Burning Mouth Syndrome (BMS)—Treatment with Verbal and Written Information, B Vitamins, Probiotics, and Low-Level Laser Therapy: A Randomized Clinical Trial

Abstract

Background: The objective of this study was to determine the most effective treatment option for burning mouth syndrome. Methods: Informative treatment alone, B vitamin injections, oral cavity probiotics, and low-level laser therapy were evaluated and compared. The study included new patients diagnosed with burning mouth syndrome, who were randomly allocated into one of four treatment groups. The primary outcome was improvement in patient’s quality of life as determined by a self-perceived Oral Health Impact Profile-14 (OHIP-14) quality of life questionnaire before and after therapy. The secondary outcome was determination of mucosal symptom intensity according to visual analog scale (VAS) grading from 0 to 10. Data were submitted to statistical analysis. Results: A total of 62 patients completed the study. Oral cavity probiotics and LLLT scores for OHIP-14 resulted in a statistically significant difference before and after therapy. Standardized effect sizes between OHIP scores before and after treatment were the greatest for patients who had received oral cavity probiotics. Conclusions: Oral cavity probiotics and LLLT were the most effective treatment for improvement in quality of life. Further investigation on a larger group of patients is required.

Efficacy of laser therapy on primary burning mouth syndrome: a systematic review

“…A total of 202 articles were excluded based on the title and the abstract. After assessing full-text articles for eligibility, 12 were excluded for different reasons [2,[21][22][23][24][25][26][27][28][29][30][31]. At the end of the study selection, 9 articles were included in the present systematic review [32][33][34][35][36][37][38][39][40].…”

Photobiomodulation as a Therapeutic Strategy in Burning Mouth Syndrome: A Scoping Review

“…Often, a combination of medications is recommended, along with treatments utilized for other neuropathic pain conditions [52,53]. Tricyclic antidepressants such as amitriptyline and clomipramine have been tried for BMS, with only 19% of patients reporting very poor outcomes and side effects such as dry mouth [54,55]. Antidepressants belonging to the group of selective serotonin reuptake inhibitors (SSRIs) such as chlordiazepoxide, diazepam, amisulpride, paroxetine, or sertraline hydrochloride have also been recommended with good results, but with the most side effects such as dizziness, insomnia, nausea, and somnolence [54,55].…”

“…Trazodone was not effective in improving BMS symptoms [56]. Anticonvulsants such as gabapentin and pregabalin are routinely recommended in the pharmacotherapy of BMS, but therapeutic success has not been achieved [55,56]. Systemic and local treatment with clonazepam should be considered in the treatment of BMS.…”

“…Clonazepam is a benzodiazepine and a γ-aminobutyric acid (GABA) receptor agonist. This receptor is widely present in the central nervous system and peripheral tissues, and this drug acting on this receptor may have positive results in the treatment of this syndrome [55][56][57][58]. Pure small-fiber peripheral neuropathy may be better controlled with local clonazepam and central mechanisms may benefit more from systemic clonazepam [55][56][57][58].…”

A Retrospect of the Special Issue “Advances in Oral Implant Health”

“…In order to guarantee the optimal health of the peri-implant tissues; probiotics; ozonized water; lasers; and low particle size powders, such as glycine and erythritol, have been proposed [ 4 , 5 , 6 ]. This non-surgical peri-implant therapy aims to reduce plaque accumulation at the different implant/mucosal interfaces, particularly at the transition point between the crown and the abutment [ 7 , 8 ].…”