Outcome predictors of initial treatment with topical lubricant and parafunctional habit control in burning mouth syndrome (BMS)

Burning mouth syndrome (BMS) is a common chronic pain condition which mainly affects elderly women. The concomitant prescription of topical lubricants with oral parafunctional habit control has been reported as an effective initial approach for patients with BMS. In this study, we have investigated outcome predictors of this initial treatment in patients with BMS. One hundred forty patients with BMS (12 men and 128 women, mean age 59.9 ± 10.7 years) were instructed to avoid oral parafunctions and to use topical lubricant for 2 weeks. The patients were sub-grouped according to psychological status, salivary flow rate, presence of psychiatric medications, symptom area and duration, symptom severity, presence of oral parafunctions, and accompanying oral complaints. The changes in symptoms were analyzed and compared between sub-groups. Subjects with T-scores ≤ 50 for each psychological symptom dimension, a flow rate of stimulated whole saliva (SWS) > 0.5 ml/min, no psychiatric medications, and a greater degree of initial symptoms (VAS ≥ 5) displayed greater decreases in symptoms compared with their counterparts. In conclusion, psychological status, psychiatric medications, flow rate SWS, and initial symptom severity can be outcome predictors of the initial treatment approach for patients with BMS.