Abstract
Burning mouth syndrome (BMS) is described by an intense burning sensation of the tongue or other oral areas without a clear etiopathology. The diagnosis of BMS is challenging due to variations of manifestations. The management of BMS is complicated due to the complex etiology of the disease. Many medications and treatment methods have been recommended for BMS management, but no one confirmed as the standard method. In this study, the therapeutic approaches of BMS were evaluated. The data of the article was obtained from PubMed/MEDLINE, Cochrane Library, and Web of Science. The following terms including “burning mouth syndrome”, “therapy”, and “treatment” were used for search in the databases. A wide range of articles about the therapeutic approach of BMS was searched and reviewed. Pharmacological and non-pharmacological approaches have been used for BMS management. Pharmacological treatments are including Capsaicin, Clonazepam, Low-dose aripiprazole, Alpha-lipoic acid, Duloxetine, Amitriptyline, Gabapentin, and Pregabalin, and ultra-micronized palmitoylethanolamide. Non-pharmacological therapies for BMS are cognitive therapy, Electroconvulsive therapy, Laser therapy, Acupuncture and auriculotherapy, Transcranial Magnetic Stimulation (rTMS), Salivary Mechanical Stimulation, and Botulinum Toxin. A detailed assessment of the etiology and pathophysiology of BMS, and having information about novel therapeutic interventions are essential for the management of BMS.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: The study is approved by ethics committee of Zahedan University of Medical Sciences.
References
1. Society HCCotIH. The international classification of headache disorders, (beta version). Cephalalgia 2013;33:629–808.10.1177/0333102413485658Search in Google Scholar
2. 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;14:275–91. https://doi.org/10.1177/154411130301400405.Search in Google Scholar
3. Zakrzewska, JM, Forssell, H, Glenny, AM. Interventions for the treatment of burning mouth syndrome. Cochrane Database Syst Rev 2005;1:CD002779. https://doi.org/10.1002/14651858.CD002779.pub2.Search in Google Scholar
4. Groushka, M, Bartoshuk, L. Burning mouth syndrome and oral dysaesthesia: taste injury is a piece of puzzle. Can J Diagnosis 2000;17:99–109.Search in Google Scholar
5. Lopez-Jornet, P, Camacho-Alonso, F, Andujar-Mateos, P, Sanchez-Siles, M, Gomez-Garcia, F. Burning mouth syndrome: an update. Med Oral Patol Oral Cir Bucal 2010;15:e562–8. https://doi.org/10.4317/medoral.15.e562.Search in Google Scholar
6. Zeller, A. Zungenbrennen bei einer 47-jahrigen Hausfrau. PRAXIS-BERN- 2001;90:1103–5.Search in Google Scholar
7. Grushka, M, Ching, V, Epstein, J. Burning mouth syndrome. Adv Otorhinolaryngol 2006;63:278–87.10.1159/000093766Search in Google Scholar
8. Siviero, M, Teixeira, MJ, Siqueira, JT, Siqueira, SR. Central mechanisms in burning mouth syndrome involving the olfactory nerve: a preliminary study. Clinics 2011;66:509–12. https://doi.org/10.1590/s1807-59322011000300026.Search in Google Scholar
9. Forssell, H, Jaaskelainen, S, Tenovuo, O, Hinkka, S. Sensory dysfunction in burning mouth syndrome. Pain 2002;99:41–7. https://doi.org/10.1016/s0304-3959(02)00052-0.Search in Google Scholar
10. Woda, A, Dao, T, Gremeau-Richard, C. Steroid dysregulation and stomatodynia (burning mouth syndrome). J Orofac Pain 2009;23:202–10.Search in Google Scholar
11. Nosratzehi, T, Payandeh, A, DehYadegari, F. The complaints, type, and severity of stressful events in patients with burning mouth syndrome referring to Zahedan School of Dentistry, Iran. Clin Cosmet Invest Dent 2020;12:123.10.2147/CCIDE.S229910Search in Google Scholar PubMed PubMed Central
12. Hakeberg, M, Hallberg, LRM, Berggren, U. Burning mouth syndrome: experiences from the perspective of female patients. Eur J Oral Sci 2003;111:305–11.10.1034/j.1600-0722.2003.00045.xSearch in Google Scholar PubMed
13. Kramp, B, Graumüller, S. Zungenbrennen-Diagnostik und Therapie. Laryngo-Rhino-Otol 2004;83:249–62.10.1055/s-2004-814527Search in Google Scholar PubMed
14. Vitkov, L, Weitgasser, R, Hannig, M, Fuchs, K, Krautgartner, WD. Candida‐induced stomatopyrosis and its relation to diabetes mellitus. J Oral Pathol Med 2003;32:46–50.10.1034/j.1600-0714.2003.00020.xSearch in Google Scholar
15. Abdollahi, M, Radfar, M. A review of drug-induced oral reactions. J Contemp Dent Pract 2003;4:10–31.10.5005/jcdp-4-1-10Search in Google Scholar
16. Cerchiari, DP, de Moricz, RD, Sanjar, FA, Rapoport, PB, Moretti, G, Guerra, MM. Burning mouth syndrome: etiology. Braz J Otorhinolaryngol 2006;72:419–23.10.1016/S1808-8694(15)30979-4Search in Google Scholar
17. Gao, J, Chen, L, Zhou, J, Peng, J. A case–control study on etiological factors involved in patients with burning mouth syndrome. J Oral Pathol Med 2009;38:24–8.10.1111/j.1600-0714.2008.00708.xSearch in Google Scholar
18. Nosratzehi, T. Salivary chemical factors in relation with oral cancer in smokers and non-smokers: a literature review. J Dent 2017;18:237.Search in Google Scholar
19. Osaki, T, Yoneda, K, Yamamoto, T, Ueta, E, Kimura, T. Candidiasis may induce glossodynia without objective manifestation. Am J Med Sci 2000;319:100–5.10.1016/S0002-9629(15)40696-2Search in Google Scholar
20. Milkov, M, Tonchev, T, Nedev, P. Diagnostic challenges of burning mouth syndrome. Scripta Scientifica Medica 2013;45:12–6.10.14748/ssm.v45i1.330Search in Google Scholar
21. Aravindhan, R, Vidyalakshmi, S, Kumar, MS, Satheesh, C, Balasubramanium, AM, Prasad, VS. Burning mouth syndrome: a review on its diagnostic and therapeutic approach. J Pharm BioAllied Sci 2014;6(1 Suppl):S21–5. https://doi.org/10.4103/0975-7406.137255.Search in Google Scholar PubMed PubMed Central
22. Nosratzehi, T, Salimi, S, Parvaee, A. Comparison of salivary cortisol and α‐amylase levels and psychological profiles in patients with burning mouth syndrome. Spec Care Dent 2017;37:120–5.10.1111/scd.12214Search in Google Scholar PubMed
23. Castillo-Felipe, C, Franco-Martínez, L, Tvarijonaviciute, A, Lopez-Jornet, P, Lamy, E. Proteomics-based identification of salivary changes in patients with burning mouth syndrome. Biology 2021;10:392.10.3390/biology10050392Search in Google Scholar PubMed PubMed Central
24. Gurvits, GE, Tan, A. Burning mouth syndrome. World J Gastroenterol 2013;19:665–72. https://doi.org/10.3748/wjg.v19.i5.665.Search in Google Scholar PubMed PubMed Central
25. Jorgensen, MR, Pedersen, AM. Analgesic effect of topical oral capsaicin gel in burning mouth syndrome. Acta Odontol Scand 2017;75:130–6. https://doi.org/10.1080/00016357.2016.1269191.Search in Google Scholar PubMed
26. Silvestre, FJ, Silvestre-Rangil, J, Tamarit-Santafe, C, Bautista, D. Application of a capsaicin rinse in the treatment of burning mouth syndrome. Med Oral Patol Oral Cir Bucal 2012;17:e1–4. https://doi.org/10.4317/medoral.17219.Search in Google Scholar PubMed PubMed Central
27. Amos, K, Yeoh, SC, Farah, CS. Combined topical and systemic clonazepam therapy for the management of burning mouth syndrome: a retrospective pilot study. J Orofac Pain 2011;25:125–30.Search in Google Scholar
28. Kuten-Shorrer, M, Treister, NS, Stock, S, Kelley, JM, Ji, YD, Woo, SB, et al.. Topical clonazepam solution for the management of burning mouth syndrome: a retrospective study. J Oral Facial Pain Headache 2017;31:257–63. https://doi.org/10.11607/ofph.1754.Search in Google Scholar PubMed
29. Takenoshita, M, Motomura, H, Toyofuku, A. Low-dose aripiprazole augmentation in amitriptyline-resistant burning mouth syndrome: results from two cases. Pain Med 2017;18:814–5. https://doi.org/10.1093/pm/pnw200.Search in Google Scholar PubMed PubMed Central
30. Mignogna, MD, Adamo, D, Schiavone, V, Ravel, MG, Fortuna, G. Burning mouth syndrome responsive to duloxetine: a case report. Pain Med 2011;12:466–9. https://doi.org/10.1111/j.1526-4637.2010.01035.x.Search in Google Scholar PubMed
31. Suga, T, Takenoshita, M, Watanabe, T, Tu, TT, Mikuzuki, L, Hong, C, et al.. Therapeutic dose of amitriptyline for older patients with burning mouth syndrome. Neuropsychiatric Dis Treat 2019;15:3599–607. https://doi.org/10.2147/NDT.S235669.Search in Google Scholar PubMed PubMed Central
32. Fenelon, M, Quinque, E, Arrive, E, Catros, S, Fricain, JC. Pain-relieving effects of clonazepam and amitriptyline in burning mouth syndrome: a retrospective study. Int J Oral Maxillofac Surg 2017;46:1505–11. https://doi.org/10.1016/j.ijom.2017.03.032.Search in Google Scholar PubMed
33. White, TL, Kent, PF, Kurtz, DB, Emko, P. Effectiveness of gabapentin for treatment of burning mouth syndrome. Arch Otolaryngol Head Neck Surg 2004;130:786–8. https://doi.org/10.1001/archotol.130.6.786.Search in Google Scholar PubMed
34. Lopez, V, Alonso, V, Marti, N, Calduch, L, Jorda, E. Marked response of burning mouth syndrome to pregabalin treatment. Clin Exp Dermatol 2009;34:e449–50. https://doi.org/10.1111/j.1365-2230.2009.03493.x.Search in Google Scholar PubMed
35. Palacios-Sanchez, B, Moreno-Lopez, LA, Cerero-Lapiedra, R, Llamas-Martinez, S, Esparza-Gomez, G. Alpha lipoic acid efficacy in burning mouth syndrome. A controlled clinical trial. Med Oral Patol Oral Cir Bucal 2015;20:e435–40. https://doi.org/10.4317/medoral.20410.Search in Google Scholar PubMed PubMed Central
36. Lopez-D’alessandro, E, Escovich, L. Combination of alpha lipoic acid and gabapentin, its efficacy in the treatment of Burning Mouth Syndrome: a randomized, double-blind, placebo controlled trial. Med Oral Patol Oral Cir Bucal 2011;16:e635–40. https://doi.org/10.4317/medoral.16942.Search in Google Scholar PubMed
37. Bergdahl, J, Anneroth, G, Perris, H. Personality characteristics of patients with resistant burning mouth syndrome. Acta Odontol Scand 1995;53:7–11. https://doi.org/10.3109/00016359509005936.Search in Google Scholar PubMed
38. Ottaviani, G, Rupel, K, Gobbo, M, Poropat, A, Zoi, V, Faraon, M, et al.. Efficacy of ultramicronized palmitoylethanolamide in burning mouth syndrome-affected patients: a preliminary randomized double-blind controlled trial. Clin Oral Invest 2019;23:2743–50. https://doi.org/10.1007/s00784-018-2720-7.Search in Google Scholar PubMed
39. Scardina, GA, Ruggieri, A, Provenzano, F, Messina, P. Burning mouth syndrome: is acupuncture a therapeutic possibility? Br Dent J 2010;209:E2. https://doi.org/10.1038/sj.bdj.2010.582.Search in Google Scholar PubMed
40. Franco, FR, Castro, LA, Borsatto, MC, Silveira, EA, Ribeiro-Rotta, RF. Combined acupuncture and auriculotherapy in burning mouth syndrome treatment: a preliminary single-arm clinical trial. J Alternative Compl Med 2017;23:126–34. https://doi.org/10.1089/acm.2016.0179.Search in Google Scholar PubMed
41. de Pedro, M, Lopez-Pintor, RM, Casanas, E, Hernandez, G. Effects of photobiomodulation with low-level laser therapy in burning mouth syndrome: a randomized clinical trial. Oral Dis 2020;26:1764–76. https://doi.org/10.1111/odi.13443.Search in Google Scholar PubMed
42. Simcic, D, Pezelj-Ribaric, S, Grzic, R, Horvat, J, Brumini, G, Muhvic-Urek, M. Detection of salivary interleukin 2 and interleukin 6 in patients with burning mouth syndrome. Mediat Inflamm 2006;2006:54632. https://doi.org/10.1155/MI/2006/54632.Search in Google Scholar PubMed PubMed Central
43. Umezaki, Y, Badran, BW, DeVries, WH, Moss, J, Gonzales, T, George, MS. The efficacy of daily prefrontal repetitive transcranial magnetic stimulation (rTMS) for burning mouth syndrome (BMS): a randomized controlled Single-blind study. Brain Stimul 2016;9:234–42. https://doi.org/10.1016/j.brs.2015.10.005.Search in Google Scholar PubMed
44. Suda, S, Takagai, S, Inoshima-Takahashi, K, Sugihara, G, Mori, N, Takei, N. Electroconvulsive therapy for burning mouth syndrome. Acta Psychiatr Scand 2008;118:503–4. https://doi.org/10.1111/j.1600-0447.2008.01261.x.Search in Google Scholar PubMed
45. Restivo, DA, Lauria, G, Marchese-Ragona, R, Vigneri, R. Botulinum toxin for burning mouth syndrome. Ann Intern Med 2017;166:762–3.10.7326/L16-0451Search in Google Scholar PubMed
46. de Souza, FT, Amaral, TM, dos Santos, TP, Abdo, EN, Aguiar, MC, Teixeira, AL, et al.. Burning mouth syndrome: a therapeutic approach involving mechanical salivary stimulation. Headache 2012;52:1026–34. https://doi.org/10.1111/j.1526-4610.2011.02037.x.Search in Google Scholar PubMed
47. Laklouk, M, Baranidharan, G. Profile of the capsaicin 8% patch for the management of neuropathic pain associated with postherpetic neuralgia: safety, efficacy, and patient acceptability. Patient Prefer Adherence 2016;10:1913–8. https://doi.org/10.2147/PPA.S76506.Search in Google Scholar PubMed PubMed Central
48. Petruzzi, M, Lauritano, D, De Benedittis, M, Baldoni, M, Serpico, R. Systemic capsaicin for burning mouth syndrome: short-term results of a pilot study. J Oral Pathol Med 2004;33:111–4. https://doi.org/10.1111/j.1600-0714.2004.0194n.x.Search in Google Scholar PubMed
49. Saraceno, R, Lore, B, Pavlidis, A, Karaiskou, M, Arcuri, C, Chimenti, S, et al.. Cyclosporine: a novel therapeutic approach for burning mouth syndrome. G Ital Dermatol Venereol 2016;151:480–4.Search in Google Scholar
50. Gremeau-Richard, C, Woda, A, Navez, ML, Attal, N, Bouhassira, D, Gagnieu, MC, et al.. Topical clonazepam in stomatodynia: a randomised placebo-controlled study. Pain 2004;108:51–7. https://doi.org/10.1016/j.pain.2003.12.002.Search in Google Scholar PubMed
51. Tan, SN, Song, E, Dong, XD, Somvanshi, RK, Cairns, BE. Peripheral GABAA receptor activation modulates rat tongue afferent mechanical sensitivity. Arch Oral Biol 2014;59:251–7. https://doi.org/10.1016/j.archoralbio.2013.11.015.Search in Google Scholar PubMed
52. Umezaki, Y, Takenoshita, M, Toyofuku, A. Low-dose aripiprazole for refractory burning mouth syndrome. Neuropsychiatric Dis Treat 2016;12:1229–31. https://doi.org/10.2147/NDT.S94426.Search in Google Scholar PubMed PubMed Central
53. Jaaskelainen, SK. Pathophysiology of primary burning mouth syndrome. Clin Neurophysiol 2012;123:71–7. https://doi.org/10.1016/j.clinph.2011.07.054.Search in Google Scholar PubMed
54. Brecht, S, Courtecuisse, C, Debieuvre, C, Croenlein, J, Desaiah, D, Raskin, J, et al.. Efficacy and safety of duloxetine 60 mg once daily in the treatment of pain in patients with major depressive disorder and at least moderate pain of unknown etiology: a randomized controlled trial. J Clin Psychiatr 2007;68:1707–16. https://doi.org/10.4088/jcp.v68n1110.Search in Google Scholar PubMed
55. Kim, YD, Lee, JH, Shim, JH. Duloxetine in the treatment of burning mouth syndrome refractory to conventional treatment: a case report. J Int Med Res 2014;42:879–83. https://doi.org/10.1177/0300060514527913.Search in Google Scholar PubMed
56. Moore, RA, Derry, S, Aldington, D, Cole, P, Wiffen, PJ. Amitriptyline for neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev 2012;12:CD008242. https://doi.org/10.1002/14651858.CD008242.pub2.Search in Google Scholar PubMed
57. Moore, RA, Derry, S, Aldington, D, Cole, P, Wiffen, PJ. Amitriptyline for neuropathic pain in adults. Cochrane Database Syst Rev 2015;7:CD008242. https://doi.org/10.1002/14651858.CD008242.pub3.Search in Google Scholar
58. Ito, M, Tokura, T, Yoshida, K, Nagashima, W, Kimura, H, Umemura, E, et al.. Five patients with burning mouth syndrome in whom an antidepressant (serotonin-noradrenaline reuptake inhibitor) was not effective, but pregabalin markedly relieved pain. Clin Neuropharmacol 2015;38:158–61. https://doi.org/10.1097/WNF.0000000000000093.Search in Google Scholar
59. Heckmann, SM, Heckmann, JG, Ungethum, A, Hujoel, P, Hummel, T. Gabapentin has little or no effect in the treatment of burning mouth syndrome – results of an open-label pilot study. Eur J Neurol 2006;13:e6–7. https://doi.org/10.1111/j.1468-1331.2006.01294.x.Search in Google Scholar
60. Dubey, PK. Gabapentin for the treatment of glossodynia due to an unusual cause. Anesth Analg 2008;107:729. https://doi.org/10.1213/ane.0b013e31817d5bbb.Search in Google Scholar
61. Singh, U, Jialal, I. Alpha-lipoic acid supplementation and diabetes. Nutr Rev 2008;66:646–57. https://doi.org/10.1111/j.1753-4887.2008.00118.x.Search in Google Scholar
62. Femiano, F, Gombos, F, Scully, C, Busciolano, M, De Luca, P. Burning mouth syndrome (BMS): controlled open trial of the efficacy of alpha-lipoic acid (thioctic acid) on symptomatology. Oral Dis 2000;6:274–7. https://doi.org/10.1111/j.1601-0825.2000.tb00138.x.Search in Google Scholar
63. Van Houdenhove, B, Joostens, P. Burning mouth syndrome. Successful treatment with combined psychotherapy and psychopharmacotherapy. Gen Hosp Psychiatr 1995;17:385–8. https://doi.org/10.1016/0163-8343(95)00061-u.Search in Google Scholar
64. Miziara, ID, Filho, BC, Oliveira, R, Rodrigues dos Santos, RM. Group psychotherapy: an additional approach to burning mouth syndrome. J Psychosom Res 2009;67:443–8. https://doi.org/10.1016/j.jpsychores.2009.01.013.Search in Google Scholar PubMed
65. Chirchiglia, D, Chirchiglia, P, Marotta, R, Gallelli, L. Add-on administration of ultramicronized palmitoylethanolamide in the treatment of new-onset burning mouth syndrome. Int Med Case Rep J 2019;12:39–42. https://doi.org/10.2147/IMCRJ.S194403.Search in Google Scholar PubMed PubMed Central
66. Chirchiglia, D, Cione, E, Caroleo, MC, Wang, M, Di Mizio, G, Faedda, N, et al.. Effects of add-on ultramicronized N-palmitol ethanol amide in patients suffering of migraine with aura: a pilot study. Front Neurol 2018;9:674. https://doi.org/10.3389/fneur.2018.00674.Search in Google Scholar PubMed PubMed Central
67. Chirchiglia, D, Chirchiglia, P, Signorelli, F. Nonsurgical lumbar radiculopathies treated with ultramicronized palmitoylethanolamide (umPEA): a series of 100 cases. Neurol Neurochir Pol 2018;52:44–7. https://doi.org/10.1016/j.pjnns.2017.11.002.Search in Google Scholar PubMed
68. Sardella, A, Lodi, G, Tarozzi, M, Varoni, E, Franchini, R, Carrassi, A. Acupuncture and burning mouth syndrome: a pilot study. Pain Pract 2013;13:627–32. https://doi.org/10.1111/papr.12031.Search in Google Scholar PubMed
69. Bardellini, E, Amadori, F, Conti, G, Majorana, A. Efficacy of the photobiomodulation therapy in the treatment of the burning mouth syndrome. Med Oral Patol Oral Cir Bucal 2019;24:e787–91. https://doi.org/10.4317/medoral.23143.Search in Google Scholar PubMed PubMed Central
70. de Matos, ALP, Silva, PUJ, Paranhos, LR, Santana, ITS, de Matos, FR. Efficacy of the laser at low intensity on primary burning oral syndrome: a systematic review. Med Oral, Patol Oral Cirugía Bucal 2021;26:e216.10.4317/medoral.24144Search in Google Scholar PubMed PubMed Central
71. George, MS, Nahas, Z, Kozel, FA, Li, X, Denslow, S, Yamanaka, K, et al.. Mechanisms and state of the art of transcranial magnetic stimulation. J ECT 2002;18:170–81. https://doi.org/10.1097/00124509-200212000-00002.Search in Google Scholar PubMed
72. Umezaki, Y, Badran, BW, Gonzales, TS, George, MS. Daily left prefrontal repetitive transcranial magnetic stimulation for medication-resistant burning mouth syndrome. Int J Oral Maxillofac Surg 2015;44:1048–51. https://doi.org/10.1016/j.ijom.2015.04.008.Search in Google Scholar PubMed
73. Abdi, S, Haruo, A, Bloomstone, J. Electroconvulsive therapy for neuropathic pain: a case report and literature review. Pain Physician 2004;7:261–3.10.36076/ppj.2004/7/261Search in Google Scholar
74. Hampf, G, Kuoppasalmi, K, Henriksson, M, Achte, K. Chronic facial pain together with severe depression is responsive to electroconvulsive therapy. A case report. Acta Odontol Scand 1992;50:129–32. https://doi.org/10.3109/00016359209012755.Search in Google Scholar PubMed
75. Ranoux, D, Attal, N, Morain, F, Bouhassira, D. Botulinum toxin type A induces direct analgesic effects in chronic neuropathic pain. Ann Neurol 2008;64:274–83. https://doi.org/10.1002/ana.21427.Search in Google Scholar PubMed
76. Restivo, DA, Tinazzi, M, Patti, F, Palmeri, A, Maimone, D. Botulinum toxin treatment of painful tonic spasms in multiple sclerosis. Neurology 2003;61:719–20. https://doi.org/10.1212/01.wnl.0000080081.74117.e4.Search in Google Scholar PubMed
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