Neuropathic and Psychogenic Components of Burning Mouth Syndrome: A Systematic Review

Abstract

The pathophysiology of primary burning mouth syndrome (BMS) has been extensively debated but is poorly understood despite a large number of hypotheses attempting to explain its etiopathogenic mechanisms. The aim of the present work was to systematically review papers that could provide arguments in favour of the neuropathic and psychogenic components of primary BMS for a better understanding of the disease. This systematic review (SR) was registered in PROSPERO (CRD42021224160). The search was limited to articles in English or French from 1990 to 01 December 2020. A total of 113 articles were considered for data extraction. We divided them into four subgroups: pharmacological and nonpharmacological management studies (n = 23); neurophysiological studies (n = 35); biohistopathological studies (n = 25); and questionnaire-based studies (n = 30). Several of these studies have shown neuropathic involvement at various levels of the neuraxis in BMS with the contribution of quantitative sensory testing (QST), functional brain imaging, and biohistopathological or pharmacologic studies. On the other hand, the role of psychological factors in BMS has also been the focus of several studies and has shown a link with psychiatric disorders such as anxiety and/or depression symptoms. Depending on the patient, the neuropathic and psychogenic components may exist simultaneously, with a preponderance of one or the other, or exist individually. These two components cannot be dissociated to define BMS. Consequently, BMS may be considered nociplastic pain.

Meine Zunge brennt! – Glossodynie/orofaziales Schmerzsyndrom

“…Auch der Begriff orales neuropathisches Schmerzsyndrom wurde synonym verwendet ebenso wie Glossopyrosis, Stomatodynie, Stomatopyrosis, wunde Zunge oder orale Dysästhesie [ 27 ]. In einem Review schlägt die Arbeitsgruppe von Misery vor, das Syndrom als „noziplastischer Schmerz“ zu bezeichnen mit Hinweis auf die nozizeptiven Veränderungen [ 30 ].…”

“…Die Anzahl an Studien, die einen neuropathischen Zusammenhang zeigen, mehren sich in den letzten Jahren [ 30 ]. Es zeigten sich Hinweise auf funktionelle Störungen der Chorda tympani [ 10 , 13 , 19 ].…”

“…1 wird eine zusammenfassende Übersicht über die aktuelle Ätiopathogenese dargestellt, und in Abb. 2 wird die Darstellung aus der Arbeit von Orliaguet und Misery [ 30 ], die eine Übersicht der neuropathischen Einflüsse zusammengestellt haben, modifiziert wiedergegeben.

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Oral Microbiome, Oral Health and Systemic Health: A Multidirectional Link

“…The latter mainly occurs in individuals who receive anti-resorptive drugs (bisphosphonates or denosumab) for the treatment of bone cancer or severe osteoporosis and who need tooth extractions, so a preventive approaches are pivotal [ 36 , 37 ]. The relation between oral disease and psychological or psychiatric disturbances is even closer in the case of burning mouth syndrome (BMS), a neuropathic pain that has psychogenic components [ 38 ], for which the management mainly includes the use of psychotropic drugs and psychological support; alternative medicine approaches, based on phytomedicine and acupuncture, are possible, albeit less supported [ 39 , 40 ].…”

Indicators of Studies of Psychological Peculiarities of Patients with Glossodynia after Complex Treatment

“…Обговорення отриманих результатів. Проведені дослідження хворих на глосодинію до початку лікування підтвердили данні науковців [1,18,19,20,21] про важливе значення психологічної складової у формуванні захворювання поряд із соматичною патологією. Встановлені авторами [22,23,24,25,26] виражені астенічні порушення, дратівливість, схильність до високого рівня тривожності, різні фобії у хворих на глосодинію підтверджені в даному дослідженні при обстеженні зазначених пацієнтів.…”