Burning mouth syndrome (BMS) is characterized by a burning sensation in the oral cavity although the oral mucosa is clinically normal. The syndrome mostly affects middle‐aged women. Various local, systemic and psychological factors have been found to be associated with BMS, but its etiology is not fully understood. Oral complaints and salivary flow were surveyed in 669 men and 758 women randomly selected from 48,500 individuals between the ages 20 and 69 years. Fifty‐three individuals (3.7%), 11 men (1.6%) and 42 women (5.5%), were classified as having BMS. In men, no BMS was found before the age group 40 to 49 years where the prevalence was 0.7%, which increased to 3.6% in the oldest age group. In women, no BMS was found in the youngest age group, but in the age group 30 to 39 years the prevalence was 0.6% and increased to 12.2% in the oldest age group. Subjective oral dryness, age, medication, taste disturbances, intake of L‐thyroxines, illness, stimulated salivary flow rate, depression and anxiety were factors associated with BMS. In individuals with BMS, the most prevalent site with burning sensations was the tongue (67.9%). The intensity of the burning sensation was estimated to be 4.6 on a visual analogue scale. There were no increased levels of depression, anxiety or stress among individuals with more pain compared to those with less pain. It was concluded that BMS should be seen as a marker of illness and/or distress, and the complex etiology of BMS demands specialist treatment.

Medication and psychological processes may affect salivary flow and cause subjective oral dryness. The importance of these factors is unclear. The aim of this study was to evaluate the association of medication, anxiety, depression, and stress with unstimulated salivary flow and subjective oral dryness. We studied 1,202 individuals divided into three groups, and controls. Intake of medication was evaluated. Anxiety, depression, and stress were assessed. Unstimulated salivary flow < 0.1 mL/min and subjective oral dryness were significantly associated with age, female gender, intake of psychotropics, anti-asthmatics, and diuretics. Unstimulated salivary flow < 0.1 mL/min and no subjective oral dryness were significantly associated with age, intake of antihypertensives, and analgesics. Subjective oral dryness and unstimulated salivary flow > 0.1 mL/min were significantly associated with depression, trait anxiety, perceived stress, state anxiety, female gender, and intake of antihypertensives. Age and medication seemed to play a more important role in individuals with hyposalivation, and female gender and psychological factors in individuals with subjective oral dryness.

The objectives were to measure the prevalence of perceived stress in adults and to evaluate gender and age differences in stress level. Association between perceived stress and depression, anxiety and medication was also studied. A total of 1275 subjects (581 men and 694 women) were randomly selected in equal age groups. Perceived stress was measured with the Perceived Stress Questionnaire (PSQ). Two PSQ cut-off scores, moderate and high stress level, were yielded by using mean score and standard deviation. Depression was assessed with the Beck Depression Inventory (BDI) and anxiety with the State and Trait Anxiety Inventory (STAI). The intake of medications was registered and classified. The prevalence of moderate stress was estimated to be 10.0 per cent, lowest in the 60-69-year and highest in the 40-44-year age group. Women of 30-34 years had a higher frequency of moderate stress (11.1 per cent) than men in the same age group (5.9 per cent). The prevalence of high stress was 4.0 per cent, higher in women (5.5 per cent) than in men (2.2 per cent). Women in the age groups 30-34 years (12.7 per cent) and 35-39 years (8.1 per cent) reported a greater proportion of high stress than the men (0 per cent for both age groups). Low and moderate stress were associated with STAI and high stress with the BDI. The BDI attitudes self-punitive wishes, sleep disturbances and loss of appetite were associated with high stress. High stress was associated with psychotropic drugs. Antidepressants comprised the majority of psychotropic drugs used. It was concluded that women in the 30 to 39-year age group are exposed to high stress and are therefore a vulnerable group. Anxiety is more important in moderate stress levels and depression in high stress levels. Clinicians should be aware of the suicidal risk associated with high stress levels. It seems that psychotropic drugs alone are not sufficient to reduce stress levels.

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The effect of cognitive therapy (CT) on resistant burning mouth syndrome (BMS) was studied. Thirty patients with resistant BMS after odontological and medical treatment were randomly divided into two equal groups; a therapy group (TG) was treated with CT and an attention/placebo group (APG) served as a control group. The intensity of BMS, which was estimated by the use of a visual analogue scale, was significantly reduced in the TG directly after CT was completed and was further reduced in a 6-month follow-up. The APG did not show any decrease in intensity of BMS. The results of this study indicate that, in some cases, resistant BMS probably is of psychological origin.

The following articles refer to this text: 2012;38(4): 291-390; 2014;40(6):539-654

Erosive lichen planus is a severe disease with symptoms and complications affecting the patient's life. Our results indicate that their psychological health is also affected and emphasize the need for close collaboration between physicians, dentists with special knowledge in oral medicine and counsellors/psychologists to optimize handling of these patients.

Taste disturbance may cause subjective discomfort and impair appetite and food intake. The aim of this study was to estimate the prevalence of perceived taste disturbance and analyze its association to age, gender, whole salivary flow rate, subjective oral dryness, burning mouth, medication, and psychological factors. Five hundred forty-seven men and 656 women aged 20 to 69 years were randomly selected from the Public Dental Health Service register in northern Sweden. Oral complaints were registered and whole salivary flow rate measured. Medication, anxiety, depression, and stress were assessed. Thirty individuals (2.5%), five men (0.9%) and 25 women (3.8%), reported perceived taste disturbances (distorted taste or loss of taste). In men, no individual with taste disturbance was found in the youngest and oldest age groups. The prevalence in the 30-39-year age group was 1.9% and in the 40-49-year group 1.8%. In women, one individual (1%) with taste disturbance was found in the youngest age group. In the 30-39-year group, the prevalence was 3.8%, increasing to 5.1% in the oldest age group. Illness, subjective oral dryness, state anxiety, perceived stress, depression, use of antiasthmatics, and trait anxiety were associated with taste disturbance. It was concluded that perceived taste disturbance might be an interaction of various health factors such as illness and mental condition.