Salivary Complaints in Burning Mouth Syndrome: A Cross Sectional Study on 500 Patients

Abstract

Background: Xerostomia and sialorrhea often accompany Burning Mouth Syndrome (BMS) despite no change in saliva quantity. This study analyzed BMS patients with different symptom combinations: burning only (B), burning and xerostomia (BX), burning and sialorrhea (BS), and burning with xerostomia and sialorrhea (BXS), using a large sample of 500 patients from the University of Naples Federico II.

Methods: After a medical evaluation, patients were divided into four groups based on their reported symptoms: B (140), BX (253), BS (49), and BXS (58). Patient data on education, BMI, smoking/alcohol habits, comorbidities, medication use, pain intensity, quality, and psychological profile were collected.

Results: The BX group showed a higher prevalence of patients taking blood thinners. Additional symptoms varied among groups, with the BX group experiencing more dysgeusia and globus, and the BS group reporting more tingling. Multivariate analysis identified BMI, dysgeusia, globus, and blood thinner use as significant factors in the B and BX groups, while male gender, tingling, alcohol use, and pain quality were significant in the BS and BXS groups.

Conclusions: Overall, BMS patients display a complex range of symptoms, with xerostomia being the most frequent additional symptom. Sociodemographic, psychological, and medical factors cannot fully explain the variations in symptomatology among different patient subgroups. Further research is needed to understand the underlying causes and develop tailored treatment approaches.

Keywords: burning mouth syndrome; saliva; sialorrhea; xerostomia.

Figure 1

Flow Chart of the study. Abbreviations: BMS: Burning Mouth Syndrome; BMI: Body Mass Index; HAM-A: Hamilton rating scale for anxiety; HAM-D: Hamilton rating scale for depression; VAS: Visual Analogue Scale; SF-MPQ: Short Form Mc-Gill Pain Questionnaire; PSQI: Pittsburgh Sleep Quality Index; ESS: Epworth Sleepiness Scale.