in four of six subjects. Conclusions: Within the study limitations, clonazepam was the most effective drug and antidepressants were efficacious in some subjects for relieving the symptoms of BMS. These pharmacological agents could be considered as first-line drugs for the management of BMS.

Diagnostic challenges of nonodontogenic toothache

  • Park, Hyung-Ok;Ha, Jung-Hong;Jin, Myoung-Uk;Kim, Young-Kyung;Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.37 no.3
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    • pp.170-174
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    • 2012
  • The objective of this article was to present two nonodontogenic conditions that may mimic odontogenic toothache: trigeminal neuralgia and burning mouth syndrome. Two cases are presented in which one is related to the upper left second premolar and the other is related to the upper left first molar. Both showed pain when chewing. These two cases highlight the complexities involved in diagnosing nonodontogenic toothache. This article demonstrates the importance of having a thorough knowledge of both odontogenic and nonodontogenic toothache, as well as the need for careful evaluation of the nature of the pain and history, clinical and radiographic examinations.