QTc in burning mouth syndrome

Burning mouth syndrome (BMS) is characterized by a burning sensation of the oral mucosa in the absence of underlying causes. BMS patients can pose a therapeutic challenge to clinicians. Amitriptyline has been a first-line treatment for BMS and is known to prolong corrected QT interval (QTc) in a dose dependent manner. However, little is known about the QTc lengthening effect of amitriptyline at analgesic dosages. The objective of this study was to evaluate changes in QTc in female BMS patients treated with amitriptyline. We conducted a single-center retrospective observational study and evaluated 40 female BMS patients. The QTc interval did not show statistically significant increase with amitriptyline (p=0.1502). However, the change in QTc of amitriptyline-responders was significantly longer than that of non-responders (p=0.0142). The change in QTc may be a non-invasive maker of clinical responses to amitriptyline in female BMS patients

Changes in Corrected QT Interval May Be Associated with Clinical Responses in Burning Mouth Syndrome

Backgrounds: Burning mouth syndrome (BMS) is characterized by a burning sensation of the oral mucosa in the absence of underlying dental causes. Only a minority of BMS patients will achieve satisfactory pain relief and little is known about clinical makers for the response. The objective of this study was to consider whether corrected QT interval (QTc) is a useful biomarker for clinical responses. Methods: We conducted a single-center retrospective observational study and evaluated 51 BMS patients treated with amitriptyline. We calculated QTc changes with amitriptyline and examined the relationship between changes in QTc and visual analogue scale (VAS). Results: Of 51 subjects, 13 (25.5%) were amitriptyline-responders and 38 (74.5%) were non-responders. The changes in QTc interval were significantly correlated with changes in VAS (Spearman's rank correlation coefficient r = 0.389, p = 0.006). Conclusions: Changes in QTc interval may be a non-invasive estimation of clinical responses in BMS patients

Psychiatric comorbidities in patients with Atypical Odontalgia

Objective: Atypical Odontalgia (AO) is a condition characterized by tooth pain with no apparent cause. Although psychiatric comorbidity seems to be very common, it has rarely been studied. To clarify the influence of psychiatric comorbidity on the clinical features in patients with AO, we retrospectively evaluated their examination records. Methods: Clinical features and psychiatric diagnoses of 383 patients with AO were investigated by reviewing patients' medical records and referral letters. Psychiatric diagnoses were categorized according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). We also analyzed visual analogue scale (VAS), self-rating depression scale (SDS), and the short-form McGill pain questionnaire (SF-MPQ) scores. Results: Of the 383 patients with AO, 177 (46.2%) had comorbid psychiatric disorders. The most common were depressive disorders (15.4%) and anxiety disorders (10.1%). Serious psychotic disorders such as bipolar disorder (3.0%) and schizophrenia (1.8%) were rare. Dental trigger of AO was reported in 217 (56.7%) patients. There were no significant correlations between psychiatric comorbidities and most of the demographic features. Higher VAS and SDS scores, higher frequency of sleep disturbance, and higher ratings of “Fearful” and “Punishing-cruel” descriptors of the SF-MPQ were found in patients with psychiatric comorbidity. Conclusions: About half of AO patients had comorbid psychiatric disorders. Dental procedures are not necessarily causative factors of AO. In AO patients with comorbid psychiatric disorders, pain might have a larger emotional component than a sensory one. VAS, SDS, and SF-MPQ scores might aid in the noticing of underlying comorbid psychiatric disorders in AO patients