Background & Aims
Burning mouth syndrome (BMS) is a chronic pain condition affecting oral cavity. This condition mostly affect peri- or postmenopausal women, for this reason, sexual hormonal changes have been implicated in BMS pathogenesis. Thus, it is of upmost importance to summarize evidence in this matter. In this sense, the aim of this systematic review was correlate sex hormones levels and report of symptoms and quality of life in patients with BMS.
Methods
A systematic review was performed in MEDLINE/PubMed, Scopus, Web of Science, Cochrane Library, and EMBASE without restriction for language or year. Eligibility criteria were controlled studies addressing the PICO question: (P)Patients with BMS; (I) detection the sex hormones; (C) patients without BMS; (O) sexual hormones changes as a risk factor for BMS severity. Risk of bias was performed with Newcastle-Ottawa Quality Assessment Scale.
Results
Four studies were included. Salivary levels were in three studies and serum blood was used in one. Three studies analyzed estradiol and/or DHEA (dehydroepiandrosterone), two assessed progesterone, and one evaluated FSH (follicle stimulating hormone). Estradiol results were contradictory, with two studies reporting lower levels in BMS patients compared with controls and one finding the opposite. DHEA was statistically lower in BMS group in one study. Progesterone showed opposite results in two studies, although anyone with statistically significance. FSH was statistically higher in BMS group compared with controls. Correlation of hormones with quality-of-life was performed in 3 studies and there was not a significant correlation with self-perceived symptoms severity.
Conclusions
Sexual hormones can be altered in BMS, especially estradiol. However, due to the paucity of studies, it is not possible to determine a range in which patients showld be at risk to develop this condition. Despite these changes, we did not find correlation with BMS symptoms intensity affecting quality of life. These findings suggested that hormonal alterations may be a promising area to improve BMS management.
References
International Classification of Orofacial Pain (ICOP). Cephalalgia 2020;40(2):129-221.
Imamura Y, Shinozaki T, Okada?Ogawa A, et al. An updated review on pathophysiology and management of burning mouth syndrome with endocrinological, psychological and neuropathic perspectives. J Oral Rehabil 2019;46(6):574-587.
Chmieliauskaite M, Stelson EA, Epstein JB, et al. Consensus agreement to rename burning mouth syndrome and improve ICD-11 disease criteria. Pain 2021;162(10):2548-2557.
Khawaja SN, Alaswaiti OF, Scrivani SJ. Burning Mouth Syndrome. Dent Clin North Am 2023;67(1):49-60.
Aljanobi H, Sabharwal A, Krishnakumar B, Kramer JM. Is it Sjögren’s syndrome or burning mouth syndrome? Distinct pathoses with similar oral symptoms. Oral Surg Oral Med Oral Pathol Oral Radiol 2017 Apr;123(4):482-495.
Currie CC, Ohrbach R, De Leeuw R, Forssell H, Imamura Y, Jääskeläinen SK, Koutris M, Nasri-Heir C, Huann T, Renton T, Svensson P, Durham J. Developing a research diagnostic criteria for burning mouth syndrome: Results from an international Delphi process. J Oral Rehabil 2021 Mar;48(3):308-331.
Teruel A, Patel S. Burning mouth syndrome: A review of etiology, diagnosis, and management. Gen Dent 2019;67(2):24-29.
Bergdahl M, Bergdahl J. Burning mouth syndrome: prevalence and associated factors. J Oral Pathol Med 2007;28(8):350-354.
Kohorst JJ, Bruce AJ, Torgerson RR, Schenck LA, Davis MDP. The prevalence of burning mouth syndrome: a population-based study. British J Dermat 2015;172(6):1654-1656.
Wardrop RW, Hailes J, Burger H, Reade PC. Oral discomfort at menopause. Oral Surg Oral Med Oral Pathol 1989;67(5):535-540.
Minicucci EM, Pires RB, Vieira RA, Miot HA, Sposto MR. Assessing the impact of menopause on salivary flow and xerostomia. Aust Dent J 2013 Jun;58(2):230-4.
Friedlander AH. The physiology, medical management and oral implications of menopause. J Am Dent Assoc 2002;133(1):73-81.
Ciesielska A, Kusiak A, Ossowska A, Grzybowska ME. Changes in the Oral Cavity in Menopausal Women-A Narrative Review. Int J Environ Res Public Health 2021;19(1).
Pereira JV, Normando AGC, Rodrigues-Fernandes CI, Rivera C, Santos-Silva AR, Lopes MA. The impact on quality of life in patients with burning mouth syndrome: A systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2021;131(2):186-194.
Thompson IOC, van der Bijl P, van Wyk CW, van Eyk AD. A comparative light-microscopic, electron-microscopic and chemical study of human vaginal and buccal epithelium. Arch Oral Biol 2001;46(12):1091-1098.
Leimola-Virtanen R, Salo T, Toikkanen S, Pulkkinen J, Syrjänen S. Expression of estrogen receptor (ER) in oral mucosa and salivary glands. Maturitas 2000;36(2):131-137.
Valimaa H, Savolainen S, Soukka T, et al. Estrogen receptor-beta is the predominant estrogen receptor subtype in human oral epithelium and salivary glands. J Endoc 2004;180(1):55-62.
Kim HI, Kim YY, Chang JY, Ko JY, Kho HS. Salivary cortisol, 17?-estradiol, progesterone, dehydroepiandrosterone, and ?-amylase in patients with burning mouth syndrome. Oral Dis 2012;18(6):613-620.
Kang JH, Kim YY, Chang JY, Kho HS. Relationships between oral MUC1 expression and salivary hormones in burning mouth syndrome. Arch Oral Biol 2017;78:58-64.
Wandeur T, de Moura SAB, de Medeiros AMC, et al. Exfoliative cytology of the oral mucosa in burning mouth syndrome: A cytomorphological and cytomorphometric analysis. Gerod 2011;28(1):44-48.
Seol SH, Chung G. Estrogen-dependent regulation of transient receptor potential vanilloid 1 (TRPV1) and P2X purinoceptor 3 (P2X3): Implication in burning mouth syndrome. J Dent Sci 2022;17(1):8-13.
Lo?car-Brzak B, Vidranski V, Andabak-Rogulj A, et al. Salivary hormones and quality of life in female postmenopausal burning mouth patients-A pilot case-control study. Dent J (Basel) 2020;8(4):2-8.
Dias Fernandes CS, Salum FG, Bandeira D, Pawlowski J, Luz C, Cherubini K. Salivary dehydroepiandrosterone (DHEA) levels in patients with the complaint of burning mouth: a case-control study. Oral Surg Oral Med Oral Pathol Oral Rad End 2009;108(4):537-543.
Gao J, Chen L, Zhou J, Peng J. A case-control study on etiological factors involved in patients with burning mouth syndrome. J Oral Pathol Med 2009;38(1):24-28.
Derogatis LR. SCL-90 (Revised) manual. In: Clinical Psychometrics Research Unit. MD; 1977.
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961 Jun;4:561-71.
Beck AT, Weissman A, Lester D, Trexler L. The measurement of pessimism: The Hopelessness Scale. J Consult Clin Psychol 1974;42(6):861-865.
Hassan S, Muere A, Einstein G. Ovarian hormones and chronic pain: A comprehensive review. Pain 2014 Dec;155(12):2448-2460.
Nappi C, Di Spiezio Sardo A, Guerra G, Bifulco G, Testa D, Di Carlo C. Functional and morphologic evaluation of the nasal mucosa before and after hormone therapy in postmenopausal women with nasal symptoms. Fertil Steril 2003 Sep;80(3):669-71.
Caruso S, Serra A, Grillo C, Maiolino L, Agnello C, Di Mari L, Cianci A. Characteristics of nasal epithelial cells in naturally postmenopausal women receiving hormone therapy with 1 mg 17beta-estradiol and 2 mg drospirenone: a prospective study. Menopause 2008;15(5):963-6.
Bergman A, Karram M, M, Bhatia N, N: Changes in Urethral Cytology following Estrogen Administration. Gynecol Obstet Invest 1990;29:211-213.
Reimer A, Johnson L. Atrophic vaginitis: signs, symptoms, and better outcomes. Nurse Pract 2011 Jan;36(1):22-8.
Cox S, Nasseri R, Rubin RS, Santiago-Lastra Y. Genitourinary Syndrome of Menopause. Med Clin North Am 2023 Mar;107(2):357-369.
Nasri C, Teixeira MJ, Okada M, Formigoni G, Heir G, Siqueira JT. Burning mouth complaints: clinical characteristics of a Brazilian sample. Clinics (Sao Paulo) 2007 Oct;62(5):561-6.
Lee YH DDS, PhD, Chon S MD, PhD. Burning mouth syndrome in postmenopausal women with self-reported sleep problems. Cranio 2020 Jul;38(4):221-232.
Lee YH, An JS, Chon S. Sex differences in the hypothalamic-pituitary-adrenal axis in patients with burning mouth syndrome. Oral Dis 2019 Nov;25(8):1983-1994.
Yoshida N, Sugimoto K, Suzuki S, Kudo H. Change in oral health status associated with menopause in Japanese dental hygienists. Int J Dent Hyg 2018 Feb;16(1):157-164.
Volpe A, Lucenti V, Forabosco A, Boselli F, Latessa AM, Pozzo P, Petraglia F, Genazzani AR. Oral discomfort and hormone replacement therapy in the post-menopause. Maturitas 1991 Mar;13(1):1-5.
Singh M, Su C. Progesterone and neuroprotection. Horm Behav 2013 Feb;63(2):284-90.
Kamin HS, Kertes DA. Cortisol and DHEA in development and psychopathology. Horm Behav 2017 Mar;89:69-85.
Lima ENA, Barbosa NG, Dos Santos AC, Araújo Moura Lemos TM, de Souza CM, Trevilatto PC, da Silveira EJ, de Medeiros AM. Comparative Analysis of Psychological, Hormonal, and Genetic Factors Between Burning Mouth Syndrome and Secondary Oral Burning. Pain Med 2016 Sep;17(9):1602-11.
Soares MS, Chimenos-Küstner E, Subirá-Pifarrè C, Rodríguez de Rivera-Campillo ME, López-López J. Association of burning mouth syndrome with xerostomia and medicines. Med Oral Patol Oral Cir Bucal 2005 Aug-Oct;10(4):301-8.
Presenting Author
Thayanne Brasil Barbosa Calcia
Poster Authors
Topics
- Gender/Sex Differences