Sphenopalatine ganglion block - a new treatment for burning mouth syndrome?: a case report

Abstract Burning mouth syndrome is a poorly understood entity for which current treatment modalities fail to provide effective relieve. Branches of the maxillary and mandibular nerves are responsible for the innervation of the affected area. These are also the nerves involved in trigeminal neuralgia, an entity where sphenopalatine block has proved to be effective. We present a case of a patient with burning mouth syndrome in whom a bilateral sphenopalatine ganglion block was successfully performed for pain treatment. It is an easy and safe technique that can be a valuable treatment option for these patients, although more studies are needed.

Effect of auricular point therapy on the psychological state and plasma β-endorphin level of patients with burning mouth syndrome / 口腔疾病防治

Objective@# To observe the clinical effects of auricular point therapy on burning mouth syndrome (BMS) and its effect on the psychological state of patients and plasma β-endorphin. @*Methods @# A total of 105 patients diagnosed with BMS were randomly divided into an auricular acupoint application group (50 cases) and a drug treatment group (55 cases). The treatment course lasted one month. The patients in the auricular acupoint application group selected 3 points on their tongue, heart and Shenmen through traditional Chinese medical dialectics used for patients with BMS. Wangbuliu seeds were applied, two ears were pressed alternately and one ear was applied each time. The patient was instructed to press the treatment site three times a day, 1-2 min each time, until the auricle skin became reddish and hot. The patients in the drug treatment group took vitamin E 100 mg+oryzanol 10 mg+vitamin B2 10 mg orally three times a day. Before and after treatment, the pain intensity and mental and psychological state of the patients were evaluated. The patient's plasma was detected before and after β-endorphin treatment. @* Results@#The pain sensation intensity of the two groups decreased after treatment (P<0.001). After treatment, the scores of somatization (t = 2.118, P = 0.037), fear (t = 2.084, P = 0.039) and diet and sleep (t = 2.047, P = 0.043) in the auricular acupoint application group were significantly improved compared with the level before treatment. The level of β-endorphin in plasma was increased, and the difference was statistically significant (t = 2.247, P = 0.027) in the auricular acupoint application group after treatment. @*Conclusion@#Auricular point therapy is an effective method for patients with BMS, improving psychological state and promoting the synthesis of plasma β-endorphin may be one of its mechanisms.

Advances in comprehensive multidisciplinary treatment for burning mouth syndrome / 口腔疾病防治

@#Burning mouth syndrome (BMS) is a chronic oral and facial pain disorder characterized by burning pain in the oral mucosa, with multiple pathogenic factors including psychosocial, neuropathological, endocrine, and immune factors. There is still a lack of effective treatment options that have been demonstrated to work. With the development of research on the pathogenesis and treatment of BMS, multidisciplinary comprehensive treatment has gradually been introduced and become a new trend of diagnosis and treatment. Before multidisciplinary treatment, it is necessary to go through a full and comprehensive diagnosis and analysis, select the best comprehensive treatment plan, take the diagnosis and treatment of stomatology as the basis and premise, and apply other multidisciplinary combined treatment, including the treatment of concurrent diseases, psychological interventions, correction of bad habits, etc. A combination of laser therapy and psychological intervention is a more effective treatment method among the current treatment methods, with high comfort and good acceptance by patients. If necessary, mecobalamin tablets, clonazepam α-lipoic acid and other drugs can be used to nourish nerves and provide symptomatic treatment. The comprehensive multidisciplinary treatment of BMS is expected to become a new trend and provide a new strategy for improving the therapeutic effect.

Monitoring results of coal-burning-borne endemic fluorosis in Yunnan Province in 2020 / 中华地方病学杂志

Objective:To learn about the current situation of prevention and control of coal-burning-borne endemic fluorosis (coal burning fluorosis for short) in Yunnan Province, and comprehensively evaluate the implementation effect of prevention and control measures.Methods:From August to November 2020, according to the requirements of the Monitoring Program of Yunnan Province for Coal-burning-borne Endemic Fluorosis (2019 edition), monitoring was carried out in all natural villages in the disease areas of 13 counties (cities and districts, hereinafter referred to as counties) of the province, and 30 households were selected from each natural village to monitor the use of stoves and the formation of related healthy living behaviors. At the same time, children aged 8 - 12 years in the natural villages in the disease areas were examined for the prevalence of dental fluorosis. The evaluation for control and elimination of disease areas was carried out in accordance with the Evaluation Approach for Control and Elimination of Priority Endemic Diseases (2019 edition).Results:A total of 392 244 households were investigated, and the rates of qualified improved stoves, the correct utilization of qualified improved stoves and correct drying of corn and pepper were 99.42% (389 982/392 244), 99.70% (388 796/389 982) and 99.07% (388 579/392 244), respectively. A total of 227 057 children aged 8 - 12 years were examined, 9 413 children of dental fluorosis were detected, the detection rate of dental fluorosis was 4.15%, the dental fluorosis index was 0.10, and the prevalence intensity was negative. Taking the county as a unit, except Fuyuan and Zhenxiong, which reached the control standard of the disease area, the remaining 11 counties reached the elimination standard.Conclusion:The prevention and control measures on coal burning fluorosis are implemented well in Yunnan Province and healthy lifestyle has gradually taken shape, with the overall condition of the disease reduced.

Evaluation of peripheral nerve fibers and mast cells in burning mouth syndrome

Abstract Emerging evidence has revealed a cross-talk in the etiopathogenesis of burning mouth syndrome (BMS) related to peripheral nerve fibers (NF) and neuropeptides secreted by mast cells. Here, we investigated the S-100+ density and PGP 9.5+ integrity of peripheral NF and the tryptase+ mast cell density in the oral mucosa of BMS patients and healthy individuals. A total of 23 oral mucosa specimens (12 BMS and 11 controls) were evaluated. The clinical diagnosis of BMS was based on a careful examination, excluding other local and systemic causes. Samples were taken from an incisional biopsy of the tongue mucosa of individuals with symptomatic BMS, while the margins of the non-neoplastic tongue biopsy served as controls of healthy individuals. Immunohistochemistry was performed to determine the density/mm2 of S-100+, PGP 9.5+ peripheral NF, and tryptase+ mast cells. Similar densities of S-100+, PGP 9.5+ peripheral NF, and tryptase+ mast cells were found in cases of BMS, with a median value of 3.70, 0.70, and 29.24/mm2, respectively, and in the control group, with a median value of 2.60, 0.80, and 26.01/mm2, respectively (p > 0.05). Moreover, the relationship between S100+ and PGP 9.5+ peripheral NF was the same in both groups (p = 0.70). This study demonstrated that there were no alterations in the density and integrity of peripheral NF in the tongue of symptomatic BMS patients. However, the sensitization of peripheral NF in this disease may not depend on mast cell density.

Voltage-gated sodium channels gene expression in Burning Mouth Syndrome: a case-control study

Abstract Burning mouth syndrome (BMS) is a condition characterized by painful symptoms of the oral mucosa, despite the absence of any clinical signs. Its etiology is unknown, and there is still no effective treatment to date. Current evidence has shown neuropathic impairment in BMS patients. Neuropathic pain can be related to the dysfunction of voltage-gated sodium channels, considering that these receptors regulate the induction of action potentials in nociceptive neurons. This study evaluated the gene expression of voltage-gated sodium channels Na v 1.7, Na v 1.8 and Na v 1.9 in these patients. The gene expressions of these channels were assessed by real time RT-PCR analysis of fresh-frozen tongue biopsies in a case-control study composed of 12 patients with BMS, and 5 healthy control patients, proportionally matched by sex and age, and analyzed using the 2^(-Delta Delta CT) method. There was no statistically significant difference between the analyzed groups, despite the increase in Na v 1.7 (fold-change = 3.13, p = 0.52) and decrease in Na v 1.9 (fold-change = 0.45, p = 0.36) gene expression in the BMS group. The Na v 1.8 gene was not expressed in any of the samples analyzed. Although the gene expression in the voltage-gated sodium channels in BMS under study seems to be comparable with that of the normal oral mucosa, the functionality of these channels in BMS has not yet been identified, thus suggesting that further research is needed to better understand these voltage-gated sodium channels.

Burning mouth syndrome is an oral disease connected to emotions

Burning mouth syndrome presents several challenges, which involve the ignorance of the disease and the psychological and economic barriers for the patients who suffer from it. This letter has a reflection on how the syndrome is related to emotions.

Efficacy of topical tulsi (Ocimum sanctum) paste for the management of oral submucous fibrosis – A clinical study

Context: Oral submucous fibrosis (OSMF) is a chronic insidious oral potentially malignant disorder characterized by increased collagen deposition and reduced collagen degradation causing burning sensation and difficulty in mouth opening. Aim: To assess the efficacy of topical Tulsi (Ocimum sanctum) paste for the management of OSMF. Settings and Design: Institution?based clinical trial. Materials and Methods: The study included a total of 60 OSMF patients categorized into three Groups A, B and C (20 in each) depending on the severity according to Lai DR et al. classification. The patients were advised for topical Tulsi paste application and were evaluated for the reduction in the burning sensation and improvement in mouth opening every month for 3 subsequent months using the numeric pain rating scale (NRS) and a Vernier calliper, respectively. Statistical Analysis: The baseline and 3?month recordings were subjected to inter? and intra?group statistical analysis using Kruskal–Wallis analysis of variance (ANOVA), Mann–Whitney U, one?way ANOVA, Tukey’s multiple post?hoc and Wilcoxon matched?pairs tests. Results: There was a reduction in the burning sensation and improvement in the mouth opening in all three groups. The reduction in the burning sensation was statistically significant among all the groups (P < 0.05) and the NRS scores after 3 months among the three groups were not statistically significant (P > 0.05). There was a statistically significant difference (P < 0.05) in the improvement of mouth opening between Group A and B; A and C; but not between B and C. Conclusion: Tulsi paste showed a significant reduction in the burning sensation and improvement of the mouth opening thereby proving to be a safe and promising medicament for OSMF

Trastornos del gusto: actualización y aproximación clínica / Taste disorders: update and clinical approach

Resumen Los trastornos del gusto constituyen un grupo de alteraciones relativamente frecuentes en la práctica clínica. Son de etiología diversa, pudiendo afectar la vía gustativa en distintos niveles, manifestándose, clínicamente, con alteraciones cuantitativas y/o cualitativas de la sensibilidad gustativa. En gran parte de los casos se puede lograr un diagnóstico etiológico con una anamnesis adecuada, examen físico y exploraciones complementarias básicas. No obstante, existe poco entendimiento de su patogénesis, así como limitadas opciones terapéuticas, lo que implica la falta de algoritmos de diagnóstico y tratamiento completamente validados. El objetivo de la presente revisión es otorgar una actualización y un abordaje práctico de los trastornos del gusto.

Abstract Taste disorders represent a group of alterations relatively frequent in clinical practice. They have a diverse etiology, and they can affect the gustatory pathway at different levels, clinically manifesting with quantitative/qualitative alterations on taste sensitivity. In most of cases it is possibly to achieve an etiologically diagnosis with appropriate anamnesis, physical exploration, and basic complementary tests. However, their pathogenesis is not well understood, and they have limited therapeutic options, which determines a lack of well-validated diagnosis and treatment algorithms. The objective of this review is to provide and update and a practical approach to taste disorders.

Análise comparativa do tratamento do ardor bucal com terapia a laser de baixa intensidade e estimulação elétrica nervosa transcutânea: um ensaio clínico randomizado / Comparative analysis of the treatment of burning mouth with low-intensity laser therapy and transcutaneous electrical nerve stimulation: a randomized clinical trial

Introdução: O manejo de pacientes com ardor bucal é um desafio no cotidiano clínico da odontologia. Objetivo: Comparar o efeito da Terapia a Laser de Baixa Intensidade (LLLT) e da Estimulação Elétrica Nervosa Transcutânea (TENS) no tratamento do ardor bucal. Metodologia: Ensaio clínico randomizado constituído por 25 pacientes com ardor bucal que foram tratados por TENS (n=12) e por LLLT (n=13). Os protocolos de tratamento foram aplicados semanalmente por 8 semanas. O teste análise de variância (ANOVA) dois fatores foi usado para verificar se existia diferença significativa entre os tempos T0 (antes de iniciar o tratamento), T1 (após a 4ª sessão de tratamento), T2 (após a 8ª sessão de tratamento) e T3 (30 dias após o término do tratamento) em relação aos sintomas, analisados por meio da Escala Visual Analógica (EVA), fluxo salivar não estimulado, xerostomia e disgeusia com as intervenções de TENS e LLLT. Resultados: A maioria dos pacientes foi do sexo feminino no período pós-menopausa com média de idade no grupo TENS de 59,25 anos e no grupo LLLT de 62,08. Hipertensão e dislipidemia foram as alterações sistêmicas mais frequentes. Ansiedade e depressão foram os únicos transtornos psiquiátricos relados. A maioria dos pacientes fazia uso de medicamentos como anti-hipertensivos e antidepressivos. Não foram observadas variações expressivas no que se refere a xerostomia e a disgeusia nos dois grupos analisados. A TENS e a LLLT foram eficazes na redução dos sintomas relatados pelos pacientes (p˂0,001), entretanto, observou-se entre os tempos T2 e T3 que o grupo LLLT apresentou uma melhor resposta quando comparado ao TENS (p=0,003). Os pacientes do grupo TENS apresentaram aumento do fluxo salivar entre os tempos T1 e T2, enquanto o grupo LLLT apresentou uma diminuição (p=0,052). Conclusão: A TENS e a LLLT foram eficazes na redução dos sintomas do ardor bucal durante o tratamento e 30 dias após o término do tratamento, sendo que o grupo LLLT apresentou uma melhor resposta na sessão de acompanhamento pós-tratamento quando comparado ao grupo TENS (AU).

Introduction: The management of patients with burning mouth is a challenge in the clinical routine of dentistry. Objective: To compare the effect of Low Intensity Laser Therapy (LLLT) and Transcutaneous Electrical Nerve Stimulation (TENS) in the treatment of burning mouth. Methodology: Randomized clinical trial consisting of 25 patients with burning mouth who were treated with TENS (n=12) and LLLT (n=13). Treatment protocols were applied weekly for 8 weeks. The two-way analysis of variance (ANOVA) test was used to verify whether there was a significant difference between the times T0 (before starting treatment), T1 (after the 4th treatment session), T2 (after the 8th treatment session) and T3 (30 days after the end of treatment) in relation to symptoms, analyzed using the Visual Analogue Scale (VAS), unstimulated salivary flow, xerostomia and dysgeusia with TENS and LLLT interventions. Results: Most patients were female in the postmenopausal period, with a mean age of 59.25 years in the TENS group and 62.08 in the LLLT group. Hypertension and dyslipidemia were the most frequent systemic alterations. Anxiety and depression were the only psychiatric disorders reported. Most patients used drugs such as antihypertensives and antidepressants. Significant variations were not observed with regard to xerostomia and dysgeusia in the two groups analyzed. TENS and LLLT were effective in reducing the symptoms reported by patients (p˂0.001), however, it was observed between times T2 and T3 that the LLLT group showed a better response when compared to TENS (p=0.003). Patients in the TENS group showed an increase in salivary flow between times T1 and T2, while the LLLT group showed a decrease (p=0.052). Conclusion: TENS and LLLT were effective in reducing the symptoms of burning mouth during treatment and 30 days after the end of treatment, and the LLLT group showed a better response in the posttreatment follow-up session when compared to the TENS group (AU).

Síndrome da ardência bucal: relato de caso clínico / Oral burning syndrome: a clinical case report

O presente estudo teve como objetivo principal descrever por meio de um relato de caso clínico o diagnóstico e a conduta clínica de uma paciente portadora da Síndrome da Ardência Bucal (SAB). A SAB é definida como uma dor crônica e de difícil diagnóstico e difícil tratamento. O local mais acometido pela SAB é a língua, lábios e mucosa jugal, mas pode estar presente em qualquer parte da mucosa oral, causando desconforto e interferindo na qualidade de vida do paciente. Paciente do sexo feminino, leucoderma, 39 anos, sem histórico de doenças sistêmicas, saúde geral em bom estado, procurou atendimento no Centro Universitário da Serra Gaúcha ­ FSG por apresentar sensação de ardência recorrente na língua e na mucosa, que aumentava em momentos de estresse ou durante a ingestão de alimentos cítricos, picantes ou quentes. A paciente realizou exames complementares (hemograma completo, glicemia de jejum, exame de vitamina B12) e primeiramente, iniciou-se o tratamento com antifúngico tópico para remoção de uma camada esbranquiçada presente no dorso da língua. Após a remissão desta, foi utilizado AD-Muc tópico 2 vezes ao dia, durante 2 semanas e relatou ter reduzido seus sintomas em torno de 70%. A paciente ainda apresentava xerostomia e, então foi prescrita saliva artificial. A paciente teve a regressão total de seus sintomas. Pode-se concluir que diversos fatores etiológicos estão relacionados com a SAB, porém sua causa específica permanece desconhecida. O tratamento é paliativo, entretanto, o Ad-muc tópico se mostrou eficaz na redução da sintomatologia da SAB juntamente com o uso da saliva artificial(AU)

The present study aimed to describe, through a clinical case report, the diagnosis and clinical conduct of a patient with Burning Mouth Syndrome (BMS). BMSis defined as chronic pain that is difficult to diagnose and difficult to treat. The site most affected by BMS is the tongue, lips, and cheek mucosa, but it can be present in any part of the oral mucosa, causing discomfort and interfering with the patient's quality of life. Female patient, leucoderma, 39 years old, with no history of systemic diseases, general health in good condition, sought care at the Centro Universitário da Serra Gaúcha - FSG for presenting a recurrent burning sensation in the tongue and mucosa, which increased in times of stress or while eating citrus, spicy or hot foods. The patient underwent complementary tests (complete blood count, fasting blood glucose, vitamin B12 test) and first, treatment with topical antifungal was started to remove a whitish layer present on the back of the tongue. After remission, topical AD-Muc was used twice a day for 2 weeks and reported to have reduced his symptoms by around 70%. The patient still had xerostomia and then artificial saliva was prescribed. The patient had a total regression of her symptoms. It can be concluded that several etiological factors are related to SAB, but its specific cause remains unknown. Treatment is palliative, however, topical Ad-muc is effective in reducing the symptomsof BMS also with the use of artificial saliva(AU)

Síndrome de la boca ardiente: revisión de la literatura / Burning mouth syndrome: literature review

Resumen El síndrome de la boca ardiente (SBA) es una condición de dolor crónico en la cavidad oral, que se presenta mayoritariamente en mujeres de edad media. Diversas causas locales y sistémicas pueden producirlo en forma secundaria, o bien, puede representar un cuadro primario, sin etiología específica identificable. Su etiopatogenia y evolución clínica es poco comprendida. Las opciones terapéuticas son variadas y en general es necesario un tratamiento multidisciplinario. A continuación, se presenta una revisión de la literatura respecto a esta patología para difusión en nuestro medio.

Abstract Burning mouth syndrome (BMS) is a chronic pain condition of the oral cavity, which occurs more frequently in middle-aged women. It can be secondary to different local and systemic causes, or represent a primary condition, with no specific identifiable etiology. Its etiopathogenesis and clinical evolution are poorly understood. Therapeutic options are multiple and a multidisciplinary treatment is necessary. We present a review of the literature regarding BMS, to provide information relevant to our area of expertise.

Assessment of therapeutic effects of low-energy laser for the treatment of burning mouth syndrome in elderly patients / 中华老年医学杂志

Objective:To assess the clinical efficacy of low-level laser therapy(LLLT)for the treatment of burning mouth syndrome(BMS)in elderly patients.Methods:As a randomized controlled study, 60 elderly BMS patients treated in the department of stomatology of Beijing Hospital from September 2018 to August 2021 were randomly divided into a laser group and a control group, including 7 man and 53 women, with an average age of(68.27±6.38)years.Patients in the laser group were treated with LLLT, and patients in the control group were treated with non-energy red light and oryzanol.The visual analogue scale and self-rating anxiety and depression scale were used to evaluate the two groups of patients.Results:After LLLT, the effectiveness rate of the laser group was 86.67%(26/30)on the 28th and 90th day, which was significantly higher than 63.33%(19/30)of the control group( χ2=4.356, P=0.037). When data for pre-treatment, the 28th day after treatment and the 90th day after treatment for the laser group were compared, results showed that after LLLT, pain symptoms of BMS patients were relieved and it lasted for some time, and anxiety and depression also improved, but there were episodes of relapse as time went on.Visual analogue scale and self-rating anxiety scores and depression scale scores of BMS patients for pre-treatment, the 28th and 90th days after treatment in the two groups were compared.Only self-rating anxiety scale scores of the laser group was lower than those of the control group on the 28th day, with statistical significance( t=2.622, P=0.011), indicating that LLLT could alleviate anxiety for BMS patients in the short term, but had no significant effect on patient depression.However, in the long term, LLLT had no significant effect on relieving anxiety and depression. Conclusions:LLLT has a certain effect on improving pain symptoms and anxiety in elderly BMS patients.

Evaluation of a Protocol For Topical Application of Capsaicine Gel 0.025 % in the Management of Burning Mouth Syndrome Correlating its Impact on Quality of Life

ABSTRACT: The aim of this study is to report the results obtained with a protocol of topical application of capsaicin gel 0.025 % in the management of burning mouth syndrome (BMS) to evaluate the influence of the disease and treatment on their quality of life (QOL) using the OHIP-14 questionnaire (Oral Health Impact Profile). After clinical examination and diagnosis of BMS, 10 patients reported the intensity of the burning by means of a subjective score ranging from 0 to 10 and also answered the OHIP-14. Then, a topical application protocol of capsaicin gel 0.025 % was initiated, with weaning from medication and complete withdrawal within 180 days. At each reassessment consultation (30, 60, 90 and 180 days), the patients answered the OHIP-14 and subjective burning scores were collected again. Overall, the capsaicin gel showed gradual reduction or elimination of symptoms of BMS, as well as an improvement in the QOL of patients throughout treatment. At 180 days, after medication withdrawal, 6 patients (60 %) reported total absence of burning and in four patients (40 %) the score remained or decreased. In one patient (10 %) the score increased, although it remained below the initial score. The results showed an improvement in the QOL of all patients who completed the protocol and the impact of BMS on the QOL decreased in relation to the initial score in all patients. The topical use of 0.025 % capsaicin gel was effective in reducing or remitting symptoms of BMS. The OHIP-14 questionnaire showed the negative impact of BMS on patients' QOL and the role of treatment in its improvement.

RESUMEN: El objetivo de este estudio fue reportar los resultados obtenidos con un protocolo de aplicación tópica de gel de capsaicina al 0,025 % en el manejo del síndrome de boca ardiente (SBA), para evaluar la influencia de la enfermedad y el tratamiento en su calidad de vida (CV) mediante el cuestionario OHIP-14. Tras el examen clínico y diagnóstico de SBA, 10 pacientes refirieron la intensidad del ardor mediante una puntuación subjetiva de 0 a 10 y también respondieron la OHIP-14. Luego, se inició un protocolo de aplicación tópica de gel de capsaicina al 0,025%, con destete de la medicación y retiro completo en 180 días. En cada consulta de reevaluación (30, 60, 90 y 180 días), los pacientes respondieron el OHIP-14 y se recogieron nuevamente las puntuaciones subjetivas de quemado. En general, el gel de capsaicina mostró una reducción o eliminación gradual de los síntomas del SBA, así como una mejora en la calidad de vida de los pacientes durante todo el tratamiento. A los 180 días, después de la retirada de la medicación, 6 pacientes (60 %) informaron ausencia total de ardor y en cuatro pacientes (40%) la puntuación se mantuvo o disminuyó. En un paciente (10 %) la puntuación aumentó, aunque se mantuvo por debajo de la puntuación inicial. Los resultados mostraron una mejora en la CV de todos los pacientes que completaron el protocolo y el impacto de SBA en la CV disminuyó en relación con la puntuación inicial en todos los pacientes. El uso tópico de gel de capsaicina al 0,025 % fue efectivo para reducir o remitir los síntomas del SBA. El cuestionario OHIP-14 mostró el impacto negativo de SBA en la CV de los pacientes y el papel del tratamiento en su mejora.

Clinical analysis and literature review of 6 cases of burning mouth syndrome-like symptoms caused by the long-term oral administration of omeprazole / 口腔疾病防治

Objective @#To analyze the oral adverse drug reactions induced by omeprazole and provide a reference for rational clinical drug use.@*Methods@#From January 2019 to June 2020, the clinical data of patients with burning mouth syndrome caused by omeprazole were collected and analyzed. Additionally, the related literature was reviewed. @*Results@#Among the six patients, omeprazole was taken orally for as little as 6 months and as long as more than 5 years. The symptoms of burning mouth syndrome were mainly burning sensation in the mouth and paresthesia on the tongue that might be accompanied by extremity numbness. Vitamin and trace element supplementation was administered. The patient discontinued omeprazole, and symptoms disappeared after symptomatic treatment for 1 month to half a year. Literature review suggests that the reason may be associated with peripheral or central nervous system injury, altered saliva composition, and impaired vitamin and micronutrient intake caused by omeprazole.@*Conclusion @# The cause of burning mouth syndrome-like symptoms may be related to peripheral nerve injury caused by omeprazole and saliva changes. The main treatment is withdrawal and symptomatic treatment.

Research progress in the treatment of oral submucous fibrosis with traditional Chinese medicine and Western medicine / 口腔疾病防治

@#Oral submucous fibrosis is a chronic, occult and progressive potentially malignant disease that seriously affects the oral function and quality of life of patients. The oral burning sensation and limitation of mouth opening are the main reasons for patients to see a doctor. At present, the main treatment for oral submucosal fibrosis is still drug therapy. To provide ideas and references for the clinical treatment of oral submucosal fibrosis, this article reviews the mechanism, therapeutic effect and characteristics of common Chinese and Western medicine in the treatment of oral submucosal fibrosis. The results of the literature review show that salvia miltiorrhiza, aloe, lycopene, curcumin and other traditional Chinese medicine and Western medicine are effective in the treatment of oral submucosal fibrosis; in addition, Taohong Siwu Decoction combined with Western medicine and other combinations of traditional Chinese and Western medicine are effective and reduce side effects, and clinicians can choose appropriate drugs according to the patient’s main symptoms and general condition. In the future, researchers can study more combinations of traditional Chinese and Western medicine to treat oral submucosal fibrosis.

Amalgam allergy and Burning Mouth Syndrom: treatment and 25 years recall / Alergia ao amálgama e Síndrome da ardência bucal: tratamento e 25 anos de proservação

Background: Burning mouth syndrome (BMS) is a non-neuropathic chronic orofacial pain condition, characterized by the presence of burning/warm sensation without specific mucosal lesions. Objective: The aim of the present clinical case report is to describe the positive outcome of dental treatment of a patient with BMS and followed up for 25 years. Data Treatment: This report describes the case of a 50-year-old black woman sought treatment for burning, and persistent swelling of tong (24h/day) occurring over years. Clinical evaluation of the oral environment revealed the tongue with cracking, darkened points areas, surrounded by whitish areas. Twelve teeth presented extensive amalgam restorations. Patch testing revealed a very strong hypersensitivity to Amalgam. All amalgam restorations were substituted by composite resin restorations. Results and Conclusion: Burning sensation disappeared completely after these restorations had been changed. After 25-year follow-up period, it was observed that burning sensation has never been felt anymore. Clinical Significance: Burning mouth syndrome is a chronic orofacial pain, usually without specific mucosal lesions. The etiology is complex and multifactorial and the treatment should be made specifically for each pacient. (AU)

Introdução: A síndrome de ardência bucal (SAB) é uma condição de dor orofacial crônica não neuropática, caracterizada pela presença de sensação de queimação/calor sem lesões específicas da mucosa. Objetivo: Oobjetivo do presente relato de caso clínico é descrever a evolução positiva do tratamento odontológico de uma paciente com SAB e o retorno após 25 anos. Tratamento dos Dados: Este relato descreve o caso de uma mulher negra de 50 anos que buscou tratamento por queimadura e edema persistente da língua (24h/dia) ocorrendo ao longo dos anos. A avaliação clínica da cavidade bucal revelou a língua com áreas fissuradas e áreas com pontos escurecidos circundadas por áreas esbranquiçadas. Doze dentes apresentavam restaurações extensas de amálgama de prata. O teste de contato revelou hipersensibilidade muito forte ao amálgama de prata. Todas as restaurações de amálgama de prata foram substituidas por restaurações de resina composta. Resultados e Conclusão: A sensação de queimação desapareceu completamente após a substituição das restaurações. Após um periodo de 25 anos, observou-se que a sensação de queimação nunca foi mais relatada. Significado Clínico: a síndrome da ardência bucal é uma dor orofacial crônica, geralmente sem lesões específicas da mucosa. A etiologia é complexa e multifatorial e o tratamento deve ser feito especificamente para cada paciente.(AU)

Conhecimento científico produzido sobre a Síndrome da Ardência Bucal nos últimos cinco anos / Scientific knowledge produced about Bucal Ardence Syndrome in the last five years

Objetivo: realizar revisão integrativa da literatura sobre a Síndrome da Ardência Bucal (SAB). Materiais e Método: trata-se de uma revisão integrativa da literatura sobre a SAB nos últimos cinco anos. Utilizou-se as bases de dados Medline, SciELO e Lilacs para a pesquisa, empregando de forma combinada os descritores relacionados à temática. Como critérios de inclusão, decidiu-se selecionar publicações sobre a temática que estivessem disponíveis para leitura em qualquer idioma dos últimos cinco anos. Foram excluídos os estudos sem relação com o tema. Resultados: após análise, apenas 42 estudos foram selecionados para esta revisão. A maior parte dos artigos era publicada em inglês, porém, foi o Brasil que apresentou o maior número de publicações. As pesquisas avaliadas demonstraram os seguintes resultados: o sexo feminino é o mais acometido; maior prevalência acima dos 60 anos; dor, queimação e xerostomia são os sintomas mais relatados. O laser foi bastante relatado como terapia, além do uso de fármacos. Conclusão: a revisão apresentada neste artigo constatou que a maioria dos artigos, apesar de oriundos do Brasil, foi publicada no idioma inglês. A maioria dos trabalhos destacou que indivíduos do sexo feminino acima dos 60 anos são mais acometidos. Pacientes com SAB apresentam dor e queimação em língua e palato, principalmente. Fatores psicológicos e gastrointestinais podem estar associados ao aparecimento desta síndrome, e os usos do laser e de fármacos fitoterápicos, ou não, parecem melhorar o quadro clínico dos indivíduos acometidos.(AU)

Objective: to perform an integrative review of the literature on Burning Mouth Syndrome (BMS). Materials and Method: This is an integrative review of the literature on Burning Mouth Syndrome over the last five years. The Medline, SciELO, and Lilacs databases were used for the research, using the descriptors related to the topic in combination. The inclusion criteria consisted of publications on the topic that were available for reading in any language over the last five years. Studies unrelated to the topic were excluded. Results: After the analysis, only 42 studies were selected for this review. Most articles were published in English but Brazil had the highest number of publications. The studies evaluated showed the following results: women are the most affected; highest prevalence over 60 years old; and pain, burning, and xerostomia are the most reported symptoms. The laser was extensively reported as therapy, as well as the use of other drugs. Conclusion: The review presented in this article found that most studies were published in Brazil but in the English language. Most studies highlighted that women over 60 years old are more affected. Patients with BMS experience pain and burning especially in the tongue and palate. Psychological and gastrointestinal factors may be associated with the onset of this syndrome, and the use of laser and other drugs, either herbal medicines or not, seems to improve the clinical condition of the individuals affected.(AU)

Eritromelalgia. Informe de un caso / Erythromelalgia. Case Report

Resumen La eritromelalgia es una enfermedad rara, crónica, poco conocida, de difícil diagnóstico y tratamiento. Caracterizada por enrojecimiento, calor, dolor intenso y ardor en la parte distal de las extremidades. Afecta fundamentalmente manos, pies, nariz y orejas. El rubor, el dolor y el calor de las extremidades aumentan al exponerse a altas temperaturas, así como después de realizar ejercicio. Los síntomas suelen aliviarse mediante la inmersión de la extremidad afectada en agua fría. Se presenta un caso de una mujer de 33 años de edad, blanca, con afectación predominantemente en las manos. A través del interrogatorio minucioso y la realización de los exámenes complementarios realizados se concluyó que la variante etiológica que presentó la paciente era una eritromelalgia primaria o idiopática. Se impuso tratamiento con aspirina y nifedipino. La evolución clínica de la paciente fue favorable (AU).

ASBTRACT Erythromelalgia is a rare, chronic, little known disease, of difficult diagnosis and treatment. It is characterized by redness, heat, and intense pain and burning in the distal part of the extremities. It mainly affects hands, feet, nose and ears. The flushing, pain and warmth of the extremities increase when exposed to high temperatures as well as after exercise. The symptoms are usually relieved by immersing the affected limb in cold water. The authors present the case of a white, 33-years-old woman, with predominantly involved hand. Through a detailed interview and complementary tests they concluded that the etiological variant presented by the patient was a primary or idiopathic erythromelalgia. Treatment with aspirin and nifedipine was prescribed; the clinical progress of the patient was successful (AU).

Is Burning Mouth Syndrome Based on a Physiological Mechanism which Resembles that of Neuropathic Pain? / Comparación entre el mecanismo fisiológico del síndrome de la boca ardiente y el dolor neuropático

Abstract: Burning mouth syndrome (BMS) is a chronic intraoral pain state that has been described as burning pain, tingling or numbness in the oral mucosa, in the absence of any organic disease. Most often affecting the tongue, anterior palate, and/or lips. The diagnosis of primary BMS is purely clinical and based on patients' description of typical subjective symptoms as well on the exclusion of any systemic or local factors that may give rise to secondary burning pain sensations within the oral mucosa. Relevant studies links BMS to a peripheral neuropathy and BMS patients have revealed distinct abnormalities within the trigeminofacial large and small fiber systems and the trigeminal brainstem complex. Therefore, treatment approach should involve a multidisciplinary character similar to the treatment for neuropathic pain including factors that might also play a role on the BMS etiology and pathophysiology.

Resumen: El síndrome de la boca ardiente (SBA) es un estado crónico de dolor intraoral descrito por pacientes como dolor o sensación quemante, de cosquilleo o adormecimiento de la mucosa oral, con ausencia de lesiones visibles en la boca. Puede afectar la lengua, el paladar anterior y o los labios. Su diagnóstico es basado en la típica descripción subjetiva del paciente, excluyendo cualquier otro factor sistémico o local que podría provocar cualquier otra sensación quemante dentro de la mucosa oral. Estudios relevantes han mostrado que SBA primario parece tener una patofisiología de origen de tipo neuropático donde pacientes con SBA pueden presentar distintas anormalidades en el complejo trigeminal a nivel de las fibras sensoriales delgadas y gruesas. Por tanto, el tratamiento y manejo de estos pacientes debe ser de la misma manera multidisciplinaria como en el caso con el dolor neuropático, sin olvidar incluir el manejo de todos los factores que podrían intervenir en la etiología del SBA.