New treatment tactics based on recent findings in the ethiopathogenesis of burning mouth syndrome. A clinical case report

Abstract

Introduction: Regardless of all the effort made in studying the Burning Mouth Syndrome, described as a chronic oro-facial pain condition, it still remains an enigma. It was regarded as a psychogenic, endocrine or neurologic disease. But the discoveries of the latest years made possible a significant progress in understanding the nature of this relatively common pathology. In this study we tried to use these recent findings in the treatment of a patient with BMS. Methods: The patient presenting classical BMS symptoms (burning at the tip of tongue, xerostomia and dysgeusia), was investigated for excluding other conditions causing secondary BMS. After confirming the diagnosis of idiopathic BMS, the patient was questioned using the specially adapted for neuropathic pain McGuill Short Form Pain Questionnaire (SF-MPQ-2) and a Visual Analogue Scale (VAS). After obtaining specific results, the patient underwent few treatment courses with alpha lipoic acid, gabapentin, clonazepam, SSRI antidepressants, separately or in combinations. After this, the investigations using SF-MPQ-2 and VAS were repeated. Results: The results for SF-MPQ-2 and VAS varied depending on the treatment applied, but none of the used drugs led to a significant improvement. Conclusion: In spite of the numerous studies which advocate the use of one of the mentioned drugs as an ultimate treatment with good results, our study found no confirmation for that. Nevertheless, this study is surely not enough for a final judgement. Thus, a perspective of a more complex study involving more patients, possible a blinded trial, remains.