• Journal of Oral Medicine and Pain
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• v.44 no.1
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• pp.25-30
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• 2019

Purpose: The exact causes of burning mouth syndrome (BMS) is unclear so far. There are many studies to elucidate the relation between oral disease and genetic predisposition. In this study, we first tried to investigate salivary exosomal genetic components that could play an important role for diagnosing and elucidating the progression of BMS. Methods: We compared salivary exosomal micro RNAs (miRNAs) of BMS Patients to those of control using next generation sequencing (NGS). Unstimulated whole saliva from 15 patients with BMS and 10 control subjects were divided into two sets. Isolated exosomes and their total RNAs were subject to NGS for the screening of miRNAs. Results: There were up-regulated 10 exosomal miRNAs (hsa-miR-1273h-5p, hsa-miR-1273a, hsa-miR-1304-3p, hsa-miR-4449, hsa-miR-1285-3p, hsa-miR-6802-5p, hsa-miR-1268a, hsa-miR-1273d, hsa-miR-1273f, and hsa-miR-423-5p) and down-regulated 18 exosomal miRNAs (hsa-miR-27b-3p, hsa-miR-16-5p, hsa-miR-186-5p, hsa-miR-142-3p, hsa-miR-141-3p, hsa-miR-150-5p, hsa-miR-374a-5p, hsa-miR-93-5p, hsa-miR-29c-3p, hsa-miR-29a-3p, hsa-miR-148a-3p, hsa-miR-22-3p, hsa-miR-27a-3p, hsa-miR-424-5p, hsa-miR-19b-3p, hsa-miR-99a-5p, hsa-miR-548d-3p, and hsa-miR-19a-3p) in BMS patients comparing with those of control subjects. Conclusions: We show that there are 28 differential expression of miRNAs between the patients with BMS and those of control subjects. The specific function of indicated miRNAs should be further elucidated.

• The Journal of Internal Korean Medicine
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• v.43 no.1
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• pp.53-67
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• 2022

Objectives: This study aimed to identify the characteristics of the heart rate variability (HRV) index in patients with burning mouth syndrome (BMS) and to evaluate the predictive value of HRV for Korean medical treatment responsiveness to tongue pain in BMS. Methods: Among BMS patients who visited the Oral Diseases Clinic of Kyung Hee University Korean Medicine Hospital from January 1, 2018, to May 31, 2021, we reviewed the clinical records of 217 women aged 50 years and over. HRV and unstimulated saliva flow rate (USFR) measurements were carried out, and all patients were asked to indicate their degree of tongue pain using the visual analog scale (VAS). The subjects were classified into subgroups according to the presence or absence of hyposalivation and VAS improvement, and each subgroup was compared using the HRV index. Logistic regression analysis was conducted to confirm whether cause-effect relationships were present between statistically significant values. Results: BMS patients had lower LF and HF than healthy people. Subgroup analysis demonstrated that there were some statistically significant differences in the HRV index according to salivation rate and degree of pain. In addition, as the LF/HF ratio increased, the pain improvement rate decreased after treatment. Conclusion: The autonomic nerve activity of BMS patients was lower than that of healthy people; however, autonomic balance was not impaired. In addition, tongue pain in BMS patients responded more favorably to Korean medical treatment when patients fell within a normal range of the LF/HF ratio, suggesting that autonomic imbalance could be used as one of the predictable factors in clinical practice.

• Journal of Dental Rehabilitation and Applied Science
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• v.35 no.3
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• pp.123-131
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• 2019

Burning mouth syndrome (BMS) is defined as the xerostomia, burning sensation and various discomfort of tongue and oral mucosa. BMS can occur in both men and women, but is more frequent in middle-aged menopausal women. Because exact cause can't be identified clearly and it is hard to make diagnosis in clinic, the purpose of the treatment have been to relieve symptoms. Etiology of BMS is divided into local, systemic, and psychological factors. ${\alpha}$-lipoic acid, clonazepam, supplemental therapy and cognitive behavior therapy can be prescribed for BMS. Nowdays, many experts focus attention on effect of combination therapy. It is necessary to solve the symptoms of the patients by combination of pharmacological approach and psychotherapy with cognitive behavior therapy considering the factors in various aspects.

• Journal of Oral Medicine and Pain
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• v.39 no.3
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• pp.96-99
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• 2014

Purpose: The objective of this retrospective pilot study was to evaluate the effectiveness of Gabapentin in patients with primary burning mouth syndrome (BMS). Methods: Ten subjects were diagnosed with primary BMS (8 women and 2 men). The mean age was 60.1 years. They had clinical examination to exclude local factors such as the presence of Candida species, xerostomia, lichen planus, etc. They also underwent hematological examination to exclude secondary BMS due to systemic disorders. Pain was assessed by patients on an 11-point numerical rating score system (0 to 10). Gabapentin was administered at a starting dose of 300 mg/day, slowly titrated up to maximum of 1,800 mg/day. All patients were treated for 4 weeks. Results: One half of the patients (n=5) obtained reduction in pain over the treatment period. Four patients reported no reduction in pain symptoms. One patient reported that symptoms were worsening. The average pain score before the treatment was 6.3 and after the treatment was 5.25. No significant relationship was detected between pretreatment and posttreatment pain score. Only one patient noted mild side effect (dizziness). Conclusions: This retrospective pilot study provides no preliminary evidence that Gabapentin has effect in the management of BMS. However, further research (well-designed, randomized, and controlled trial with large sample) would be needed to investigate the efficacy of Gabapentin in treatment of BMS.

• The Journal of Internal Korean Medicine
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• v.39 no.4
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• pp.699-707
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• 2018

Objectives: This study was designed to investigate characteristics of digital infrared thermal imaging (DITI) and quantitative evaluations in patients with burning mouth syndrome (BMS). Methods: We reviewed the clinical records of 38 patients with BMS who visited the Oral Diseases Clinic of Kyung Hee University Korean Medicine Hospital from March 1st, 2018 to June 30th, 2018. The subjects were evaluated with digital infrared thermal imaging (DITI) and for heart rate variability (HRV), unstimulated salivary flow rate (USFR), and the proportion of coated tongue. Results: Most patients showed higher temperatures on the central part of the tongue (T2) than on the middle of the forehead (T1). The patients tended to have a high Low frequency/High frequency (LF/HF) ratio. Statistically significant negative correlations were noted between the age of patients and the temperature of T1 and T2. Statistically significant negative correlations were also observed between the LF/HF ratio and 'T1-T2' values. Conclusions: This study suggests that DITI and HRV are useful for the validation of patients with BMS. Correlations between the result values suggest that sympathetic function acceleration is related to temperature distribution and, ultimately, to symptoms.

• The Journal of Internal Korean Medicine
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• v.41 no.4
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• pp.624-643
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• 2020

Objectives: The aim of this study was to analyze the correlation between Ryodoraku and two pattern-identification questionnaires in patients with Burning Mouth Syndrome (BMS). Methods: The study participants were 30 patients with BMS who visited the Oral Diseases Clinic of Kyung Hee Oriental Medicine Hospital from June to November, 2019. The Ryodoraku test and two pattern-identification questionnaires were administered to all patients. Measurements included the average Ryodoraku score, which is called the Total Average (TA), and each score on the Ryodoraku point scale. The degree of Yin-deficiency, Qi-stagnation, and pain were assessed with the Yin-deficiency Questionnaire (YDQ), Qi-stagnation Questionnaire (QSQ), and Visual Analogue Scale (VAS), respectively. Results: The average TA score was 29.90. The LF5 (p=0.013) and RF5 (p=0.016) scores were lower than the TA scores, and the RH5 (p=0.020) and RH6 (p=0.006) scores were higher than the TA scores. A negative correlation was detected between the YDQ scores and the LH1 (r=-0.366, p=0.046), LH2 (r=-0.507, p=0.004), LH3 (r=-0.374, p=0.042), RH1 (r=-0.361, p=0.050), RH2 (r=-0.403, p=0.027) points. The LF5 (p=0.050) and RF2 (p=0.048) scores were lower in the patients with Qi-stagnation patients than without Qi-stagnation. Conclusions: Our results suggest that low TA and Ryodoraku scores on LF5 and RF5 and high Ryodoraku scores on RH5 and RH6 could be quantitative indicators for the diagnosis of BMS. The LH1, LH2, LH3, RH1, RH2, LF5, and RF2 scores could also be an indicators for diagnosis of Yin-deficiency and Qi-stagnation in patients with BMS.

• The Journal of Internal Korean Medicine
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• v.39 no.3
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• pp.363-371
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• 2018

Objective: The aim of this study was to investigate the clinical characteristics of patients showing fissured tongue (FT) with burning mouth syndrome (BMS). Methods: We reviewed the clinical records of 16 FT patients with BMS who visited the Oral Diseases Clinic of Kyung Hee University Korean Medicine Hospital from March 1, 2017 to February 28, 2018. The subjects were graded by FT classification and compared with each group on a numeral rating scale (NRS) of tongue pain, proportion of coated tongue, unstimulated salivary flow rate (USFR), Ryodoraku, and heart rate variability (HRV) results. Results: FT grade had no significant correlation with NRS of tongue pain and USFR. FT grade had a substantially significant positive correlation with BMI and LF/HF ratio in HRV. FT grade had a substantially significant negative correlation with proportion of coated tongue. The most frequent accompanying symptoms were xerostomia and insomnia. Conclusions: The results of this study suggest that FT has no correlation with tongue pain in BMS. Rather, FT seems to correlate with sympathetic function acceleration.

• Journal of Oral Medicine and Pain
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• v.41 no.1
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• pp.1-6
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• 2016

Purpose: To investigate the efficacy of pregabalin for patients with primary burning mouth syndrome (BMS) who are unresponsive to topical clonazepam therapy. Methods: By searching the clinical electronic records from the Department of Oral Medicine, Pusan National University Dental Hospital from 2012 to 2014, a retrospective analysis was performed on patients with primary BMS who were treated with topical clonazepam therapy during this period. Of the patients who were unresponsive to this therapy, 19 patients who were subsequently treated with pregabalin were included in the study. A pain assessment was performed using the 11-point numerical rating scale at first visit, following topical clonazepam therapy, and again after pregabalin therapy. The treatment outcomes were statistically analyzed using the Wilcoxon signed rank test. Results: Following additional pregabalin administration, the mean pain score was slightly reduced. A total of 7 patients reported a marked response (>50% pain reduction), and 3 patients reported a slight reduction in pain. Pain reduction following pregabalin therapy was statistically significant (p<0.05). Conclusions: Pregabalin has a slight therapeutic effect on patients with primary BMS. Therefore, we recommend pregabalin as an alternative drug for BMS patients who are unresponsive to topical clonazepam therapy.

• Journal of Oral Medicine and Pain
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• v.42 no.4
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• pp.102-108
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• 2017

Purpose: Many metal ions released from dental casting alloys have been reported to influence the intraoral symptoms of oral lichen planus (OLP) and burning mouth syndrome (BMS). The aim of this study was to investigate the relationship between salivary metal ion levels and the prosthetic duration as well as to evaluate the time-dependent morbid effects of metal ions in OLP and BMS patients. Methods: Three study groups consist of the following subjects respectively: 17 OLP patients, 12 BMS patients, and 12 patients without oral symptoms. The salivary concentrations of 13 metal ions (copper, cobalt, zinc, chromium, nickel, aluminum, silver, iron, titanium [Ti], platinum, tin, palladium, and gold) were measured by Laser Ablation Microprobe Inductively coupled Plasma Mass Spectrometry. Results: The Ti ions had statistically significant differences among the groups with a prosthetic duration of less than 5 years. There were no significant differences between all ion levels among the groups wearing dental cast alloys for over 5 years. In the BMS group, the level of Ti ions in patients with prosthetic restorations less than 5 years old were significantly high (p<0.05). Conclusions: In the BMS group, 3-60 months during which salivary Ti levels were higher were matched with the duration of burning symptoms ($15.6{\pm}17.1months$). Furthermore, Ti ions were statistically high in the oral cavity of BMS patients fitted with dental casting alloys for 5 years. These results suggest that Ti ions released from dental implants and oral prostheses could attribute to burning sensation of BMS.

• Journal of Oral Medicine and Pain
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• v.38 no.4
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• pp.313-318
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• 2013

The aim of this study was to the relationship between sleep disturbances and Burning mouth syndrome(BMS). BMS presents as a chronic burning sensation in the oral mucous membrane that is frequently associated with sleep disturbances. BMS is considered neuropathic pain condition with dysfunction of small diameter afferent sensory fiber. A review of the studies reveals, BMS suggested peripheral and cental nervous system changes. Sleep disruption or Rem sleep deprivation cause an inhibition of opioid protein synthesis and a reduced affinity of ${\mu}$ and ${\delta}$ opioid receptors. Let me say that sleep disturbances suggest a risk factor For BMS and support to evaluate as a part of BMS treatment. Further study will be required to ascertain the relationship between distruption of sleep continuity or Rem sleep deprivation and BMS and the evidence of altered neurochemical degeneration of BMS.