Pain threshold and pain recovery after experimental stimulation in patients with burning mouth syndrome

Abstract

The aim of the present study was to examine pain threshold and pain recovery in patients with burning mouth syndrome (BMS) and matched no-pain controls. Twenty female patients diagnosed with BMS without organic gross changes were enrolled in the study. Twenty control subjects were chosen from age-matched healthy female volunteers. We compared the thermal pain threshold using heat beam dolorimeter on the finger and tongue between patients and controls. Warm (at 50°C for 5 s), cold (at 0°C for 30 s) and mechanical (stimulation by electric tooth brush for 15 s) stimulation was applied to the tongue for both groups. Participants were asked to rate the subjective pain using a visual analogue scale (VAS). Although there was no significant differences between patients and controls in terms of the threshold on the finger, the threshold on the tongue was significantly higher in patients than in controls. We suggest there were peripheral dysfunction at the tongue, and/or central dysfunction in patients with BMS. Among the three types of stimulation, the patients perceived significantly the highest pain from the mechanical stimulation for the first 5 min after the stimulation. Furthermore, when patients with BMS perceived some pain, they continued to complain of the pain longer and more intricately than the controls. This indicates that the pain of the patients is strongly affected not only at a sensory component but also at an affective/motivational component than the controls. However, we should be cautious of simply advancing psychogenic theory in this etiology.

Burning Mouth Syndrome. Update

“…Balasubramaniam et al [16] No systematic review. The article reviews different conditions and diseases that may be possible causes of oral burning.…”

“…Other changes in sensitivity are known to take place, besides oral stinging, which include: a feeling of dryness in the mouth [13][14][15] or gustative alterations, such as the perception of a bitter or metallic taste [16]. In certain instances dysesthesia in the mouth might also occur, which is characterized by the feeling of having sand in the mouth or swelling of the mouth [12,16,17].…”

“…Specific criteria should be observed, since symptoms of oral burning are common and can be caused by either local or systemic factors, which do not describe true BMS [15][16][17]28]. The clinical or laboratorial conditions associated with burning mouth include candidiasis, geographic tongue, hyposalivation, esophagic reflux, parafunctional habits, diabetes, nutritional deficiencies (iron, folate, B 1 , B 2 , B 6 , B 12 ), and adverse effects of certain drugs.…”

Síndrome de Boca Ardiente: actualización

“…Los hábitos parafuncionales (7,16,31) y la xerostomía (subjetiva u objetiva) se encuentran ínti-mamente ligados a este síndrome (12,(15)(16)(17)(32)(33)(34)(35)(36)(37)(38)(39). Sustancias de uso diario, como por ejemplo los dentífricos y otros cosméticos, pueden producir reacciones que desencadenen el síndrome (16,(40)(41)(42)(43)(44). También se asocian factores ligados a la actividad neural sensitiva de la mucosa bucal, pudiéndose encontrar disminución en el umbral del dolor y alteraciones del gusto tales como la "fantogeusia" (sabor a algo sin que halla nada dentro de la boca) (22, 45-47) (Tabla 2).…”

"The discomfort is still there, but I do not care much about it!" The Therapeutic Role of the Transference Relationship between the Patient Suffering from Complex Oral Sensitivity Disorder and the Oral Health-care Provider

“…Similarly, neuropathic mechanisms due to central (Albuquerque et al, 2006;Jaaskelainen et al, 2001;Hagelberg et al, 2003) and peripheral (Ito et al, 2002;Granot and Nagler, 2005;Lauria, et al, 2005;Just et al, 2010) nervous system impairment as well as psychiatric/psychosocial disturbances (Amenabar et al, 2008;Malik et al, 2011;Mignogna et al, 2011;de Souza et al, 2012;Schiavone et al, 2012;Adamo et al, 2013;Lopez-Jornet et al, 2015) have been implicated. Therefore, it is not surprising that diagnosis and management still appear an enormous challenge and enigma (Klasser et al, 2008;Klasser et al, 2011b).…”