Pharmacological and non-pharmacological management of burning mouth syndrome: A systematic review

Reyad, Ayman Antoun; Mishriky, Raafat; Girgis, Eriny

doi:10.17219/dmp/120991

Cited by 15 publications

(9 citation statements)

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“…Three SRs [ 34 – 36 ] did not fully report characteristics, including search date, design of included studies, and participants. According to the evaluation of treatments, 11SRs [ 37 – 47 ] only evaluated CBT-related techniques, 11 SRs [ 34 , 48 – 57 ] also evaluated other psychological therapies, 5 SRs [ 58 – 62 ] evaluated nonpharmacological interventions in addition to psychological therapies, 2 SRs [ 35 , 63 ] evaluated pharmacological and nonpharmacological interventions, and 5 SRs [ 36 , 64 – 67 ] evaluated various interventions. Of the available data, 15 SRs [ 38 – 40 , 43 – 45 , 47 , 50 , 53 – 57 , 63 , 65 ] included migraine, 7 SRs [ 34 , 35 , 52 , 60 , 64 , 66 , 67 ] included burning mouth syndrome, 4 SRs [ 36 , 42 , 46 , 62 ] included cancer-related neuropathic pain, 3 SRs [ 51 , 59 , 61 ] included diabetic peripheral neuropathy, 3 SRs [ 48 , 49 , 58 ] included pain after spinal cord injury, and 2 SRs [ 37 , 41 ] included patients with NP of different causes.…”

Section: Resultsmentioning

confidence: 99%

“…According to the AMSTAR-2 scoring criteria ( Figure 3 ), 2 SRs were rated “high.” 2 SRs were rated “moderate,” 6 SRs were rated “low,” and 24 SRs were rated “critically low.” The main reasons for downgrading the SRs were as follows: there was no protocol reported before the review or no explanation for differences from protocol [ 35 – 38 , 42 – 47 , 51 , 52 , 55 – 57 , 61 , 65 – 67 ]; there was no list of excluded studies and reasons for exclusion [ 34 – 37 , 39 , 40 , 42 , 43 , 45 – 47 , 51 , 55 – 57 , 59 – 62 , 65 – 67 ]; there was no explanation for the study design included in the SRs [ 34 – 42 , 45 – 53 , 55 , 57 – 62 , 64 – 67 ]; there was no report of funding sources for studies included in the SRs [ 35 – 47 , 50 , 51 , 55 – 58 , 60 – 62 , 65 – 67 ]; the risk bias of the included studies was not considered when interpreting or discussing the study results [ 35 – 38 , 40 , 43 , 46 , 47 , 50 , 51 , 56 , 57 , 59 , 62 , 63 , 66 ]; the publication bias was not adequately investigated when quantitative synthesis...…”

Section: Resultsmentioning

confidence: 99%

“…Three SRs [34][35][36] did not fully report characteristics, including search date, design of included studies, and participants. According to the evaluation of treatments, 11SRs [37][38][39][40][41][42][43][44][45][46][47] only evaluated CBT-related techniques, 11 SRs [34,[48][49][50][51][52][53][54][55][56][57]] also evaluated other psychological therapies, 5 SRs [58][59][60][61][62] [38-40, 43-45, 47, 50, 53-57, 63, 65] included migraine, 7 SRs [34,35,52,60,64,66,67] included burning mouth syndrome, 4 SRs [36,42,46,62] included cancer-related neuropathic pain, 3 SRs [51,59,61] included diabetic peripheral neuropathy, 3 SRs [48,49,…”

Section: Resultsmentioning

confidence: 99%

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Evidence Mapping Based on Systematic Reviews of Cognitive Behavioral Therapy for Neuropathic Pain

Hou

Ding

et al. 2023

Neural Plasticity

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Objective. This evidence mapping is aimed at identifying, summarizing, and analyzing the available evidence on cognitive behavioral therapy (CBT) for neuropathic pain (NP). Methods. This study was conducted following the methodology of Global Evidence Mapping (GEM). Searches were conducted in PubMed, Embase, the Cochrane Library, and PsycINFO to identify systematic reviews (SRs) with or without meta-analysis published before February 15, 2022. The authors independently assessed eligibility, extracted data, and evaluated the methodological quality of the included SRs using AMSTAR-2. The results were presented in the tables and a bubble plot based on the identified population-intervention-comparison-outcome (PICO) questions. Results. A total of 34 SRs met the eligibility criteria. According to the AMSTAR-2, 2 SRs were rated “high,” 2 SRs were rated “moderate,” 6 SRs were rated “low,” and 24 SRs were rated “critically low.” The most common study design utilized to evaluate the efficacy of CBT for NP was the randomized controlled trial. In total, 24 PICOs were identified. Migraine was the most studied population. CBT for NP usually reaches the “potentially better” result at follow-up. Conclusions. Evidence mapping is a useful way to present existing evidence. Currently, the existing evidence on CBT for NP is limited. Overall, the methodological quality of the included SRs was low. Further improvements in the methodological quality of SRs and more research on the most efficient CBT formats for NP are recommended in the future.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Evidence Mapping Based on Systematic Reviews of Cognitive Behavioral Therapy for Neuropathic Pain

Hou

Ding

et al. 2023

Neural Plasticity

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“…Systemic treatments with gabapentin (1200 mg/day for over 26–32 weeks) and pregabalin (50–150 mg/day) showed efficacy in subjects with BMS [ 31 , 32 ]. Other systemic treatments that succeed in BMS are dosulepin (75 mg/day), α-lipoic acid (800 mg/day), duloxetine (20–60 mg/day), and clonazepam (3 mg/day) [ 26 , 31 , 33 , 34 ] and the combination of gabapentin and nortriptyline, gabapentin and α-lipoic acid, and diazepam and olanzapine [ 31 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Exploring the Association of Burning Mouth Syndrome with Depressive and Anxiety Disorders in Middle-Aged and Older Adults: A Systematic Review

Dibello

Ballini

Lozupone

et al. 2023

JPM

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Background: Burning Mouth Syndrome (BMS) is an idiopathic condition mainly affecting middle-aged and older individuals with hormonal disturbances or psychiatric disorders and is characterized by chronic pain. The etiopathogenesis of this multifactorial syndrome is largely unknown. The objective of the present systematic review was therefore to evaluate the relationship of BMS with depressive and anxiety disorders in middle-aged and older individuals. Methods: We selected studies evaluating BMS and depressive and anxiety disorders assessed with validated tools, published from their inception up to April 2023, using PubMed, MEDLINE, EMBASE, Scopus, Ovid, and Google Scholar databases and adhering to the PRISMA 2020 guidelines/PRISMA 2020 27-item checklist. This study is registered on PROSPERO (CRD42023409595). The National Institutes of Health Quality Assessment Toolkits for Observational Cohort and Cross-Sectional Studies were used to examine the risk of bias. Results: Two independent investigators rated 4322 records against the primary endpoint and found 7 records meeting the eligibility requirements. Anxiety disorders were found to be the most common psychiatric disorders related to BMS (63.7%), followed by depressive disorders (36.3%). We found a moderate association of BMS with anxiety disorders, with multiple studies included (n = 7). Moreover, we found a low association of BMS with depressive disorders (included studies, n = 4). The role of pain appeared to be controversial in explaining these associations. Conclusions: In middle-aged and older subjects, anxiety and depressive disorders may be potentially related to the development of BMS. Furthermore, also in these age groups, females showed higher risk of developing BMS than males, even when taking into account multimorbidity such as sleep disorders, personality traits, and biopsychosocial changes as suggested by study-specific findings.

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“…A number of pharmacological and non-pharmacological strategies have been found to improve patient pain and quality of life. In this context, drugs such as anxiolytics or antidepressants have been shown to be effective in managing the symptoms of BMS, with clonazepam being the most widely used drug [10].…”

Section: Introductionmentioning

confidence: 99%

Burning Mouth Syndrome Treated with Low-Level Laser and Clonazepam: A Randomized, Single-Blind Clinical Trial

Garcia Martinez,

Lopez-Jornet,

Pardo Marin

et al. 2024

Biomedicines

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Objective: Burning mouth syndrome (BMS) is a chronic pain disorder characterized by intraoral burning or dysaesthetic sensation, with the absence of any identifiable lesions. Numerous treatments for BMS have been investigated, though without conclusive results. An analysis was conducted of the efficacy of treatment with a low-level diode laser and clonazepam in patients with BMS, and a study was carried out on the levels of different salivary biomarkers before and after treatment. Material and methods: A randomized, single-blind clinical trial was carried out involving 89 patients divided into the following groups: group 1 (laser, The Helbo® Theralite Laser 3D Pocket Probe + clonazepam) (n = 20), group 2 (sham laser placebo) (n = 19), group 3 (laser) (n = 21) and group 4 (clonazepam) (n = 18). Symptom intensity was scored based on a visual analogue scale (VAS). Sialometry was performed before and after treatment, and the Xerostomia Inventory, Oral Health Impact Profile-14 (OHIP-14) and Mini-Nutritional Assessment (MNA) questionnaires were administered. The following markers were measured in saliva samples: interleukins (IL2, IL4, IL5, IL6, IL7, IL8, IL1β, IL10, IL12, IL13, IL17, IL21 and IL23), proteins (MIP-3α, MIP-1α and MIP-1β), GM-CSF, interferon gamma (IFNγ), interferon-inducible T-cell alpha chemoattractant (ITAC), fractalkine and tumor necrosis factor α (TNFα). Results: A significant decrease in the VAS scores was observed after treatment in group 1 (laser + clonazepam) (p = 0.029) and group 3 (laser) (p = 0.005). In turn, group 3 (laser) showed a decrease in the salivary concentration of fractalkine (p = 0.025); interleukins IL12 (p = 0.048), IL17 (p = 0.020), IL21 (p = 0.008), IL7 (p = 0.001) and IL8 (p = 0.007); proteins MIP1α (p = 0.048) and MIP1β (p = 0.047); and TNFα (p = 0.047) versus baseline. Following treatment, group 1 (laser + clonazepam) showed significant differences in IL21 (p = 0.045) and IL7 (p = 0.009) versus baseline, while group 4 (clonazepam) showed significant differences in IL13 (p = 0.036), IL2 (p = 0.020) and IL4 (p = 0.001). No significant differences were recorded in group 2 (sham laser placebo). Conclusions: The low-level diode laser is a good treatment option in BMS, resulting in a decrease in patient symptoms and in salivary biomarkers. However, standardization of the intervention protocols and laser intensity parameters is needed in order to draw more firm conclusions.

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Pharmacological and non-pharmacological management of burning mouth syndrome: A systematic review

Cited by 15 publications

References 0 publications

Evidence Mapping Based on Systematic Reviews of Cognitive Behavioral Therapy for Neuropathic Pain

Evidence Mapping Based on Systematic Reviews of Cognitive Behavioral Therapy for Neuropathic Pain

Exploring the Association of Burning Mouth Syndrome with Depressive and Anxiety Disorders in Middle-Aged and Older Adults: A Systematic Review

Burning Mouth Syndrome Treated with Low-Level Laser and Clonazepam: A Randomized, Single-Blind Clinical Trial

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