Burning mouth syndrome (BMS): double blind controlled study of alpha-lipoic acid (thioctic acid) therapy. Benzydamine hydrochloride oral rinses in management of burning mouth syndrome. A clinical trial. Cognitive therapy in the treatment of patients with resistant burning mouth syndrome: a controlled study. Trazodone in burning mouth pain: a placebo-controlled, double-blind study. Topical clonazepam in stomatodynia: a randomised placebo-controlled study. Burning mouth syndrome (BMS): controlled open trial of the efficacy of alpha-lipoic acid (thioctic acid) on symptomatology. Burning mouth syndrome (BMS): an open trial of comparative efficacy of alpha-lipoic acid (thioctic acid) with other therapies. The effect of steroid hormones on buccal mucosa of menopausal women.
Burning mouth syndrome (BMS) has features of a neuropathy and could be related to the production of the toxic free radicals that are released in stress situations. Alpha-lipoic acid is an antioxidant able to increase the levels of intracellular glutathione and eliminate free radicals. This study aimed to examine the effectiveness of alpha-lipoic acid in the therapy of BMS.
                This was a double blind, controlled study conducted for two months on 60 patients with constant BMS. Comparing alpha-lipoic acid (test) with cellulose starch (placebo), there was no laboratory evidence of deficiencies in iron, vitamins or thyroid function and no hyperglycaemia.
                Following treatment with alpha-lipoic acid, there was a significant symptomatic improvement, compared with placebo, with the majority showing at least some improvement after 2 months, thus supporting the hypothesis that burning mouth syndrome is a neuropathy. This improvement was maintained in over 70% of patients at the 1 year follow-up. The purpose of this study was to evaluate the efficacy of the topical use of benzydamine hydrochloride 0.15% oral mouthwashes in the control of burning mouth syndrome symptoms.
                In this double-blind, randomized, longitudinal investigation, each of 30 patients with burning mouth syndrome was assigned to one of 3 management modalities. Those in group A received an oral rinse solution of benzydamine hydrochloride 0.15% 3 times a day for 4 weeks, those in group B received a placebo 3 times a day for 4 weeks, and those in group C did not receive any kind of treatment. A visual analog scale was used for evaluation of the symptoms; a Kruskal-Wallis analysis of variance exact test was performed on the resulting data.
                The findings of this investigation failed to reveal significant differences among the groups.
                The clinical application of benzydamine hydrochloride oral rinses in the treatment of patients with burning mouth syndrome did not demonstrate significative efficacy in comparison with use of a placebo solution. The effect of cognitive therapy (CT) on resistant burning mouth syndrome (BMS) was studied. Thirty patients with resistant BMS after odontological and medical treatment were randomly divided into two equal groups; a therapy group (TG) was treated with CT and an attention/placebo group (APG) served as a control group. The intensity of BMS, which was estimated by the use of a visual analogue scale, was significantly reduced in the TG directly after CT was completed and was further reduced in a 6-month follow-up. The APG did not show any decrease in intensity of BMS. The results of this study indicate that, in some cases, resistant BMS probably is of psychological origin. An 8-week parallel, placebo-controlled, double-blind trial evaluated the efficacy of the antidepressant trazodone in the treatment of chronic burning mouth pain.
                Thirty-seven carefully selected women aged 39 to 71 (mean 58.6 years) were randomized to receive either 200 mg of trazodone or a placebo in a similar manner. Pain and pain-related symptoms were evaluated on a visual analogue scale and other measures at 0, 2, 4, and 8 weeks.
                There were no significant differences between the groups in treatment effects for pain or pain-related symptoms. Seven patients in the trazodone group and 2 in the placebo group failed to complete the trial because of side effects. The most common side effects were dizziness and drowsiness.
                In this controlled trial, trazodone failed to relieve burning mouth pain. Stomatodynia is characterised by a spontaneous burning pain in the oral mucosa without known cause or recognised treatment. The purpose of this double-blind, randomised, multicentre parallel group study was to evaluate the efficacy of the topical use of clonazepam. Forty-eight patients (4 men and 44 women, aged 65+/-2.1 years) were included, of whom 41 completed the study. The patients were instructed to suck a tablet of 1 mg of either clonazepam or placebo and hold their saliva near the pain sites in the mouth without swallowing for 3 min and then to spit. This protocol was repeated three times a day for 14 days. The intensity was evaluated by a 11-point numerical scale before the first administration and then after 14 days. Two weeks after the beginning of treatment, the decrease in pain scores was 2.4+/-0.6 and 0.6+/-0.4 in the clonazepam and placebo group, respectively (P = 0.014). Similar effects were obtained in an intent-to-treat analysis (P = 0.027). The blood concentration of clonazepam was similar whether it was measured 14 days after sucking a tablet three times a day or during the 5 h that followed sucking a single tablet (n = 5). It is hypothesised that clonazepam acts locally to disrupt the mechanism(s) underlying stomatodynia. Alpha-lipoic acid (ALA), is a potent antioxidant mitochondrial coenzyme, the trometamol salt of thioctic acid that has been shown in clinical studies to be neuroprotective. This study examined the effect of ALA on the symptomatology of Burning mouth syndrome (BMS).
                Forty-two patients with BMS and no clinical or laboratory evidence of organic oral disease were divided into two groups (Test and Control) each of 21 subjects, matched for age and sex. The Test group were given ALA (thioctic acid; Tiobec) for 30 days, as 600 mg per day orally for 20 days followed by 200 mg per day for 10 days. The Control group were given cellulose starch 100 mg per day as placebo for 30 days. All BMS patients were reviewed at 10-day intervals and scored for changes in symptomatology.
                Significant improvements were shown in the symptomatology of BMS in up to two-thirds of patients with BMS receiving alpha-lipoic acid, in about 15% of those using placebo and also in up to two-thirds of those who, having tried placebo, were switched to ALA. Alpha-lipoic acid (ALA) is a potent antioxidant mitochondrial coenzyme, trometamol salt of thioctic acid, shown in clinical studies to be neuroprotective and in a preliminary study to have an effect on the symptomatology of Burning Mouth Syndrome (BMS).
                We were interested in extending our studies as to whether alpha-lipoic acid might improve the symptomatology in BMS and therefore carried out a larger open controlled clinical study on the effects of alpha-lipoic acid on BMS symptomatology.
                We have examined the effects on 4 groups of 20 patients with BMS of ALA, compared with bethanecol, Biotene and placebo, and found ALA of remarkable benefit with minimal adverse effects.
                These results suggest that double-blind randomized controlled multicenter studies of ALA are indicated. The effects of local application of estrone and progesterone on the oral mucosa was studied in sixty-one patients. These included forty-one postmenopausal women with various subjective oral complaints, ten postmenopausal women with no oral complaints, and ten normally menstruating women. Subjective complaints (dryness, bad taste, burning sensation, and viscous saliva), quantity of saliva, and histologic changes in buccal mucosa were evaluated before and after treatment. Treatment comprised three modalities: an ointment containing estrone alone; another ointment of estrone and progesterone; and a third with a placebo base. These were massaged three times daily over the gingivae and oral mucosa for 30 days. A significant increase in secretion of saliva was observed with all three treatment modalities. Biopsies showed marked proliferative changes with all three types of ointment. A moderate improvement in subjective complaints followed all types of medication. These results indicate no specific effect of female sex hormones on the factors considered in this study. It appears that simple, repeated massage with any suitable ointment base is an effective method of inducing proliferative changes in atrophic buccal mucosa, increasing salivary secretion, and alleviating some of the subjective oral complaints of postmenopausal women.
Given the chronic nature of BMS, the need to identify an effective mode of treatment for sufferers is vital. However, there is little research evidence that provides clear guidance for those treating patients with BMS. Further trials, of high methodological quality, need to be undertaken in order to establish effective forms of treatment for patients suffering from BMS.