Clinical Oral Investigations

, Volume 23, Issue 2, pp 757–762 | Cite as

Mechanical sensitivity and psychological factors in patients with burning mouth syndrome

  • Mika HondaEmail author
  • Takashi Iida
  • Hirona Kamiyama
  • Manabu Masuda
  • Misao Kawara
  • Peter Svensson
  • Osamu Komiyama
Original Article



The aim of this study was to compare mechanical sensitivity on the tongue using quantitative sensory testing (QST) and psychological factors using the General Health Questionnaire (GHQ) between burning mouth syndrome (BMS) patients and healthy participants.

Materials and methods

Participants comprised 20 female BMS patients (68.1 ± 7.4 years) and 20 healthy females (65.4 ± 4.6 years). Psychological factors were evaluated with GHQ. Tactile detection thresholds (TDT) and filament-prick pain detection thresholds (FPT) were used to evaluate mechanical sensitivity on the tongue in all participants. TDT and FPT were measured on the tongue within both the painful area and the non-painful area in BMS patients, and on the tongue on both sides in healthy participants. As controls, TDT and FPT were measured with Semmes-Weinstein monofilaments on the skin of the mentum and palm in all participants.


GHQ scores were significantly higher in BMS patients than in healthy participants (P = 0.024). No significant differences in TDT or FPT on the tongue, mentum, or palm were seen between BMS patients and healthy participants (P > 0.05). BMS patients showed no significant differences in TDT or FPT between the painful and non-painful areas on the tongue (P > 0.05). There were no significant correlations among TDT/FPT and GHQ score in BMS patients (P > 0.05).


These findings could indicate a more important role for psychological factors than mechanical sensitivity in BMS pathophysiology.

Clinical relevance

Pain on the tongue in elderly female patients with BMS may be more related to psychological factors.


Burning mouth syndrome Psychological factors Primary orofacial pain Tongue Quantitative sensory testing 



This study was supported by the Technology of Japan and a grant-in-aid for scientific research (17K11785 and 17K11786) from the Japanese Society for the Promotion of Science.

Compliance with ethical standards

Ethical approval of the protocol was provided by the Department of Oral Function and Rehabilitation, Nihon University School of Dentistry at Matsudo, Japan. This protocol was approved by the Ethics Committee of Nihon University School of Dentistry at Matsudo (EC 11-024), based on the guidelines set forth in the Declaration of Helsinki II.

Conflict of interest

The authors declare that they have no competing interests.

Informed consent

Informed consent was obtained from all participants before the experiment.


  1. 1.
    Merskey H, Bogduk N (1994) Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. IASP Press, Seattle, pp 209–214Google Scholar
  2. 2.
    Grushka M, Epstein JB, Gorsky M (2002) Burning mouth syndrome. Am Fam Physician 15:615–620Google Scholar
  3. 3.
    Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, Cohen M, Evers S, Finnerup NB, First MB, Giamberardino MA, Kaasa S, Kosek E, Lavandʼhomme P, Nicholas M, Perrot S, Scholz J, Schug S, Smith BH, Svensson P, Vlaeyen JW, Wang SJ (2015) A classification of chronic pain for ICD-11. Pain 156:1003–1007Google Scholar
  4. 4.
    Jimson S, Rajesh E, Krupaa RJ, Kasthuri M (2015) Burning mouth syndrome. J Pharm Bioallied Sci 7:194–196Google Scholar
  5. 5.
    Coculescu EC, Tovaru S, Coculescu BI (2014) Epidemiological and etiological aspects of burning mouth syndrome. J Med Life 7:305–309Google Scholar
  6. 6.
    Lauria G, Majorana A, Borgna M, Lombardi R, Penza P, Padovani A, Sapelli P (2005) Trigeminal small-fiber sensory neuropathy causes burning mouth syndrome. Pain 115:332–337CrossRefGoogle Scholar
  7. 7.
    Albuquerque RJ, de Leeuw R, Carlson CR, Okeson JP, Miller CS, Andersen AH (2006) Cerebral activation during thermal stimulation of patients who have burning mouth disorder: an fMRI study. Pain 122:23–34CrossRefGoogle Scholar
  8. 8.
    López-Jornet P, Camacho-Alonso F, Andujar-Mateos P, Sánchez-Siles M, Gómez-Garcia F (2010) Burning mouth syndrome: an update. Med Oral Patol Oral Cir Bucal 15:562–568CrossRefGoogle Scholar
  9. 9.
    Ishida Y, Ugawa S, Ueda T, Murakami S, Shimada S (2002) Vanilloid receptor subtype-1 (VR1) is specifically localized to taste papillae. Brain Res Mol Brain Res 30:17–22CrossRefGoogle Scholar
  10. 10.
    Komiyama O, De Laat A (2005) Tactile and pain thresholds in the intra- and extra-oral regions of symptom-free subjects. Pain 115:308–315CrossRefGoogle Scholar
  11. 11.
    Rolke R, Magerl W, Campbell KA, Schalber C, Caspari S, Birklein F, Treede RD (2006) Quantitative sensory testing: a comprehensive protocol for clinical trials. Eur J Pain 10:77–88CrossRefGoogle Scholar
  12. 12.
    Komiyama O, Kawara M, De Laat A (2007) Ethnic differences regarding tactile and pain thresholds in the trigeminal region. J Pain 8:363–369CrossRefGoogle Scholar
  13. 13.
    Komiyama O, Gracely RH, Kawara M, Laat AD (2008) Intraoral measurement of tactile and filament-prick pain threshold using shortened Semmes-Weinstein monofilaments. Clin J Pain 24:16–21CrossRefGoogle Scholar
  14. 14.
    Pigg M, Baad-Hansen L, Svensson P, Drangsholt M, List T (2010) Reliability of intraoral quantitative sensory testing (QST). Pain 148:220–226CrossRefGoogle Scholar
  15. 15.
    Svensson P, Baad-Hansen L, Pigg M, List T, Eliav E, Ettlin D, Michelotti A, Tsukiyama Y, Matsuka Y, Jääskeläinen SK, Essick G, Greenspan JD, Drangsholt M (2011) Guidelines and recommendations for assessment of somatosensory function in oro-facial pain conditions—a taskforce report. J Oral Rehabil 38:366–394CrossRefGoogle Scholar
  16. 16.
    Geber C, Klein T, Azad S, Birklein F, Gierthmuhlen J, Huge V, Lauchart M, Nitzsche D, Stengel M, Valet M, Baron R, Maier C, Tolle T, Treede RD (2011) Test-retest and interobserver reliability of quantitative sensory testing according to the protocol of the German Research Network on Neuropathic Pain (DFNS): a multi-centre study. Pain 152:548–556CrossRefGoogle Scholar
  17. 17.
    Lu S, Baad-Hansen L, List T, Zhang Z, Svensson P (2013) Somatosensory profiling in healthy subjects modified by intra-oral capsaicin and menthol. Eur J Oral Sci 121:29–35CrossRefGoogle Scholar
  18. 18.
    Baad-Hansen L, Pigg M, Ivanovic SE, Faris H, List T, Drangsholt M, Svensson P (2013) Intraoral somatosensory abnormalities in patients with atypical odontalgia—a controlled multicenter quantitative sensory testing study. Pain 154:1287–1294CrossRefGoogle Scholar
  19. 19.
    Naganawa T, Baad-Hansen L, Ando T, Svensson P (2015) Influence of topical application of capsaicin, menthol and local anesthetics on intraoral and aspects. Exp Brain Res 233:1189–1199CrossRefGoogle Scholar
  20. 20.
    Mo X, Zhang J, Fan Y, Svensson P, Wang K (2015) Thermal and mechanical quantitative sensory testing in Chinese patients with burning mouth syndrome—a probable neuropathic pain condition? J Headache Pain 16:84CrossRefGoogle Scholar
  21. 21.
    Okayasu I, Komiyama O, Ayuse T, De Laat A (2016) Effect of topical lidocaine in the oral and facial regions on tactile sensory and pain thresholds. Arch Oral Biol 72:51–55CrossRefGoogle Scholar
  22. 22.
    Honda M, Baad-Hansen L, Iida T, Komiyama O, Kawara M, Svensson P (2016) Somatosensory profile changes evoked by topical application of capsaicin to the tongue in healthy individuals. J Oral Facial Pain Headache 31:139–146CrossRefGoogle Scholar
  23. 23.
    van der Ploeg HM, van der Wal N, Eijkman MA, van der Waal I (1987) Psychological aspects of patients with burning mouth syndrome. Oral Surg Oral Med Oral Pathol 63:664–668CrossRefGoogle Scholar
  24. 24.
    Browning S, Hislop S, Scully C, Shirlaw P (1987) The association between burning mouth syndrome and psychosocial disorders. Oral Surg Oral Med Oral Pathol 64:171–174CrossRefGoogle Scholar
  25. 25.
    Svensson P, Kaaber S (1995) General health factors and denture function in patients with burning mouth syndrome and matched control subjects. J Oral Rehabil 22:887–895CrossRefGoogle Scholar
  26. 26.
    Lamey PJ (1996) Burning mouth syndrome. Dermatol Clin 14:339–354CrossRefGoogle Scholar
  27. 27.
    Bergdahl M, Bergdahl J (1999) Burning mouth syndrome: prevalence and associated factors. J Oral Pathol Med 28:350–354CrossRefGoogle Scholar
  28. 28.
    Dersh J, Polatin PB, Gatchel RJ (2002) Chronic pain and psychopathology: research findings and theoretical considerations. Psychosom Med 64:773–786Google Scholar
  29. 29.
    Scala A, Checchi L, Montevecchi M, Marini I, Giamberardino MA (2003) Update on burning mouth syndrome: overview and patient management. Crit Rev Oral Biol Med 14:275–291CrossRefGoogle Scholar
  30. 30.
    Suresh KV, Shenai P, Chatra L, Ronad YA, Bilahari N, Pramod RC, Kumar SP (2015) Oral mucosal diseases in anxiety and depression patients: hospital based observational study from south India. J Clin Exp Dent 1:95–99CrossRefGoogle Scholar
  31. 31.
    Chaundhary S (2004) Psychosocial stressors in oral lichen planus. Psychosocial stressors in oral lichen planus. Aust Dent J 49:192–195CrossRefGoogle Scholar
  32. 32.
    Tabolli S, Bergamo F, Alessandroni L, Di Pietro C, Sampogna F, Abeni D (2009) Quality of life and psychological problems of patients with oral mucosal disease in dermatological practice. Dermatology 218:314–320CrossRefGoogle Scholar
  33. 33.
    Wan KY, McMillan AS, Wong MC (2012) Orofacial pain symptoms and associated disability and psychosocial impact in community-dwelling and institutionalized elderly in Hong Kong. Community Dent Health 29:110–116Google Scholar
  34. 34.
    Ohara C, Komaki G, Yamagata Z, Hotta M, Kamo T, Ando T (2016) Factors associated with caregiving burden and mental health conditions in caregivers of patients with anorexia nervosa in Japan. Biopsychosoc Med 22:21CrossRefGoogle Scholar
  35. 35.
    Mortazavi F, Mousavi SA, Chaman R, Khomsravi A (2014) Maternal quality of life during the transition to motherhood. Iran Red Crescent Med 16:5Google Scholar
  36. 36.
    Galli F, Lodi G, Sardella A, Vegni E (2016) Role of psychological factors in burning mouth syndrome: a systematic review and meta-analysis. Cephalalgia 37:265–277CrossRefGoogle Scholar
  37. 37.
    Schiavone V, Adamo D, Ventrella G, Morlino M, De Notaris EB, Ravel MG, Kusmann F, Piantadosi M, Pollio A, Fortuna G, Mignogna MD (2012) Anxiety, depression, and pain in burning mouth syndrome: first chicken or egg? Headache 52:1019–1025CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Mika Honda
    • 1
    • 2
    Email author
  • Takashi Iida
    • 1
  • Hirona Kamiyama
    • 1
  • Manabu Masuda
    • 1
  • Misao Kawara
    • 1
  • Peter Svensson
    • 2
    • 3
    • 4
  • Osamu Komiyama
    • 1
  1. 1.Department of Oral Function and RehabilitationNihon University School of Dentistry at MatsudoMatsudoJapan
  2. 2.Section of Orofacial Pain and Jaw Function, Department of DentistryAarhus UniversityAarhusDenmark
  3. 3.Scandinavian Center for Orofacial Neurosciences (SCON)AarhusDenmark
  4. 4.Department of Dental MedicineKarolinska InstitutetHuddingeSweden

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