The Role of Stress in Burning Mouth Syndrome Triggered by Dental Treatments: A Two-Step Hypothesis

IF 3.1 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of oral rehabilitation Pub Date : 2025-03-26 DOI:10.1111/joor.13964

Ashley Lebel, Géraldine Lescaille, Iva Alajbeg, Ivan Alajbeg, Yves Boucher

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引用次数: 0

Abstract

Objectives

Burning mouth syndrome (BMS) is a complex and debilitating orofacial pain disorder, defined as a persistent burning sensation in the oral mucosa without any identifiable causative lesion. Its prevalence increases with age, and women are disproportionately more affected. Onset typically occurs around menopause, sometimes associated with triggers such as stressful life events. Interestingly, some patients report dental treatments (DTs) as a precipitating event, yet evidence supporting the association between DTs and BMS onset remains scarce in the literature.

Patients and Methods

In this retrospective study based on electronic medical records, we identified BMS patients from the ABCD cohort of Chronic Orofacial Pain Department (COFPD) of the Pitié-Salpêtrière hospital in Paris, France, between January 2020 and December 2023. Patients fulfilling the International Classification of Orofacial Pain (ICOP) and International Classification of Headache Disorders (ICHD-3) criteria for BMS, who reported burning tongue pain following DTs and had a well-documented clinical history, were included.

Results

Among 78 identified BMS patients (70 women, 8 men), seven cases (all women, mean age 51.0 ± 3.8 years) of unilateral or bilateral burning tongue pain with a well-documented dental history were included. Detailed demographic, medical and pain characteristics are thoroughly reported. Pathophysiological hypotheses focusing on neurobiological mechanisms, the significant role of stress and neuronal sensitization are discussed.

Conclusion

The diagnosis of BMS should be considered cautiously in cases of unilateral symptoms to avoid misdiagnosis with other orofacial pain conditions, such as painful trigeminal neuropathy. A two-step hypothesis is proposed to explain the development of BMS, emphasising the interplay between stress and dental treatments in its onset.

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压力在牙科治疗引发的灼口综合征中的作用：一个两步假说。

目的：灼口综合征（BMS）是一种复杂的、使人衰弱的口腔面部疼痛疾病，定义为口腔黏膜持续烧灼感，无任何可识别的病因病变。它的流行率随着年龄的增长而增加，女性受到的影响更大。发病通常发生在更年期前后，有时与生活压力事件等触发因素有关。有趣的是，一些患者报告牙科治疗（DTs）是一个突发事件，然而文献中支持DTs与BMS发病之间关联的证据仍然很少。患者和方法：在这项基于电子病历的回顾性研究中，我们从法国巴黎Pitié-Salpêtrière医院慢性口腔面部疼痛科（COFPD）的ABCD队列中确定了2020年1月至2023年12月期间的BMS患者。符合国际口腔面部疼痛分类（ICOP）和国际头痛疾病分类（ICHD-3）标准的BMS患者，在DTs后报告灼烧性舌痛，并有良好的临床病史。结果：78例BMS患者（女性70例，男性8例）中，7例（均为女性，平均年龄51.0±3.8岁）有单侧或双侧舌痛，且有良好的牙科病史。详细的人口统计、医学和疼痛特征被彻底报告。病理生理假说集中在神经生物学机制，应激和神经元致敏的重要作用进行了讨论。结论：BMS的诊断应慎重考虑单侧症状，避免误诊为其他口面部疼痛情况，如疼痛性三叉神经病变。提出了一个两步假说来解释BMS的发展，强调压力和牙科治疗之间的相互作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of oral rehabilitation 医学-牙科与口腔外科

CiteScore

5.60

自引率

10.30%

发文量

116

审稿时长

4-8 weeks

期刊介绍： Journal of Oral Rehabilitation aims to be the most prestigious journal of dental research within all aspects of oral rehabilitation and applied oral physiology. It covers all diagnostic and clinical management aspects necessary to re-establish a subjective and objective harmonious oral function. Oral rehabilitation may become necessary as a result of developmental or acquired disturbances in the orofacial region, orofacial traumas, or a variety of dental and oral diseases (primarily dental caries and periodontal diseases) and orofacial pain conditions. As such, oral rehabilitation in the twenty-first century is a matter of skilful diagnosis and minimal, appropriate intervention, the nature of which is intimately linked to a profound knowledge of oral physiology, oral biology, and dental and oral pathology. The scientific content of the journal therefore strives to reflect the best of evidence-based clinical dentistry. Modern clinical management should be based on solid scientific evidence gathered about diagnostic procedures and the properties and efficacy of the chosen intervention (e.g. material science, biological, toxicological, pharmacological or psychological aspects). The content of the journal also reflects documentation of the possible side-effects of rehabilitation, and includes prognostic perspectives of the treatment modalities chosen.