Alpha lipoic acid efficacy in burning mouth syndrome. A controlled clinical trial

Abstract

BackgroundA double-blind placebo-controlled trial was conducted in order to evaluate the efficacy of alpha lipoic acid (ALA) and determine the statistical significance of the outcome variables. Burning mouth syndrome (BMS) is defined as an oral burning sensation in the absence of clinical signs which could justify the syndrome. Recent studies suggest the existence of neurological factors as a possible cause of the disease.Material and Methods60 patients with BMS, in two groups: case group with 600 mg/day and placebo as control group; with follow up of 2 months.Results64% of ALA patients reported some level of improvement, with a level of maintenance of 68.75% one month after treatment. 27.6% of the placebo group also demonstrated some reduction in BMS symptoms.ConclusionsLong-term evolution and the intensity of symptoms are variables that reduce the probability of improvement with ALA treatment. Key words: Burning mouth syndrome, neuropathy, alpha lipoic acid.

Retrospective Review of Effectiveness of Various Pharmacological Agents in Treating Burning Mouth Syndrome

“…12) Results pertaining to the therapeutic effect of alpha-lipoic acid are mixed and inconclusive. Some studies 13,14) reported improvement, while others [15][16][17] failed to demonstrate effectiveness over placebo.…”

An overview of burning mouth syndrome for the dermatologist

“…A final recent RCT found in favour of α‐LA 600 mg/day for 2 months over placebo (16/25 patients improving in the active arm versus 8/29 in the placebo group, P < 0.05) . There were significant methodological and reporting deficiencies in the study.…”

The efficacy of fluoxetine in BMS—A cross‐over study

“…Idiopathic BMS represents chronic intraoral burning sensation for which no local or systemic cause can be found, and clinical examination shows no pathological changes in oral mucosa . It has been shown that many disorders such as Xerostomia, oral infections, denture‐related problems, allergies, diseases of oral mucosa, Sjogren's syndrome, nutritional deficiencies, hormonal disturbances, some endocrine disorders, oesophageal reflux, medication side effects, depression, anxiety, hypochondriasis and cancerophobia are associated with BMS, although a causative relationship has not been proven between BMS and a majority of these disorders …”

“…The symptoms of BMS are usually bilateral. They do not follow the anatomical distribution of peripheral sensory nerve, and their intensity varies during the day and rarely affects sleep . They include burning sensation which most commonly affects the tongue, then lips, palate and gingival, or a whole oral cavity.…”

“…The therapy for primary BMS is not established due to its unknown aetiology. Establishing the therapy depends on the condition of the patient and doctor's preferences . Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) antidepressant and is effective in treating neuropathic pain.…”