Burning mouth syndrome: update

Burning Mouth Syndrome (BMS) is a chronic disorder that predominately affects middle-aged women in the postmenopausal period. The condition is distinguished by burning symptoms of the oral mucosa and the absence of any clinical signs. The etiology of BMS is complex and it includes a variety of factors. Local, systemic and psychological factors such as stress, anxiety and depression are listed among the possible causes of BMS. BMS may sometimes be classified as BMS Type I, II or III. Although this syndrome is not accompanied by evident organic alterations and it does not present health risks, it can significantly reduce the patient's quality of life. This study analyzes the available literature related to BMS, and makes special reference to its therapeutic management. The pages that follow will also discuss the diagnostic criteria that should be respected, etiological factors, and clinical aspects. We used the PubMed database and searched it by using the keywords 'burning mouth syndrome', 'BMS and review', and 'burning mouth and review', in the title or abstract of the publication. BMS treatment usually steers towards the management of the symptoms; however, the specific local factors that could play a significant role in worsening the oral burning sensation should be eradicated. The most widely accepted treatment options that show variable results include tricyclic antidepressants, benzodiazepines and antipsychotic drugs; nevertheless there are other therapies that can also be carried out. Professionals that work in the field of dentistry should formulate standardized symptomatic and diagnostic criteria in order to more easily identify the most effective and reliable strategies in BMS treatment through multidisciplinary research

Oral granuloma gravidarum: a retrospective study of 41 cases in Southern Brazil

Granuloma gravidarum (GG) is an inflammatory lesion, which develops in the oral mucosa of pregnant women in response to chronic low-grade irritants, under the influence of hormonal factors. Objective To characterize GG clinically by means of a retrospective study of the cases of the Oral Medicine Division, São Lucas Hospital, Brazil. Material and Methods Cases of GG diagnosed between 1980 and 2012 were analyzed. Data were obtained referring to the age of the patients, lesion location, clinical features, as well as the presence of local irritants. The gestation period in which the lesion developed was also investigated. Results Forty-one cases of GG were found. The lesions developed predominantly in the third trimester of pregnancy (51.22%) and the mean age of the patients was 28 years. Most GG was found in the gingiva (73.17%), was reddish color and had a mean diameter of 1.5 cm. Local irritants were involved in 75.6% of the cases. Conclusions The hormonal conditions of pregnancy can have an impact on the oral cavity, predisposing the patient to inflammatory lesions such as GG

Cutaneous, genital and oral lichen planus : a descriptive study of 274 patients

Lichen planus (LP) is a chronic autoimmune disease that affects the oral mucosa as well as the skin, genital mucosa and other sites. Objective: to evaluate the correlation between oral, genital and cutaneous lichen planus, in a sample of LP patients. This descriptive study reviewed 274 clinical histories of patients, who all presented histological confirmation of lichen planus verified by a pathologist, attending research centers in Barcelona. A total of 40 LP patients (14.59%) presented genital lesions. Of 131 patients with cutaneous LP (47.8%), the most commonly affected zones were the body?s flexor surfaces, representing 60.1% of cases. 24% of patients (n=55) related the start of the lesions with previous stress events. Of the 131 subjects with cutaneous lesions, 19% (n=25) also presented oral lichen planus (OLP). Of the total sample, 53.6% (n=147) of patients presented oral lesions. The systemic diseases most commonly associated with this patient sample were psychological problems such as stress, anxiety and depression (48%), hypertension (27%), gastric problems (12%), and diabetes (9.7%). A family history of lichen planus was found in only 2 cases (0,72%) out of the total of 274. Any patient with OLP should undergo a thorough history and examination to investigate potential extraoral manifestations. The fact that 37 patients with OLP in this patient series were identified with simultaneous involvement at more than one site highlights the need for thorough evaluation and multidisciplinary approaches to this disease

Oral lichen planus and its relationship with systemic diseases. A review of evidence

Oral lichen planus (OLP) is one of the most common dermatological diseases which are present in the oral cavity. It is a chronic autoimmune, mucocutaneous disease that affects the oral mucosa as well as the skin, genital mucosa and other sites. Review the relevant information to OLP and its relationship with systemic diseases. Searches were carried out in the Medline/PubMed, Lilacs, Bireme, BVS, and SciELO databases by using key-words. After an initial search that provided us with 243 papers, this number was reduced to 78 from the last seven years. One of the first criteria adopted was a selective reading of the abstracts of articles for the elimination of publications that presented less information regarding the subject proposed for this work. All the selected articles were read in their entirety by all of the authors, who came to a consensus about their level of evidence. The Scottish Intercollegiate Guidelines Network (SIGN) criteria were used as the criteria of methodological validation. Only 9 articles showed an evidence level of 1+, 2+, 3 or 4, as well as a recommendation level of A, B, C or D. Three of them were non-systematic reviews, one was a cohort study and only one was a controlled clinical trial. Three of the studies were case series, with respective sample sizes of 45, 171 and 633 patients. Several factors have been associated with OLP. Patients with OLP are carriers of a disease with systemic implications and may need the care of a multidisciplinary team. The correct diagnosis of any pathology is critical to making effective treatment and minimizes iatrogenic harm. For OLP is no different, taking into account its association with numerous systemic diseases that require special attention from health professionals. Periodic follow-up of all patients with OLP is recommended

Low-level laser therapy in patients with Burning Mouth Syndrome : a double-blind, randomized, controlled clinical trial

Evaluate the effect of LLLT in the treatment of burning mouth syndrome (BMS). 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. 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). LLLT may be an alternative treatment for the relief of oral burning in patients with BMS

Low-level laser therapy in patients with Burning Mouth Syndrome: a double-blind, randomized, controlled clinical trial

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

Efficacy of photobiomodulation in reducing pain and improving the quality of life in patients with idiopathic burning mouth syndrome. A systematic review and meta-analysis

[EN] Burning mouth syndrome is a chronic condition, which is characterised by a burning sensation or pain in the mucosa of the oral cavity. Treatment options include antidepressants, antipsychotics, anticonvulsants, analgesics, hormone replacement therapies and more recently photobiomodulation. This study aims to perform a systematic review with meta-analysis in order to determine the effect of photobiomodulation on pain relief and the oral health-related quality of life associated with this condition. A bibliographical search of the Pubmed, Embase, Web of Science and Scopus databases was conducted. Only randomised clinical trials were included. Pain and quality of life were calculated as mean difference and pooled at different treatment points (baseline= TO and final time point = Tf) and laser modality. From a total of 103 records, 7 articles were retrieved for inclusion. PBM group had a greater decrease in pain than control group at Tf with a mean difference = - 2.536 (IC 95% - 3.662 to - 1.410; I-2 = 85.33%, p < 0.001). An improvement in oral health-related quality of life was observed in both groups, although this was more significant in the photobiomodulation group mean difference = - 5.148 (IC 95% - 8.576 to - 1.719; I-2= 84.91%, p = 0.003). For the red laser, a greater improvement than infrared was observed, in pain, mean difference = - 2.498 (IC 95% - 3.942 to - 1.053; I-2= 79.93%, p < 0.001), and in quality of life, mean difference = - 8.144 (IC 95% - 12.082 to - 4.206; I-2= 64.22%, p = 0.027). Photobiomodulation, in particular, red laser protocols, resulted in improvement in pain and in quality of life of burning mouth syndrome patients

Efeito da terapia laser de baixa pot?ncia no tratamento da s?ndrome da ard?ncia bucal : ensaio cl?nico, randomizado, placebo-controlado

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS ([email protected]) on 2015-06-15T20:28:57Z No. of bitstreams: 1 470513 - Texto Completo.pdf: 7701806 bytes, checksum: 06768de1fcc024bbd22d468864df46c9 (MD5)Made available in DSpace on 2015-06-15T20:28:57Z (GMT). No. of bitstreams: 1 470513 - Texto Completo.pdf: 7701806 bytes, checksum: 06768de1fcc024bbd22d468864df46c9 (MD5) Previous issue date: 2015-03-30Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPESConselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPqBurning mouth syndrome (BMS) is a complex disease characterized mainly by symptoms of burning, pain or itching in the oral mucosa without apparent clinical alterations. The literature was reviewed in the first manuscript, emphasizing BMS characteristics, etiology and therapeutics. Low-level laser therapy (LLLT) has been widely used in oral disorders because of its analgesic, anti-inflammatory and tissue repair effects. Thereby, in the second manuscript we reviewed the applicability and protocols of LLLT in the management of lichen planus, xerostomia, recurrent aphthous stomatitis, herpes labialis, oral mucositis and BMS. Controlled trials investigating the effects of LLLT on BMS are still rare. The present randomized, placebo-controlled study aimed to clinically assess the effect of LLLT in the treatment of patients with BMS, and to investigate the impact of such therapy in the quality of life of these individuals. The sample consisted of 78 BMS patients who were randomly assigned into three laser groups and one control group (n=19), which was treated with sham LLLT. Laser groups were treated with the following parameters: IR1w group, n=20 (830 nm, 100 mW, 5 J, 176 J/cm2, 50 s, weekly LLLT sessions, ten sessions); IR3w group, n=20 (830 nm, 100 mW, 5 J, 176 J/cm2, 50 s, three weekly LLLT sessions, nine sessions); red laser group, n=19 (685 nm, 35 mW, 2 J, 72 J/cm2, 58 s, three weekly LLLT sessions, nine sessions). Symptoms were assessed at initial, at the end of the treatment and eight weeks later using visual analogue scale and visual numeric scale. Quality of life related to oral health was assessed through the Oral Health Impact Profile (OHIP-14). Statistical analysis was carried out using repeated measures ANOVA followed by the Tukey test. There was a significant reduction in the symptoms in all groups at the end of the treatment, which was maintained in the follow-up. The scores of the IR1w and IR3w laser groups were significantly lower in comparision to the control group. On the other hand, there was no significant difference between Red laser group and control group. There was also a decrease in the OHIP-14 scores in the four groups. The scores of the IR3w laser group differed significantly from those of the control group, showing that LLLT had a positive impact on the quality of life related to oral health. Based on the results of this study it is possible to conclude that infrared LLLT, in the parameters used, reduces the BMS symptoms and can be an alternative therapeutic for this disorder.A s?ndrome da ard?ncia bucal (SAB) ? uma doen?a de etiopatogenia desconhecida, caracterizada pela sensa??o de queima??o e ard?ncia na mucosa bucal, que se apresenta clinicamente normal. No primeiro artigo desta tese foi realizada uma revis?o da literatura com ?nfase nas caracter?sticas da SAB, etiologia e terap?utica. Uma vez que a terapia laser de baixa pot?ncia (LLLT) tem sido amplamente utilizada em enfermidades bucais devido aos seus efeitos analg?sicos, biomoduladores e antiinflamat?rios, no segundo artigo foram revisados a aplicabilidade e os protocolos da LLLT no manejo do l?quen plano, xerostomia, ulcera??o aftosa recorrente, herpes labial, mucosite e SAB. Ensaios cl?nicos controlados investigando o efeito da LLLT na SAB s?o ainda escassos; portanto, o presente estudo cl?nico randomizado e controlado teve como objetivos avaliar o efeito da LLLT nos sintomas da SAB, bem como, o impacto desta terapia na qualidade de vida relacionada ? sa?de bucal dos pacientes. A amostra foi constitu?da por 78 pacientes com SAB, distribu?dos em tr?s grupos laser e um grupo-controle (n=19), no qual foi empregada sham LLLT. Os seguintes protocolos de LLLT foram empregados nos grupos-laser: grupo IR1w, n=20 (830 nm, 100 mW, 5 J, 176 J/cm2, 50 s, uma sess?o semanal, total de 10 sess?es); IR3w, n=20 (830 nm, 100 mW, 5 J, 176 J/cm2, 50 s, tr?s sess?es por semana, total de nove sess?es); laser vermelho, n=19 (685 nm, 35 mW, 2 J, 72 J/cm2, 58 s, tr?s sess?es por semana, total de nove sess?es). Os sintomas foram avaliados por meio de escala visual num?rica e escala visual anal?gica no in?cio e fim do tratamento, e oito semanas ap?s. Para avalia??o da qualidade de vida relacionada ? sa?de bucal foi usado o instrumento Oral Health Impact Profile (OHIP- 14). Os dados foram analisados por meio do teste ANOVA de medidas repetidas, seguido pelo teste de Tukey. Houve redu??o significativa dos sintomas ao final do tratamento em todos os grupos, o que se manteve no acompanhamento de oito semanas. Os escores dos grupos laser IR1w e IR3w foram significativamente inferiores aos do grupo-controle. Por outro lado, n?o houve diferen?a significativa entre o grupo laser vermelho e o grupo-controle. Houve tamb?m redu??o significativa nos escores do OHIP-14 nos quatro grupos, entretanto, somente o grupo laser IR3w apresentou diferen?a significativa em rela??o ao grupo-controle, mostrando que o tratamento teve impacto positivo na qualidade de vida relacionada ? sa?de bucal. Com base nos resultados, pode-se concluir que a LLLT no comprimento de onda infravermelho e nos par?metros utilizados neste estudo, reduz os sintomas da SAB e pode ser uma alternativa terap?utica no tratamento desta doen?a

Efeito da catuama? na sintomatologia da s?ndrome da ard?ncia bucal: ensaio cl?nico, randomizado, duplo-cego, placebo-controlado

Made available in DSpace on 2015-04-14T13:29:57Z (GMT). No. of bitstreams: 1 432303.pdf: 1802342 bytes, checksum: d9a8b204784fe52f77e108dfe0c1a9d6 (MD5) Previous issue date: 2011-03-02A s?ndrome da ard?ncia bucal (SAB) ? uma doen?a de etiopatogenia desconhecida, caracterizada pela sensa??o de queima??o e ard?ncia na mucosa bucal, que se apresenta clinicamente normal. F?rmacos antidepressivos, benzodiazep?nicos e antipsic?ticos s?o as op??es terap?uticas mais utilizadas no tratamento da SAB. Estudos t?m demonstrado que o fitoter?pico Catuama? , composto por quatro extratos de plantas medicinais (Paullinia cupana, Trichilia catigua, Zingiber officinalis e Ptychopetalum olacoides), possui a??o vasorelaxante, antinociceptiva e antidepressiva. Este estudo cl?nico, randomizado, duplo-cego, placebo-controlado objetivou avaliar clinicamente, por meio de escala visual num?rica (EVN) e escala de faces (EF), o efeito do uso sist?mico da Catuama? na sintomatologia da SAB. A amostra foi constitu?da por 72 pacientes com a doen?a, que foram distribu?dos aleatoriamente em grupos experimental (n=38) e controle (n=34). Foram inclu?dos pacientes com idade m?nima de 40 anos que relatassem sintomas de ard?ncia, queima??o ou dor na mucosa bucal, com no m?nimo seis meses de dura??o e sem les?es bucais ao exame f?sico. Exclu?ram-se indiv?duos que estivessem utilizando f?rmacos antidepressivos, ansiol?ticos ou anticonvulsivantes, pacientes com hipossaliva??o, altera??es no hemograma, nas concentra??es s?ricas de glicose, ferro, ?cido f?lico e vitamina B12. Os pacientes foram orientados a ingerir duas c?psulas ao dia, antes do almo?o e do jantar, durante oito semanas e foram reavaliados ap?s 4, 8 e 12 semanas do in?cio do experimento. Sessenta indiv?duos conclu?ram o estudo. Embora ambos os grupos tenham demonstrado redu??o da sintomatologia, a melhora obtida pelo grupo experimental foi significativamente superior ? do grupocontrole ap?s 4 (EF, p=0.010) e 8 (EVN, p=0.003; EF, p<0.001) semanas de uso da Catuama?. Ap?s 12 semanas de acompanhamento, isto ?, 30 dias ap?s o t?rmino do tratamento, os pacientes com a s?ndrome apresentaram redu??o de 51,3% na sintomatologia, enquanto no grupo-controle este valor foi de 18,8% (EVN, p=0.001). Baseados nos achados do presente estudo, conclui-se que a administra??o sist?mica da Catuama? reduz os sintomas da SAB e pode ser uma alternativa terap?utica, com menos efeitos adversos quando comparada ?s drogas comumente utilizadas no tratamento dessa doen?