Jornet García, Vicente

López Jornet, María Pía

Martínez Beneyto, Yolanda

Velandrino Nicolás, Antonio Pablo

English

Repositori d'Objectes Digitals per a l'Ensenyament la Recerca i la Cultura

E753Med Oral Patol Oral Cir Bucal. 2008 Dec 1;13(12):E753-4.                                                                                                                                                   Attitude in relation to burning mouth syndrome                                                                           Med Oral Patol Oral Cir Bucal. 2008 Dec 1;13(12):E753-4.                                                                                                                                                     Attitude in relation to burning mouth syndromeLetter to the Editor: Attitudes among Spanish general dentists in relation to burning mouth syndrome: Results of a national surveyYolanda Martínez Beneyto 1, Pía López Jornet 1, Antonio Velandrino Nicolás 2, Vicente Jornet García  1(1) Department of Stomatology(2) Department of PsychologyUniversity of Murcia. SpainCorrespondence:Dr. Yolanda Martínez BeneytoClínica Odontológica UniversitariaHospital Morales MeseguerAvda. Marqués de los Vélez s/n30008 – Murcia (Spain)yolandam@um.esReceived: 03/05/2008Accepted: 11/07/2008 Martínez-Beneyto, Y, López-Jornet, P, Velandrino-Nicolás A, Jornet-García V. Attitudes among Spanish general dentists in relation to burning mouth syndrome: Results of a national survey. Med Oral Patol Oral Cir Bucal. 2008 Dec 1;13(12):E753-4.© Medicina Oral S. L. C.I.F. B 96689336 - ISSN 1698-6946http://www.medicinaoral.com/medoralfree01/v13i12/medoralv13i12p753.pdf              Article Number: 1111111804              © Medicina Oral S. L. C.I.F. B 96689336 - ISSN 1698-6946               eMail:  medicina@medicinaoral.com Dear Editor,Burning mouth syndrome (BMS) is a complex and mul-tifactorial clinical disorder characterized by a continuous burning and itching sensation in the absence of oral lesions that would account for the discomfort. (1) The estimated prevalence is 0.7-4.5%. (1,2) While BMS can affect many areas in the mouth, the tongue is the most commonly affec-ted area.(1) Almost 90% of affected patients are women in the aged 50-70 years. (1,2) The etiopathogenesis is not known, although many studies have related the syndrome with pharmacotherapy (3), and proposed treatments have been aimed at hypothetical etiological factors, or simply in-tended to lessen or eliminate the symptoms. (4-6) Proposed management includes patient information, the correction of habits, protection of the oral mucosa and the prescrip-tion of rinses and antiseptic products.(5) Benzydamine (an antiinflammatory and antiseptic drug) in 0.15% solution has also been proposed, but with no significant degree of effectiveness. The same can be said of rinses with local anesthetics such as lidocaine. At present, use is being made of psychoactive drugs such as trazodone, paroxetine and sertraline. Tricyclic antidepressants such as amitriptyline (at a dose of 10-150 mg/day) or nortriptyline; anxiolytics such as diazepam (6-15 mg/day) and other benzodiazepine derivates such as clonazepam (0.25-1 mg/day) have been shown to be effective. Studies have also demonstrated some efficacy with alpha-lipoic acid for the treatment of BMS symptoms. (5, 6)A review of the literature yielded no previous studies of the behavior of dental professionals in relation to BMS. We thus decided to evaluate the knowledge, attitudes and practices among Spanish dentists in relation to suspected BMS, attempting to identify differences in therapeutic practice and the possible influence of the years of pro-fessional experience, gender, work setting (private, public) and professional grade (dental surgeons or physicians spe-cialized in dental care). Sampling surveys were used in the study, which was approved by the Ethics Committee of the University of Murcia. The study design was based on the list of the affiliated dentist provided by the General Stoma-tological and Odontological Council of Spain, 2005. The size of the sample was defined by adopting the random extraction method, assuming a confidence interval of 95%, a maximum variance of P=Q=50 and a sampling error of less than 3%. The initial sample was chosen by a stratifi-cation process, using individual provinces as strata. The inclusion criterion was general dentist in practice and the exclusion criterion was oral surgeons, orthodontics, etc. Of the 1022 dentists chosen, 840 replied (74%). The study was conducted between January and November 2006, and assurances of anonymity were given. The questionnaire comprised several item blocks and was pre-tested with 30 dentists to improve the validity of responses.A first item block evaluated socio-demographic aspects Indexed in: - Science Citation Index Expanded- Journal Citation Reports- Index Medicus, MEDLINE, PubMed- Excerpta Medica, Embase, SCOPUS, - Indice Médico EspañolPublication Types: Letter E754Med Oral Patol Oral Cir Bucal. 2008 Dec 1;13(12):E753-4.                                                                                                                                                   Attitude in relation to burning mouth syndrome                                                                           Med Oral Patol Oral Cir Bucal. 2008 Dec 1;13(12):E753-4.                                                                                                                                                     Attitude in relation to burning mouth syndromeand the years of professional experience, gender, work setting (public and private) and grade (dental surgeons or physicians specialized in dental care). A second item block explored therapeutic attitudes in relation to patients with BMS (patient information on BMS, drug treatment (anxiolytics, antidepressants) and rinses). Males slightly out numbered females (50.4% versus 48.1%). The mean age of the global series was 27.99 years, with standard deviation (SD) = 9.967. As to the variable “years of professional experience”, the mean was found to be 12.25 (SD = 8.432). Lastly, in relation to the work setting, 97.3% of the interviewed professionals were de-dicated to private practice, and 8.8% to public practice. In turn, 67.1% of interviewed professionals had studied dentistry in dental schools, while 32.9% held a degree in medicine, with stomatology as a specialty. The frequency with which the professionals diagnosed BMS was not influenced (p=0.195) by the years of pro-fessional experience (12.16±8.35), although it should be noted that a greater number of years in practice led to a higher number of cases being diagnosed on a monthly basis (>3 cases). However there was a significant relation between public and private practice (p=0.000). A high percentage (44.6%) of professionals referred the patients to specialised centres, while those who treated the pathology themselves tended to have more experience (p=0.02). There was no relation in this respect with gender or place of work (private or public). Among the non-exclusive options of treatment and the results should be noted the information given to the patient concerning the illness (53.57%), the use of mouth washes (41.66%) and psychotropic drugs (17.02%), while only 8.57% of dentists affirmed that the treatments available were effective for BMS syndrome. No significant gender differences were observed regarding the management of BMS patients, except as refers to the use of systemic drugs (used by 15.2% of the males versus 11.3% of the females; p=0.01) (p<0.05). No statistically significant relation was observed between the treatment used and the work setting, although the most experienced dentists (p=0.024) opted for systemic treatment. As regards professional grade, odontologists were more inclined to provide information to the patient (43.7% versus 41.3% among medical doctors specialized in den-tistry; p=0.000), and to prescribe rinses (e.g., triclosan or chlorhexidine) (34.1% versus 31.9%; p=0.02). In contrast, the stomatologists were more inclined to treat glossodynia with anxiolytics or antidepressants (16.2% versus 11.8% among the dental surgeons; p=0.000) (see Table I).We are dealing with a syndrome of diverse etiology and still unknown in many respects. Such a situation requi-res the use of agreed protocols or guidelines about the treatments available for a disease that Spanish dentists in general practice are increasingly faced with.  References1. Scala A, Checchi L, Montevecchi M, Marini I, Giamberardino MA. Update on burning mouth syndrome: overview and patient management. Crit Rev Oral Biol Med. 2003;14(4):275-91. 2. Silvestre FJ, Serrano C. Burning mouth syndrome: concepts review and update. Med Oral. 1997 Jan;2(1):30-38. 3. Salort-Llorca C, Mínguez-Serra MP, Silvestre FJ. Drug-induced burning mouth syndrome: a new etiological diagnosis. Med Oral Patol Oral Cir Bucal. 2008 Mar 1;13(3):E167-70. 4. Gorsky M, Silverman S Jr, Chinn H. Clinical characteristics and ma-nagement outcome in the burning mouth syndrome. An open study of 130 patients. Oral Surg Oral Med Oral Pathol. 1991 Aug;72(2):192-5. 5. Zakrzewska JM, Forssell H, Glenny AM. Interventions for the treatment of burning mouth syndrome: a systematic review. J Orofac Pain. 2003 Fall;17(4):293-300. 6. Patton LL, Siegel MA, Benoliel R, De Laat A. Management of burning mouth syndrome: systematic review and management recommendations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Mar;103 Suppl:S39.e1-13. Table I. Statistical significance between the way in which BMS is treated and socio-demographic items.Experience (years of professional experience), gender (males and females), work setting (public private and mixed) and profes-sional grade (odontologist and stomatologist)..* statistically significant  p<0.05Treatment alternatives Experience Gender Work setting GradePatient informationT=-2.259 Χ2=0.475 Χ2=7.876 Χ2=17.459P=0.024* P=0.491    P=0.019* P=0.000*Anxiolytics/antidepressantsT=-4.083 Χ2=6.264 Χ2=0.645 Χ2=18.431P=0.000* P=0.012* P=0.724 P=0.000*Chlorhexidine, triclosan, rinsesT=-2,279 Χ2=1.290 Χ2=3.507 Χ2=10.012P=0.023* P=0.256 P=0.173 P=0.002*Effectiveness of current treatmentsT=-0.962 Χ2=2.008 Χ2=0.794 Χ2=5.062P=0.337 P=0.366 P=0.939 P=0.080Other treatmentsT=-0.608 Χ2=0.097 Χ2=5.005 Χ2=0.031P=0.543 P=0.756 P=0.082 P=0.860

Letter to the Editor : Attitudes among Spanish general dentists in relation to burning mouth syndrome: Results of a national survey

https://roderic.uv.es/bitstream/10550/63660/1/5989361.pdf

Letter to the Editor : Attitudes among Spanish general dentists in relation to burning mouth syndrome: Results of a national survey

Abstract

Similar works

Full text

Available Versions

Repositori d'Objectes Digitals per a l'Ensenyament la Recerca i la Cultura