The Orofacial Pain Clinic Questionnaire (EDOF-HC) in the evaluation and diagnosis of orofacial pain.

BACKGROUND: Diagnostic tools are necessary for the anamnesis and examination of orofacial pain, in order to fulfill diagnostic criteria and to screen potential causes of pain. OBJECTIVE: To evaluate the Orofacial Pain Clinic Questionnaire (EDOF-HC) in the assessment and diagnosis of orofacial pain. METHODS: Overall, 142 patients were evaluated and classified according to the criteria of the International Headache Society and International Association for the Study of Pain. All of them were evaluated with the EDOF-HC questionnaire, which consists of the orofacial and medical history, as well as the orofacial examination. Data were statistically analyzed with chi-square test and Bonferroni correction, one-way ANOVA with Tukey post hoc test, the two-step cluster and decision tree methods. RESULTS: There were diferences in pain descriptors, pain in maximum mouth opening, number of trigger points, and history of previous surgery between the groups, which were classified into trigeminal neuralgia, burning mouth syndrome, temporomandibular disorders and trigeminal posttraumatic neuropathic pain with classification analysis. CONCLUSIONS: The EDOF-HC is a clinical supportive tool for the assessment of orofacial pain. The instrument may be used to support data collection from anamnesis and examination of patients according to the diagnostic criteria of most common orofacial conditions. It is also useful in the investigation of local and systemic abnormalities and contributes for the diagnosis of conditions that depend on exclusion criteria.

The Orofacial Pain Clinic Questionnaire (EDOF-HC) in the evaluation and diagnosis of orofacial pain / Questionário da Equipe de Dor Orofacial (EDOF-HC) na avaliação e diagnóstico da dor orofacial

ABSTRACT Background: Diagnostic tools are necessary for the anamnesis and examination of orofacial pain, in order to fulfill diagnostic criteria and to screen potential causes of pain. Objective: To evaluate the Orofacial Pain Clinic Questionnaire (EDOF-HC) in the assessment and diagnosis of orofacial pain. Methods: Overall, 142 patients were evaluated and classified according to the criteria of the International Headache Society and International Association for the Study of Pain. All of them were evaluated with the EDOF-HC questionnaire, which consists of the orofacial and medical history, as well as the orofacial examination. Data were statistically analyzed with chi-square test and Bonferroni correction, one-way ANOVA with Tukey post hoc test, the two-step cluster and decision tree methods. Results: There were diferences in pain descriptors, pain in maximum mouth opening, number of trigger points, and history of previous surgery between the groups, which were classified into trigeminal neuralgia, burning mouth syndrome, temporomandibular disorders and trigeminal posttraumatic neuropathic pain with classification analysis. Conclusions: The EDOF-HC is a clinical supportive tool for the assessment of orofacial pain. The instrument may be used to support data collection from anamnesis and examination of patients according to the diagnostic criteria of most common orofacial conditions. It is also useful in the investigation of local and systemic abnormalities and contributes for the diagnosis of conditions that depend on exclusion criteria.

RESUMO Introdução: Instrumentos diagnósticos são necessários para a anamnese e exame da dor orofacial, auxiliando na identificação das causas potenciais de dor. Objetivo: Avaliar o Questionário da Equipe de Dor Orofacial (EDOF-HC) na abordagem e diagnóstico da dor orofacial. Métodos: Ao todo, 142 pacientes foram avaliados e classificados de acordo com os critérios da Sociedade Internacional de Cefaleias e da Associação Internacional para o Estudo da Dor. Todos foram avaliados com o questionário EDOF-HC, que consiste na anamnese orofacial e médica, além do exame físico orofacial. Os dados foram analisados estatisticamente com os testes qui-quadrado com correção de Bonferroni, ANOVA de um fator e post hoc de Tukey, além dos métodos de classificação em cluster e árvore decisória. Resultados: Houve diferenças entre os diagnósticos quanto aos descritores da dor, dor na abertura bucal máxima, número de pontos-gatilho mastigatórios e história prévia de cirurgia, o que esteve de acordo com a classificação nos diagnósticos de neuralgia do trigêmeo, síndrome da ardência bucal, disfunção temporomandibular e dor neuropática pós-traumática trigeminal. Conclusões: O Questionário da Equipe de Dor Orofacial (EDOF-HC) mostrou ser um instrumento de apoio para a avaliação da dor orofacial, útil na coleta de dados de anamnese e exame clínico dos pacientes, observando os principais sinais e sintomas relacionados aos critérios diagnósticos das condições orofaciais dolorosas mais comuns. Também é útil na avaliação de comorbidades locais e sistêmicas e contribui para o diagnóstico de condições que dependem em critérios de exclusão.

No Association of Polymorphisms in Nav1.7 or Nerve Growth Factor Receptor Genes with Trigeminal Neuralgia.

OBJECTIVE: Trigeminal neuralgia is defined as a sudden severe shock-like pain within the distribution of the trigeminal nerve. Pain is a subjective experience that is influenced by gender, culture, environment, psychological traits, and genes. Sodium channels and nerve growth factor play important roles in the transmission of nociceptive signals and pain. The aim of this study was to investigate the occurrence of Nav1.7 sodium channel and nerve growth factor receptor TrkA gene polymorphisms (SCN9A/rs6746030 and NTRK1/rs633, respectively) in trigeminal neuralgia patients. METHODS: Ninety-six subjects from pain specialty centers in the southeastern region of Brazil were divided into 2 groups: 48 with classical trigeminal neuralgia diagnosis and 48 controls. Pain was evaluated using the visual analog scale and multidimensional McGill Pain Questionnaire. Genomic DNA was obtained from oral swabs in all individuals and was analyzed by real-time polymerase chain reaction. RESULTS: No association was observed between evaluated polymorphisms and trigeminal neuralgia. For allele analyses, patients and controls had similar frequencies for both genes. Genotype distribution or allele frequencies of polymorphisms analyzed here did not correlate to pain scores. CONCLUSIONS: Although no association of evaluated polymorphisms and trigeminal neuralgia diagnosis or pain severity was observed, our data do not exclude the possibility that other genotypes affecting the expression of Nav1.7 or TrkA are associated with the disease. Further studies should investigate distinct genetic polymorphisms and epigenetic factors that may be important in expression of these molecules.

Quantitative sensory testing in elderly: longitudinal study.

OBJECTIVE: To evaluate elderly patients in a geriatric service, along with their sensory characteristics and their association with clinical aspects. METHODS: This was a descriptive longitudinal study. We enrolled 36 healthy participants of both sexes in this study. The following instruments were used and evaluations performed: clinical evaluation, Mini-Mental State Exam, and quantitative sensory testing. RESULTS: During the follow-up, there was reduction of mean corpuscular volume at each evaluation (p < 0.001) and significant increase in mean corpuscular hemoglobin concentration (p < 0.001). There was an increase of the olfactory (p < 0.001), salty (p = 0.024), sour (p = 0.020), bitter (p = 0.001), facial cold (p = 0.019), hand cold (p = 0.004), facial tactile (p < 0.001), hand tactile (p = 0.012) and facial vibration (p = 0.018) thresholds. Previous existing morbidities were associated with sensitivity changes in the individuals in this sample. CONCLUSION: This longitudinal study suggests that the loss of sensitivity with aging may be associated with the presence of morbidities in elders.

Quantitative sensory testing in elderly: longitudinal study / Teste sensitivo quantitativo em idosos: estudo longitudinal

ABSTRACT Objective: To evaluate elderly patients in a geriatric service, along with their sensory characteristics and their association with clinical aspects. Methods: This was a descriptive longitudinal study. We enrolled 36 healthy participants of both sexes in this study. The following instruments were used and evaluations performed: clinical evaluation, Mini-Mental State Exam, and quantitative sensory testing. Results: During the follow-up, there was reduction of mean corpuscular volume at each evaluation (p < 0.001) and significant increase in mean corpuscular hemoglobin concentration (p < 0.001). There was an increase of the olfactory (p < 0.001), salty (p = 0.024), sour (p = 0.020), bitter (p = 0.001), facial cold (p = 0.019), hand cold (p = 0.004), facial tactile (p < 0.001), hand tactile (p = 0.012) and facial vibration (p = 0.018) thresholds. Previous existing morbidities were associated with sensitivity changes in the individuals in this sample. Conclusion: This longitudinal study suggests that the loss of sensitivity with aging may be associated with the presence of morbidities in elders.

RESUMO Objetivo: Avaliar pacientes idosos em um serviço de geriatria, juntamente com as características sensitivas e sua associação com aspectos clínicos. Métodos: Este é um estudo longitudinal descritivo. Foram avaliados 36 sujeitos saudáveis de ambos os sexos. Os seguintes instrumentos e avaliações foram realizados: Avaliação clínica, Mini Exame de Estado Mental (Mini-Mental) e testes sensitivos quantitativos. Resultados: Durante o acompanhamento houve redução do volume corpuscular médio (VCM) em cada avaliação (P < 0,001) e aumento significativo das concentrações de hemoglobina corpuscular média (CHCM) (P < 0,001). Houve aumento dos limiares olfativos (p < 0,001), salgado (p = 0,024), azedo (p = 0,020), amargo (p = 0,001), frio face (p = 0,019), frio mão (p = 0,004), tato face (p < 0,001), tato mão (p = 0.012) e vibração face (p = 0,018). Morbidades prévias foram associadas às alterações de sensibilidade nos indivíduos desta amostra. Conclusão: Este estudo longitudinal sugere que a perda de sensibilidade no envelhecimento pode estar associada à presença de morbidades em idosos.

Personality, coping and atypical facial pain. Case reports / Personalidade, enfrentamento e dor facial atípica. Relato de casos

ABSTRACT BACKGROUND AND OBJECTIVES: Idiopathic facial pain is a chronic condition with unknown etiology and pathophysiology. Its diagnostic criteria depend on the exclusion of any somatic cause of orofacial pain. Several studies have investigated anxiety and depression, but there is a lack of publications about personality. The objective of this study was to describe three cases of patients with idiopathic facial pain that had their temperament and character evaluated in order to verify the relation between the findings with pain behavior and pain characteristics. The instruments used were a free interview and the Temperament and Character Inventory. CASE REPORTS: Case 1 was proactive and had high scores of cooperativity and self-transcendence correspondent to the well-coping behavior. On the other side, cases 2 and 3 showed similarities about their harm avoidance, novelty seeking and poor coping, correspondent to a self-protective insecure personality. CONCLUSION: These cases show the importance of personality assessment in order to determine coping strategies in complex chronic facial pain such as idiopathic facial pain.

RESUMO JUSTIFICATIVA E OBJETIVOS: Dor facial idiopática persistente é uma condição crônica cujas etiologia e fisiopatologia permanecem obscuras. Os critérios diagnósticos dependem da exclusão de todas as possíveis causas somáticas de dor orofacial. Vários estudos investigaram frequentes comorbidades psiquiátricas como ansiedade e depressão, mas há carência de estudos que tenham observado aspectos de personalidade nesses doentes. O objetivo deste estudo foi descrever três casos de pacientes com dor facial idiopática persistente que foram avaliados quanto a traços de personalidade e de caráter, bem como a associação desses traços com as características da dor e o comportamento doloroso. Os instrumentos utilizados foram a entrevista livre e o Inventário de Caráter e Temperamento de Cloninger. RELATO DOS CASOS: O caso 1 apresentava traços de proatividade e altos índices de cooperatividade e autotranscendência, correspondentes com seu perfil de bom enfrentamento. Por outro lado, os casos 2 e 3 apresentaram similaridades quanto à evitação de dor, busca por novidades e enfrentamento pobre, o que correspondeu a uma personalidade insegura e autoprotetora. CONCLUSÃO: Esses casos mostram a importância de abordar a personalidade do paciente para que estratégias de enfrentamento adequadas sejam estabelecidas para a dor facial crônica complexa.

Oral infections, comorbidities and sensory evidences in elderly: Cross-sectional study.

BACKGROUND: Oral infections affect the general health and overlap with chronic diseases due to infectious-immune mechanisms. On the other side, sensory abnormalities may be symptoms of this association. OBJECTIVE: To evaluate the prevalence of oral infections, comorbidities, health parameters and sensory abnormalities in elderly patients. METHODS: Thirty (30) elderly with mean age 70.4 yo, distributed according to ages were evaluated with a protocol that included demographics, comorbidities, medications, laboratory tests, blood pressure, heart rate, mini-mental state examination, clinical oral evaluation and systematized sensory testing (gustative, olfactory, thermal, mechanical and pain thresholds). Data were tabled and statistically analyzed. RESULTS: Twenty-three (76.6%) subjects had chronic diseases that increased according to the age. Seventeen (56.7%) elderly were having medication. Mean probing pocket depth was 1.90mm±0.39mm, mean clinical attachment level was 0.76mm±0.54mm and mean gingival bleeding index was 29.10%±29.05%. All periodontal indexes increased with age (p <0.05) and were associated with comorbidities and use of medication. Patients with chronic diseases had more numbness and pricking sensations (p=0.031; p=0.000). Main sensory findings were: abnormal gustative and vibratory thresholds, which were associated with hematological parameters (blood count, cholesterol levels and glycaemia). Periodontal parameters were associated with facial cold threshold (p=0.000). CONCLUSION: This study showed an association between systemic diseases, periodontal indexes and sensory thresholds. Sensory findings were associated with blood parameters and are potential tools for periodical health evaluation. Inflammatory or neural mechanisms need further investigation.

Could pain understanding by patients help the assessment of trigeminal neuralgia? / A compreensão da dor pelo paciente pode ajudar no tratamento da neuralgia do trigêmeo?

ABSTRACT BACKGROUND AND OBJECTIVES: To observe the efficacy of pain management by means of an educational proposal to address patients with trigeminal neuralgia, which is a chronic pain with high daily activity limitation rates. METHODS: Eight patients being treated of trigeminal neuralgia participated in weekly meetings on pain in a general reference hospital. Patients had uncontrollable pain in spite of treatments so they would come very frequently to the hospital (once every one or two weeks). Patients were invited to participate in a series of meetings (four) to receive information and discuss about the disease and pain. RESULTS: There has been increased interval between appointments for two patients, who went from weekly to biannual visits, and six patients were discharged with controlled symptoms. CONCLUSION: Education on pain has helped its management and coping by patients, by means of understanding their condition, in addition to improving their abilities to deal with it, decreasing hospital visits due to less pain recurrence.

RESUMO JUSTIFICATIVA E OBJETIVOS: Verificar a eficácia do tratamento da dor, por meio de uma proposta educativa para a abordagem de pacientes com neuralgia do trigêmeo, uma dor crônica com alto índice de limitações em atividades diárias. MÉTODOS: Oito pacientes com neuralgia do trigêmeo em tratamento frequentaram encontros semanais sobre a dor em um hospital geral de referência. Eles apresentavam dor incontrolável apesar dos tratamentos e por isso compareciam em atendimentos com alta frequência (1 vez a cada 1 ou 2 semanas). Eles foram convidados a participar de uma série de encontros (4) para receber informações e discutir sobre a doença e a dor. RESULTADOS: Observou-se que houve um aumento nos intervalos de tempo entre as consultas de 2 pacientes, que passaram de visitas semanais para bienais, e 6 pacientes tiveram alta e controle dos sintomas. CONCLUSÃO: Educação em dor auxiliou no seu manuseio pelos pacientes e em seu enfrentamento, por meio do entendimento de sua condição e no aumento de habilidades para lidar com ela, reduzindo visitas ao ambulatório por conta da menor recorrência de dor.

Orofacial neuropathic pain / Algias neuropáticas orofaciais

ABSTRACT BACKGROUND AND OBJECTIVES: To carry out a literature review on major orofacial neuropathic pains, their differential diagnosis and therapies. CONTENTS: Neuropathic pains may be classified as episodic or continuous. They may be unilateral and more infrequently bilateral. They may last for seconds, hours or days and may present as electrical shock or burning pain, favorably responding to pharmacological treatment. There are situations in which the first therapeutic choice is dental surgery and/or neurosurgery, especially in cases of malignancies. Without accurate diagnosis there is major possibility of poor results. Diagnosis is based on clinical history associated to pain quality, duration and clinical, surgical or combined therapeutic response. Additional exams may be needed in some cases, such as standard periapical radiography of the area to be investigated, panoramic X-rays, computerized tomography and magnetic resonance of the skull base for possible diagnostic confirmation. Treatment may be conservative using anticonvulsants associated or not to antidepressants, local anesthetic infiltration with or without steroid, and orofacial and neurosurgical procedures. CONCLUSION: Health professionals acting in the area of orofacial pain have to be able to establish the differential diagnosis of different neuropathic orofacial pains, since they may have similar clinical presentations involving a same facial territory in a same temporal space, responding differently to the same therapies. Understanding all of this makes available basically two favorable outcomes: improved quality of life or cure of existing neuropathic pain.

RESUMO JUSTIFICATIVA E OBJETIVOS: Realizar uma revisão da literatura sobre as principais dores orofaciais neuropáticas seu diagnóstico diferencial e as suas terapias. CONTEÚDO: As dores neuropáticas podem ser classificadas em episódicas ou continuas. Pode ter caráter unilateral e, mais raramente, de forma bilateral. Podem durar segundos, ou horas a dias. Ter uma natureza em choque elétrico, ou em queimação. Respondem, favoravelmente, ao emprego farmacológico. Há situações em que a primeira escolha terapêutica é a cirúrgica odontológica, e/ou neurocirúrgica principalmente nos casos de neoplasias. Sem o correto diagnóstico há grande possibilidade de um fraco resultado. Esse se baseia na história clínica associada à qualidade da dor, duração e a resposta terapêutica clínica, cirúrgica ou combinada. Pode ser necessário, em alguns casos, solicitar-se exames complementares, como radiografia periapical padrão da área a ser investigada, radiografia panorâmica, tomografia computadorizada e exame de ressonância nuclear magnética nuclear da base do crânio no intuito de uma possível confirmação diagnóstica. O tratamento pode ser clínico conservador utilizando anticonvulsivantes associados ou não a antidepressivos, infiltração anestésica local, com ou sem corticosteroide e procedimentos orofaciais e neurocirúrgicos. CONCLUSÃO: Os profissionais da área da saúde, que medeiam na área da dor orofacial, têm de serem capazes de estabelecer o diagnóstico diferencial das diferentes algias orofaciais neuropáticas, uma vez que podem apresentar quadros clínicos similares envolvendo um mesmo território facial em um mesmo espaço temporal, respondendo diferentemente as mesmas terapêuticas. A compreensão de tudo isso, disponibiliza basicamente dois desfechos favoráveis: a melhora da qualidade de vida do paciente ou a cura da dor neuropática presente.

Chronic pain relief after the exposure of nitrous oxide during dental treatment: longitudinal retrospective study.

The objective was to investigate the effect of nitrous/oxygen in chronic pain. Seventy-seven chronic pain patients referred to dental treatment with conscious sedation with nitrous oxide/oxygen had their records included in this research. Data were collected regarding the location and intensity of pain by the visual analogue scale before and after the treatment. Statistical analysis was performed comparing pre- and post-treatment findings. It was observed a remarkable decrease in the prevalence of pain in this sample (only 18 patients still had chronic pain, p < 0.001) and in its intensity (p < 0.001). Patients that needed fewer sessions received higher proportions of nitrous oxide/oxygen. Nitrous oxide may be a tool to be used in the treatment of chronic pain, and future prospective studies are necessary to understand the underlying mechanisms and the effect of nitrous oxide/oxygen in patients according to the pain diagnosis and other characteristics.

Chronic pain relief after the exposure of nitrous oxide during dental treatment: longitudinal retrospective study / Alívio da dor crônica após exposição ao óxido nitroso durante tratamento odontológico: estudo retrospectivo longitudinal

The objective was to investigate the effect of nitrous/oxygen in chronic pain. Seventy-seven chronic pain patients referred to dental treatment with conscious sedation with nitrous oxide/oxygen had their records included in this research. Data were collected regarding the location and intensity of pain by the visual analogue scale before and after the treatment. Statistical analysis was performed comparing pre- and post-treatment findings. It was observed a remarkable decrease in the prevalence of pain in this sample (only 18 patients still had chronic pain, p < 0.001) and in its intensity (p < 0.001). Patients that needed fewer sessions received higher proportions of nitrous oxide/oxygen. Nitrous oxide may be a tool to be used in the treatment of chronic pain, and future prospective studies are necessary to understand the underlying mechanisms and the effect of nitrous oxide/oxygen in patients according to the pain diagnosis and other characteristics.

O objetivo deste estudo foi investigar o efeito do óxido nitroso na dor crônica. Os prontuários de 77 pacientes com dor crônica submetidos a tratamento odontológico com sedação consciente (óxido nitroso/oxigênio) foram incluídos. Os dados sobre localização e intensidade de dor pela escala visual analógica foram considerados, e foi realizada comparação e análise estatística entre os momentos pré- e pós-tratamento. Foi observada redução marcante na prevalência de dor nesta amostra (apenas 18 doentes ainda tinham dor, p < 0,001) e na intensidade de dor (p < 0,001). Os doentes que precisaram de menor quantidade de sessões receberam maiores proporções de óxido nitroso/oxigênio. Em conclusão, pode-se considerar o oxido nitroso como uma ferramenta a ser investigada no tratamento da dor crônica em estudos futuros prospectivos, que poderão identificar os mecanismos associados de acordo com o diagnóstico de dor e outras características.

Evaluation of patients with Alzheimer's disease before and after dental treatment.

Oral infections may play a role in Alzheimer's disease (AD). Objective To describe the orofacial pain, dental characteristics and associated factors in patients with Alzheimer's Disease that underwent dental treatment. Method 29 patients with mild AD diagnosed by a neurologist were included. They fulfilled the Mini Mental State Exam and Pfeffer's questionnaire. A dentist performed a complete evaluation: clinical questionnaire; research diagnostic criteria for temporomandibular disorders; McGill pain questionnaire; oral health impact profile; decayed, missing and filled teeth index; and complete periodontal investigation. The protocol was applied before and after the dental treatment. Periodontal treatments (scaling), extractions and topic nystatin were the most frequent. Results There was a reduction in pain frequency (p=0.014), mandibular functional limitations (p=0.011) and periodontal indexes (p<0.05), and an improvement in quality of life (p=0.009) and functional impairment due to cognitive compromise (p<0.001) after the dental treatment. Orofacial complaints and intensity of pain also diminished. Conclusion The dental treatment contributed to reduce co-morbidities associated with AD and should be routinely included in the assessment of these patients.

Evaluation of patients with Alzheimer's disease before and after dental treatment / Avaliação de pacientes com doença de Alzheimer antes e depois do tratamento dentário

Oral infections may play a role in Alzheimer's disease (AD). Objective To describe the orofacial pain, dental characteristics and associated factors in patients with Alzheimer's Disease that underwent dental treatment. Method 29 patients with mild AD diagnosed by a neurologist were included. They fulfilled the Mini Mental State Exam and Pfeffer's questionnaire. A dentist performed a complete evaluation: clinical questionnaire; research diagnostic criteria for temporomandibular disorders; McGill pain questionnaire; oral health impact profile; decayed, missing and filled teeth index; and complete periodontal investigation. The protocol was applied before and after the dental treatment. Periodontal treatments (scaling), extractions and topic nystatin were the most frequent. Results There was a reduction in pain frequency (p=0.014), mandibular functional limitations (p=0.011) and periodontal indexes (p<0.05), and an improvement in quality of life (p=0.009) and functional impairment due to cognitive compromise (p<0.001) after the dental treatment. Orofacial complaints and intensity of pain also diminished. Conclusion The dental treatment contributed to reduce co-morbidities associated with AD and should be routinely included in the assessment of these patients. .

Infecções orais podem ter um papel na doença de Alzheimer (DA). Objetivo Descrever as características orofaciais, dor, odontológicas e fatores associados em doentes com DA submetidos a tratamento dentário. Método 29 doentes diagnosticados com DA por neurologista foram avaliados através do Mini Exame do Estado Mental e questionário Pfeffer. O exame odontológico foi realizado antes e depois do tratamento dentário e incluiu: questionário clínico; critérios diagnósticos de pesquisa para disfunção temporomandibular; questionário de dor McGill; protocolo de impacto de saúde oral; dentes cariados, perdidos e obturados; e avaliação periodontal. Os procedimentos mais frequentes foram raspagem periodontal, exodontias e prescrição de nistatina tópica. Resultados Houve uma redução na frequência de dor (p=0,014), limitações mandibulares (p=0,011), índices periodontais (p<0.05), e melhora na qualidade de vida (p=0,009) e no comprometimento funcional e cognitivo (p<0,001) após o tratamento dentário. Queixas orofaciais e intensidade de dor também diminuíram. Conclusão O tratamento dentário contribuiu para reduzir comorbidades associadas à DA e deveria ser incluído na rotina de avaliação desses pacientes. .

The role of xerostomia in burning mouth syndrome: a case-control study.

OBJECTIVE: To assess the efficacy of anti-xerostomic topical medication (urea 10%) in patients with burning mouth syndrome (BMS). METHOD: Thirty-eight subjects diagnosed with BMS according to the International Association for the Study of Pain guidelines were randomized to either placebo (5% sodium carboxymethylcellulose, 0.15% methyl paraben, and 10% glycerol in distilled water qsp 100 g) or treatment (urea 10%) to be applied to the oral cavity 3-4 times per day for 3 months. The patients were evaluated before and after treatment with the following instruments: the EDOF-HC protocol (Orofacial Pain Clinic - Hospital das Clínicas), a xerostomia questionnaire, and quantitative sensory testing. RESULTS: There were no differences in salivary flow or gustative, olfactory, or sensory thresholds (P>0.05). Fifteen (60%) patients reported improvement with the treatments (P=0.336). CONCLUSION: In conclusion, there were no differences between groups, and both exhibited an association between reported improvement and salivation.

The role of xerostomia in burning mouth syndrome: a case-control study / O papel da xerostomia na sindrome da ardencia bucal: estudo caso controle

Objective : To assess the efficacy of anti-xerostomic topical medication (urea 10%) in patients with burning mouth syndrome (BMS). Method : Thirty-eight subjects diagnosed with BMS according to the International Association for the Study of Pain guidelines were randomized to either placebo (5% sodium carboxymethylcellulose, 0.15% methyl paraben, and 10% glycerol in distilled water qsp 100 g) or treatment (urea 10%) to be applied to the oral cavity 3-4 times per day for 3 months. The patients were evaluated before and after treatment with the following instruments: the EDOF-HC protocol (Orofacial Pain Clinic – Hospital das Clínicas), a xerostomia questionnaire, and quantitative sensory testing. Results : There were no differences in salivary flow or gustative, olfactory, or sensory thresholds (P>0.05). Fifteen (60%) patients reported improvement with the treatments (P=0.336). Conclusion : In conclusion, there were no differences between groups, and both exhibited an association between reported improvement and salivation. .

Objetivo : Avaliar a eficácia do uso de medicação tópica anti xerostomica (ureia 10%) em pacientes com síndrome de ardência bucal. Método : Trinta e oito sujeitos diagnosticados com síndrome de ardência bucal de acordo com os critérios da Associação Internacional para Estudo da Dor foram randomizados para grupo placebo (5% de carboximetilcelulose de sódio, 0,15% de metilparabeno e 10% de glicerol em água destilada qsp 100g) ou grupo tratamento (ureia 10%) para ser aplicada na cavidade oral 3-4 vezes ao dia, durante três meses. Os pacientes foram avaliados antes e depois do tratamento: protocolo EDOF-HC, questionário de xerostomia, testes sensitivos quantitativos. Resultados : Não houve diferenças no fluxo salivar, limiares gustativos, olfativos e somestésicos (Mann-Whitney P>0,05). Quinze (60%) dos pacientes tiveram melhora com o tratamento (P=0,336, oneway ANOVA ). Conclusão : Em conclusão não houve diferenças entre os grupos, ambos apresentaram uma associação entre melhora e salivação. .