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Current Management Strategies for the Pain of Elderly Patients With Burning Mouth Syndrome: A Critical Review

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Review

Current Management Strategies for the Pain of Elderly Patients With Burning Mouth Syndrome: A Critical Review

Trang T H Tu et al. Biopsychosoc Med.

Abstract

Burning Mouth Syndrome (BMS), a chronic intraoral burning sensation or dysesthesia without clinically evident causes, is one of the most common medically unexplained oral symptoms/syndromes. Even though the clinical features of BMS have been astonishingly common and consistent throughout the world for hundreds of years, BMS remains an enigma and has evolved to more intractable condition. In fact, there is a large and growing number of elderly BMS patients for whom the disease is accompanied by systemic diseases, in addition to aging physical change, which makes the diagnosis and treatment of BMS more difficult. Because the biggest barrier preventing us from finding the core pathophysiology and best therapy for BMS seems to be its heterogeneity, this syndrome remains challenging for clinicians. In this review, we discuss currently hopeful management strategies, including central neuromodulators (Tricyclic Antidepressants - TCAs, Serotonin, and Norepinephrine Reuptake Inhibitors - SNRIs, Selective Serotonin Reuptake Inhibitors - SSRIs, Clonazepam) and solutions for applying non-pharmacology approaches. Moreover, we also emphasize the important role of patient education and anxiety management to improve the patients' quality of life. A combination of optimized medication with a short-term supportive psychotherapeutic approach might be a useful solution.

Keywords: Burning mouth syndrome; Elderly; Management strategies; Medically unexplained oral symptoms; Neuromodulators; Oral facial pain; Psychotherapy.

Conflict of interest statement

Not applicable.Not applicable.The authors report no conflicts of interest in this work.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The proportion of elderly among first-visit Burning Mouth Syndrome patients over the past 10 years (2008–2017)
Fig. 2
Fig. 2
Causative components of Burning Mouth Syndrome
Fig. 3
Fig. 3
MR imaging a 70 year old male complaining of burning tongue. He was found to have a carcinoma of the left submandibular gland
Fig. 4
Fig. 4
Typical clinical course of a Burning Mouth Syndrome patient treated with Tricyclic Antidepressants

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