Analysis of the Effect of Mindfulness Meditation on Patients with Burning Mouth Syndrome

Objective:To explore the effect of mindfulness meditation on patients with burning mouth syndrome.Methods:60 patients with burning mouth syndrome in our hospital who were treated from January 2021 to December 2022 were selected for this study.The patients were divided into two groups of thirty cases each using the randomized numerical table method.The observation underwent psychological intervention and mindfulness meditation training,while the control group only received symptomatic care.The condition of the patients of both groups was observed and compared.Results:Upon receiving treatment,the patients in the observation group had lower Hamilton Anxiety(HAM-A)scores,and Hamilton Depression(HAMD)scores compared to the control group(P<0.05).The visual analog scale(VAS)scores of the observation group were also lower than those of the control group(P<0.05).Moreover,the efficacy of the nursing intervention in the observation group was higher than that of the control group(P<0.05).Conclusion:Psychological intervention and mindfulness meditation training can effectively improve the clinical symptoms of patients with burning mouth syndrome.Therefore,this treatment method should be popularized.

Burning Mouth Syndrome

Most clinicians dread seeing the patient presenting with a primary complaint of a burning pain on one or more oral mucosal surfaces. Unlike most other clinical conditions presenting in a dental office, burning mouth syndrome is poorly understood with few evidence based remedies. More recently, advances have been made towards clarifying the possible etiology of the disorder and testing the possible therapeutic modalities available. This article attempts to summarize the ＂state of the art＂ today.

Dopamine agonist responsive burning mouth syndrome:Report of eight cases

BACKGROUND Burning mouth syndrome(BMS)is characterized by burning sensation of the oral mucosa.There is a lack of effective treatment.In recent years,a special subtype of BMS has been reported,in which oral burning sensation is alleviated after chewing,speaking,or dopaminergic drug delivery.Currently,there are few reports about the subtype of BMS in China.This study was a retrospective analysis of the clinical data of BMS patients sensitive to dopamine agonist at our hospital,aiming to improve the recognition on this disease.CASE SUMMARY Eight patients diagnosed with dopamine agonist responsive BMS at the Liaocheng People's Hospital from January 1,2017 to June 30,2020 were recruited.The clinical manifestations,treatment,and prognosis were retrospectively analyzed.There were three male and five females in the eight patients.The median age was 56 years(range,46-65 years).All the eight patients showed burning pain in the mouth.The symptoms were mild in the morning and severe in the evening,and alleviated after chewing,talking,and other oral activities.Four patients were accompanied by restless legs syndrome(RLS).Family history of RLS was positive in two patients.All patients were treated with pramipexol,and symptoms were basically relieved after 2-8 wk.CONCLUSION Dopamine agonist responsive BMS is a special subtype of BMS,which is alleviated after oral activities.Dopamine receptor agonist is an effective treatment.

Acupuncture as an Alternative Therapy in the Management of Burning Mouth Syndrome(BMS)

In the routine of dental care,complaints of burning sensation,burning tongue and dry mouth are frequent.Due to the complexity of etiology and diagnosis,treating patients with these sensations is a challenge for clinicians.This study aimed to assess acupuncture as an alternative therapy for patients with burning mouth syndrome(BMS).Clinical data were collected from visits of patients to the School of Dentistry of Piracicaba,State University of Campinas,with the application of a protocol of acupuncture points:LI-4(Hegu),HT-7(Shenmen),SP-6(Sanyinjiao),ST-36(Zusanli),REN-23(Lianquan),REN-6(Qihai),LI-11(Quchi),ExHn3(Yintang),LV-3(Taichong),ExHn12(Jinjin),and ExHn13(Yuye)to treat the symptoms of BMS,from August 2017 to March 2020.The sample consisted of 6 volunteers–5 female and 1 male patients–aged 40 to 79 years.The intensity of BMS was assessed before and after each session with self-reported verbal numerical rating scale(VNRS)during the treatment.On average,each patient had 8.16 sessions using 9.92 acupuncture points per session.Variation of VNRS during the treatment showed a decline in burning mouth in most patients,and 83.34%of the sample showed partial or total improvement of symptoms.This study showed that acupuncture was effective in relieving burning mouth,reducing it by 43%,representing an alternative therapy in the management of symptoms of burning mouth syndrome.

Use of metaphors when treating unexplained medical symptoms

The words one chooses to describe personal pain mirror current usage, but may also hold echoes of an individual’s lived experience. They may provide clues to the origin of physical symptoms that are medically hard to explain. The aim of this commentary is to propose, on the basis of the available literature, that verbal metaphors can prove effective in the psychotherapy of such conditions. I provide a case history of a 45 year old woman referred to psychiatry because of extreme ‘burning’ pain in her mouth and tongue. She had been to numerous doctors, had undergone a variety of tests, had tried many medical treatments, and had been prescribed a number of different pharmaceutical agents. She had changed her diet, done her daily dental mouth exercises, drunk a lot of water, but the burning continued and interfered, with her job(she was a teacher), her friendships, and her everyday life. This made her angry and recalcitrant to therapy, but the metaphor ‘burning with rage,’ as applicable to her pain, worked to establish a good alliance that led to a decrease of symptoms. Burning Mouth Syndrome is a medically unexplained condition of complex etiology that psychotherapy alone cannot reverse. The literature bears out, however, that the use of metaphors can help to open avenues of psychological exploration that accelerate adaptation to pain and improve quality life.

Multifactor analysis of patients with oral sensory complaints in a case-control study

Background:There are an increasing number of patients with oral sensory complaints(OSCs)presenting to our dental clinic.For most dentists,it is difficult to distinguish burning mouth syndrome(BMS)from other oral mucosal diseases that may cause symptoms such as burning mouth.It is beneficial to effectively distinguish OSC patients to reduce misdiagnosis and eliminate burning symptoms as much as possible.Methods:Patients with oral burning sensations in the oral mucosal disease clinic were collected from the Peking University Hospital of Stomatology between September 1,2014 and December 31,2018.After excluding oral candidiasis,anemic stomatitis,dental material allergy,and other diseases from patients with oral sensory complaints,basic conditions such as gender,age,education level,job status,hyperglycemia,hypertension,hyperlipidemia,history of brain abnormalities,history of cervical spondylitis,history of thyroid disease,history of thyroid disease and insomnia were obtained.The BMS patients were compared with the control group.The t test and Chi-square test were used for statistical analysis to compare the clinical symptoms of these diseases and explore the risk factors for BMS.Results:In this case-control study,395 patients(321 females and 74 males,mean age 55.26±10.51 years)with oral sensory complaints and 391 healthy controls(281 females and 110 males,mean age 47.11±13.10 years)were enrolled,among which,8.4%(33/395)had oral candidiasis,1.3%(5/395)had dental material allergy,0.8%(3/395)had anemic stomatitis and 0.5%(2/395)had lichen planus.A total of 352 patients were eventually diagnosed with BMS.Anxiety and depression were more severe in BMS patients,as were the incidences of sleep disorders and brain abnormalities.Logistic regression analysis showed that age(odds ratio[OR]=2.79,95%confidence interval[CI]:1.61-4.83,P<0.001),total cholesterol level(OR=2.92,95%CI:1.32-6.50,P=0.009)and anxiety score(OR=1.75,95%CI:1.01-2.77,P=0.017)significantly increased the incidence of BMS.Patients with hyperglycemia(OR=0.46,95%CI:0.23-0.89,P=0.022),low body mass index(BMI:OR=0.57,95%CI:0.34-0.93,P=0.026)and low education level(OR=3.43,95%CI:1.91-6.15,P<0.001)were more likely to suffer from BMS.Conclusions:Oral candidiasis,anemic stomatitis,and dental material allergy with burning symptoms should be excluded from patients with BMS.It is recommended to conduct a questionnaire survey(including anxiety and depression),blood cell analysis,and salivary fungus culture for all patients with an oral burning sensation.It is necessary to conduct a patch test on patients with oral burning sensations and metal restorations.