Pain and Pain Behavior in Burning Mouth Syndrome: A Pain Diary Study

Key words: burning mouth syndrome, pain behavior, pain coping, pain diary, stomatodynia

Heli Forssell, DDS, PhD/Tuija Teerijoki-Oksa, DDS, PhD/Ulla Kotiranta, DDS/Rosita Kantola, DDS/ Marjaliina Bäck, DDS/Tiina-Riitta Vuorjoki-Ranta, DDS/Maria Siponen, DDS/Ari Leino, DDS/ Pauli Puukka, MsocSc/Ann-Mari Estlander, PhD

Aims: To characterize pain related to primary burning mouth syndrome (BMS) in terms of intensity, interference, and distress caused by the pain, as well as factors influencing the pain across a period of 2 weeks, and to study the use of coping and management strategies on a daily basis.

Methods: Fifty-two female patients with primary BMS completed a 2-week pain diary. Pain intensity, interference, distress, and mood on a 0 to 10 numeric rating scale (NRS), as well as pain amplifying and alleviating factors, were recorded three times a day. The use of treatments (medication or other means) and coping strategies were recorded at the end of each day. Coefficient of variation, repeated measures analysis of variance, and correlative methods were used to assess the between- and within-subject variation, pain patterns, and associations between various pain scores.

Results: The overall mean pain intensity score of the 14 -diary days was 3.1 (SD: 1.7); there was considerable variation in pain intensity between patients. Most patients experienced intermittent pain. On average, pain intensity increased from the morning to the evening. Intercorrelations between pain intensity, interference, distress, and mood were high, varying between rs = .75 and rs = .93 (P < .001). Pungent or hot food or beverages, stress, and tiredness were the most frequently mentioned pain-amplifying factors. The corresponding pain-alleviating factors were eating, sucking pastilles, drinking cold beverages, and relaxation. Thirty (58%) patients used pain medication and 35% reported using other means to alleviate their BMS pain. There was large variation in the use of coping strategies -between subjects.

Conclusion: There were considerable differences in pain, in factors influencing the pain, and in pain behavior across BMS patients. This indicates that patient information and education as well as treatment of BMS pain should be individualized.- J OROFAC PAIN 2012;26:117–125

Burning mouth syndrome causes chronic burning pain in your mouth. The pain from burning mouth syndrome may affect your tongue, gums, lips, inside of your cheeks, roof of your mouth, or widespread areas of your whole mouth. The pain can be severe and very frustrating to deal with because it can be hard to pinpoint the cause. Fortunately, the emerging specialty of Orofacial Pain focuses on these types of conditions, as well as other difficult conditions to treat like Trigeminal Neuralgia. Dr. Stan Farrell is Board Certified in Orofacial Pain and has several conservative treatment options available for Burning Mouth patients. Call and schedule a consultation today @ 480-945-3629.