Burning mouth syndrome: a therapeutic approach involving mechanical salivary stimulation.

OBJECTIVE: The study aimed to evaluate the effects of salivary stimulation therapy on the salivary flow, quality of saliva, and symptoms in patients with burning mouth syndrome (BMS). BACKGROUND: BMS is a chronic disorder characterized by a burning sensation. Some reports have proposed a role for saliva in the pathogenesis of BMS. METHODS: Twenty-six BMS patients underwent treatment with salivary mechanical stimulation. Resting and stimulated saliva were collected before and after therapy. Salivary levels of total protein, brain-derived neurotrophic factor, interleukin-10, tumor necrosis factor-α, interleukin-6, and nerve growth factor were assessed before and 90 days after therapy by enzyme-linked immunosorbent assay. RESULTS: A significant reduction in the burning sensation and number of burning sites as well as an improvement of taste disturbances and xerostomia were observed after therapy. The salivary flow was not significantly modified. However, the therapy resulted in a significant decrease in salivary levels of total protein and an increase of tumor necrosis factor-α. CONCLUSION: Salivary mechanical stimulation therapy is effective in reducing clinical symptoms of BMS.

The impact of burning mouth syndrome on health-related quality of life.

BACKGROUND: Burning mouth syndrome is a chronic disorder that is characterized by a burning sensation and a normal clinical appearance of the oral mucosa. This condition often affects the health-related quality of life in patients. As such, the aim of this study was to compare the health-related quality of life of patients with BMS and healthy controls, using the validated Portuguese versions of the SF-36 and OHIP-49 questionnaires. METHODS: A calculated sample of Brazilian patients with BMS (n = 26) was compared with a control group (n = 27), paired for gender and age. Sociodemographic information and clinical characteristics were obtained, and interviews were conducted using the SF-36 and OHIP-49. To evaluate the normality of the variables, we used the Kolmogorov-Smirnov test. The chi-square test, Fisher exact test and Mann-Whitney U-Test were used to compare sociodemographic and clinical characteristics of individuals with BMS and controls Mann-Whitney U-test were carried out to compare SF-36 and OHIP-49 between BMS patients and controls. The significance level was set at 0.05. To compare the dimensions of the SF-36 and OHIP-49 between BMS patients and controls, we considered Bonferroni correction. So for comparison of the dimensions, the significance level was set at 0.00625 for SF-36 and at 0.00714 for OHIP-49. RESULTS: The clinical and demographic data were similar in both groups (P > 0.05). SF-36 scores were significantly lower in all domains for patients with BMS (P < 0.00625). OHIP-49 scores were higher for individuals with BMS (P < 0.00714). CONCLUSIONS: BMS has a negative impact on the health-related quality of life of individuals, as can be shown by instruments such as the SF-36 and OHIP-49. So, the evaluation of quality of life might be useful for more information about the nature and severity of BMS, to evaluate the effects of treatment protocols, in order to improve their outcomes by means a humanized clinical practice.

Equal but different: Natural ecotones are dissimilar to anthropic edges.

Increasing deforestation worldwide has expanded the interfaces between fragmented forests and non-forest habitats. Human-made edges are very different from the original forest cover, with different microclimatic conditions. Conversely, the natural transitions (i.e., ecotones) are distinct from human-made forest edges. The human-made forest edges are usually sharp associated with disturbances, with abrupt changes in temperature, humidity, luminosity and wind incidence towards the forest interior. However, the natural forest-lake ecotones, even when abrupt, are composed of a complex vegetal physiognomy, with canopy structures close to the ground level and a composition of herbaceous and arboreal species well adapted to this transition range. In the present study, fruit-feeding butterflies were used as models to investigate whether faunal assemblages in natural ecotones are more similar to the forest interior than to the anthropic edges. Butterflies were sampled monthly over one year in the Rio Doce State Park, Southeastern Brazil, following a standardized design using a total of 90 bait traps, in three different forest habitats (forest interior, forest ecotone and anthropic edges), in both canopy and understory. A total of 11,594 individuals from 98 butterfly species were collected (3,151 individuals from 79 species in the forest interior, 4,321 individuals from 87 species in the ecotone and 4,122 individuals from 83 species in the edge). The results indicated that the butterfly richness and diversity were higher in transition areas (ecotones and edges). The ecotone included a combination of butterfly species from the forest interior and from anthropic edges. However, species composition and dominance in the ecotone were similar to the forest interior in both vertical strata. These results suggest that human made forest edges are quite distinct from ecotones. Moreover, ecotones represent unique habitats accommodating species adapted to distinct ecological conditions, while anthropic edges accommodate only opportunistic species from open areas or upper canopies.

Psychiatric disorders in burning mouth syndrome.

BACKGROUND: Prevalence of psychiatric disorders in burning mouth syndrome (BMS) is high, but their role in the pathogenesis of BMS remains unclear. OBJECTIVE: The authors aimed to assess the frequency of psychiatric disorders and the severity of psychopathology in BMS. METHODS: Thirty BMS patients and thirty-one controls underwent a psychiatric evaluation which included a structured interview (MINI-Plus) and five psychometric scales. A Visual Analogue Scale (VAS) was used to measure the intensity of burning sensation. RESULTS: Patients with BMS showed a higher frequency of current major depressive disorder, past major depressive disorder, generalized anxiety disorder, hypochondria and cancerophobia (p<0.05). In BMS patients, generalized anxiety disorder was significantly associated with current major depression and social phobia (p<0.05). As expected, cancerophobia was significantly associated with hypochondria (p<0.05). Patients with BMS had higher scores in Hamilton Rating Scale for Depression (HRSD), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI) and Dutch Fatigue Scale (DUFS) (p<0.05). CONCLUSION: BMS patients may have a particular psychological and/or psychiatric profile. Psychometric scales might be useful in screening psychiatric disorders, as well as for assessment of treatment outcomes. In the presence of clinical relevant psychiatric symptoms, patients must be treated appropriately.