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Comparative analysis of photobiomodulation therapy and transcutaneous electrical nerve stimulation for burning mouth: a randomized clinical trial

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Abstract

Objective

To compare the effect of photobiomodulation (PBM) and transcutaneous electrical nerve stimulation (TENS) in the treatment of burning mouth.

Materials and methods

Randomized clinical trial of 25 patients with burning mouth treated by TENS (n=12) and PBM (n=13). The patients were treated weekly for 8 weeks. Two-factor ANOVA was used to determine whether the two interventions promoted significant differences in symptoms (measured with a visual analogue scale), unstimulated salivary flow, xerostomia, and dysgeusia between T0 (baseline), T1 (after the 4th treatment session), T2 (after the 8th treatment session), and T3 (30 days after the end of treatment).

Results

Intragroup comparison of VAS scores for pain showed a significant difference between T0xT1, T0xT2, and T0xT3 in the TENS group and between T0xT2 and T0xT3 in the PBM group (p˂0.001). Intergroup comparison of VAS scores for pain between T2xT3 showed a better response to PBM than to TENS (p=0.003). Patients of the TENS group showed an increase in salivary flow between T1 and T2 (p=0.052). There were no expressive variations in xerostomia or dysgeusia in the two groups analyzed.

Conclusion

TENS and PBM were effective in reducing the symptoms of burning mouth during and after treatment. The PBM group showed a better response during follow-up.

Trial registration

This clinical trial was registered at http://clinicaltrials.gov (Number: NCT05816200).

Clinical relevance

TENS was found to be a safe and effective therapy for burning mouth. Trial registration number (TRN) and date of registration: This clinical trial was registered at http://clinicaltrials.gov (Number: NCT05816200; date: May 08, 2023).

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References

  1. Klasser GD, Grushka M, Su N (2016) Burning mouth syndrome. Oral Maxillofac Surg Clin North Am 28:381–396. https://doi.org/10.1016/j.coms.2016.03.005

    Article  PubMed  Google Scholar 

  2. Nicholas M, Vlaeyen JWS, Rief W, Barke A, Aziz Q, Benoliel R, Cohen M, Evers S, Giamberardino MA, Goebel A, Korwisi B, Perrot S, Svensson P, Wang SJ, Treede RD (2019) IASP Taskforce for the Classification of Chronic Pain. The IASP classification of chronic pain for ICD-11: chronic primary pain. Pain 160:28-37. https://doi.org/10.1097/j.pain.0000000000001390

  3. Chmieliauskaite M, Stelson EA, Epstein JB, Klasser GD, Farag A, Carey B, Albuquerque R, Mejia L, Ariyawardana A, Nasri-Heir C, Sardella A, Carlson C, Miller CS (2021) Consensus agreement to rename burning mouth syndrome and improve International Classification of Diseases-11 disease criteria: an international Delphi study. Pain 162:2548–2557. https://doi.org/10.1097/j.pain.0000000000002243

    Article  PubMed  PubMed Central  Google Scholar 

  4. Headache Classification Committee of the International Headache Society (IHS) (2018) The International Classification of Headache Disorders, 3rd edition. Cephalalgia 38:1–211. https://doi.org/10.1177/0333102417738202

    Article  Google Scholar 

  5. Morr Verenzuela CS, Davis MDP, Bruce AJ, Torgerson RR (2017) Burning mouth syndrome: results of screening tests for vitamin and mineral deficiencies, thyroid hormone, and glucose levels-experience at Mayo Clinic over a decade. Int J Dermatol 56:952–956. https://doi.org/10.1111/ijd.13634

    Article  PubMed  Google Scholar 

  6. Jääskeläinen SK, Woda A (2017) Burning mouth syndrome. Cephalalgia 37:627–647. https://doi.org/10.1177/0333102417694883

    Article  PubMed  Google Scholar 

  7. Arduino PG, Cafaro A, Garrone M, Gambino A, Cabras M, Romagnoli E, Broccoletti R (2016) A randomized pilot study to assess the safety and the value of low-level laser therapy versus clonazepam in patients with burning mouth syndrome. Lasers Med Sci 31:811–816. https://doi.org/10.1007/s10103-016-1897-8

    Article  PubMed  Google Scholar 

  8. Bender SD (2018) Burning mouth syndrome. Dent Clin North Am 62:585–596. https://doi.org/10.1016/j.cden.2018.05.006

    Article  PubMed  Google Scholar 

  9. López-Jornet P, Collado Y, Zambudio A, Pons-Fuster E, Castillo Felipe C, Tvarijonaviciute A (2021) Chemosensory function in burning mouth syndrome a comparative cross-sectional study. Nutrients 13:722. https://doi.org/10.3390/nu13030722

    Article  PubMed Central  Google Scholar 

  10. Thoppay JR, Rossi SS, Ciarrocca KN (2013) Burning mouth syndrome. Dent Clin North Am 57:497–512. https://doi.org/10.1016/j.cden.2013.04.010

    Article  PubMed  Google Scholar 

  11. 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 (2021) Developing a research diagnostic criteria for burning mouth syndrome: results from an international Delphi process. J Oral Rehabil 48:308–331. https://doi.org/10.1111/joor.13123

    Article  PubMed  Google Scholar 

  12. Kolkka-Palomaa M, Jääskeläinen SK, Laine MA, Teerijoki-Oksa T, Sandell M, Forssell H (2015) Pathophysiology of primary burning mouth syndrome with special focus on taste dysfunction: a review. Oral Dis 21:937–948. https://doi.org/10.1111/odi.12345

    Article  PubMed  Google Scholar 

  13. das Neves de Araújo Lima E, Barbosa NG, Dos Santos AC, Araújo Moura Lemos TM, de Souza CM, Trevilatto PC, da Silveira EJ, de Medeiros AM (2016) Comparative analysis of psychological, hormonal, and genetic factors between burning mouth syndrome and secondary oral burning. Pain Med 17:1602–1611. https://doi.org/10.1093/pm/pnv087

    Article  PubMed  Google Scholar 

  14. Sugaya NN, Silva ÉF, Kato IT, Prates R, Gallo CB, Pellegrini VD (2016) Low Intensity laser therapy in patients with burning mouth syndrome: a randomized, placebo-controlled study. Braz Oral Res 30:e108. https://doi.org/10.1590/1807-3107BOR-2016.vol30.0108

    Article  PubMed  Google Scholar 

  15. Galli F, Lodi G, Sardella A, Vegni E (2017) Role of psychological factors in burning mouth syndrome: a systematic review and meta-analysis. Cephalalgia 37:265–277. https://doi.org/10.1177/0333102416646769

    Article  PubMed  Google Scholar 

  16. Ritchie A, Kramer JM (2018) Recent advances in the etiology and treatment of burning mouth syndrome. J Dent Res 97:1193–1199. https://doi.org/10.1177/0022034518782462

    Article  PubMed  Google Scholar 

  17. de Pedro M, López-Pintor RM, Casañas E, Hernández G (2020) Effects of photobiomodulation with low-level laser therapy in burning mouth syndrome: a randomized clinical trial. Oral Dis 26:1764–1776. https://doi.org/10.1111/odi.13443

    Article  PubMed  Google Scholar 

  18. Al-Maweri SA, Javed F, Kalakonda B, AlAizari NA, Al-Soneidar W, Al-Akwa A (2017) Efficacy of low level laser therapy in the treatment of burning mouth syndrome: a systematic review. Photodiagnosis Photodyn Ther 17:188–193. https://doi.org/10.1016/j.pdpdt.2016.11.017

    Article  PubMed  Google Scholar 

  19. Melzack R, Wall PD (1965) Pain mechanisms: a new theory. Science 150:971–979. https://doi.org/10.1126/science.150.3699.971

    Article  PubMed  Google Scholar 

  20. Johnson MI, Jones G (2017) Transcutaneous electrical nerve stimulation: current status of evidence. Pain Manag 7:1–4. https://doi.org/10.2217/pmt-2016-0030

    Article  PubMed  Google Scholar 

  21. Martimbianco ALC, Porfírio GJ, Pacheco RL, Torloni MR, Riera R (2019) Transcutaneous electrical nerve stimulation (TENS) for chronic neck pain. Cochrane Database Syst Rev 12:CD011927. https://doi.org/10.1002/14651858.CD011927

    Article  PubMed  Google Scholar 

  22. Peng WW, Tang ZY, Zhang FR, Li H, Kong YZ, Iannetti GD, Hu L (2019) Neurobiological mechanisms of TENS-induced analgesia. Neuroimage 195:396–408. https://doi.org/10.1016/j.neuroimage.2019.03.077

    Article  PubMed  Google Scholar 

  23. Dalbem Paim É, Costa Batista Berbert M, Gonzales Zanella V, Beatris Martins V, Edler Macagnan F (2019) Effects of transcutaneous electrical nerve stimulation on the salivary flow of patients with hyposalivation induced by radiotherapy in the head and neck region-a randomised clinical trial. J Oral Rehabil 46:1142–1150. https://doi.org/10.1111/joor.12851

    Article  PubMed  Google Scholar 

  24. Vijayan A, Asha ML, Babu S, Chakraborty S (2014) Prospective phase II study of the efficacy of transcutaneous electrical nerve stimulation in post-radiation patients. Clin Oncol (R Coll Radiol) 26:743–747. https://doi.org/10.1016/j.clon.2014.09.004

    Article  PubMed  Google Scholar 

  25. Lakshman AR, Babu GS, Rao S (2015) Evaluation of effect of transcutaneous electrical nerve stimulation on salivary flow rate in radiation induced xerostomia patients: a pilot study. J Cancer Res Ther 11:229–233. https://doi.org/10.4103/0973-1482.138008

    Article  PubMed  Google Scholar 

  26. Navazesh M, Kumar SKS (2008) Measuring salivary flow: challenges and opportunities. J Am Dent Assoc 139(Suppl):35S–40S. https://doi.org/10.14219/jada.archive.2008.0353

    Article  PubMed  Google Scholar 

  27. Murray Thomson W, Chalmers JM, John Spencer A, Slade GD, Carter KD (2006) A longitudinal study of medication exposure and xerostomia among older people. Gerodontology 23:205–213. https://doi.org/10.1111/j.1741-2358.2006.00135.x

    Article  PubMed  Google Scholar 

  28. Mueller C, Kallert S, Renner B, Stiassny K, Temmel AF, Hummel T, Kobal G (2003) Quantitative assessment of gustatory function in a clinical context using impregnated “taste strips”. Rhinology 41:2–6

    PubMed  Google Scholar 

  29. Henn IW, da Silva RO, Chaiben CL, Fernandes Â, Naval Machado MÂ, de Lima AA (2017) Perception of taste in HIV-positive individuals in treatment antiretroviral: results of a case-control study. Spec Care Dentist 37:3–9. https://doi.org/10.1111/scd.12186

    Article  PubMed  Google Scholar 

  30. Kettenmann B, Mueller C, Wille C, Kobal G (2005) Odor and taste interaction on brain responses in humans. Chem Senses 30(Suppl 1):i234–i235. https://doi.org/10.1093/chemse/bjh200

    Article  PubMed  Google Scholar 

  31. Sikora M, Včev A, Siber S, Vučićević Boras V, Rotim Ž, Matijević M (2028) The efficacy of low-level laser therapy in burning mouth syndrome - a pilot study. Acta Clin Croat 57:312–315. https://doi.org/10.20471/acc.2018.57.02.12

    Article  Google Scholar 

  32. Liu YF, Kim Y, Yoo T, Han P, Inman JC (2018) Burning mouth syndrome: a systematic review of treatments. Oral Dis 24:325–334. https://doi.org/10.1111/odi.12660

    Article  PubMed  Google Scholar 

  33. Barbosa NG, Gonzaga AKG, de Sena Fernandes LL, da Fonseca AG, Queiroz SIML, Lemos TMAM, da Silveira ÉJD, de Medeiros AMC (2018) Evaluation of laser therapy and alpha-lipoic acid for the treatment of burning mouth syndrome: a randomized clinical trial. Lasers Med Sci 33:1255–1262. https://doi.org/10.1007/s10103-018-2472-2

    Article  PubMed  Google Scholar 

  34. Arbabi-Kalati F, Bakhshani NM, Rasti M (2015) Evaluation of the efficacy of low-level laser in improving the symptoms of burning mouth syndrome. J Clin Exp Dent 7:e524–e527. https://doi.org/10.4317/jced.52298

    Article  PubMed  PubMed Central  Google Scholar 

  35. Spanemberg JC, López López J, de Figueiredo MA, Cherubini K, Salum FG (2015) Efficacy of low-level laser therapy for the treatment of burning mouth syndrome: a randomized, controlled trial. J Biomed Opt 20:098001. https://doi.org/10.1117/1.JBO.20.9.098001

    Article  PubMed  Google Scholar 

  36. Spanemberg JC, Segura-Egea JJ, Rodríguez-de Rivera-Campillo E, Jané-Salas E, Salum FG, López-López J (2019) Low-level laser therapy in patients with burning mouth syndrome: a double-blind, randomized, controlled clinical trial. J Clin Exp Dent 11:e162–e169. https://doi.org/10.4317/jced.55517

    Article  PubMed  PubMed Central  Google Scholar 

  37. Pezelj-Ribarić S, Kqiku L, Brumini G, Urek MM, Antonić R, Kuiš D, Glažar I, Städtler P (2013) Proinflammatory cytokine levels in saliva in patients with burning mouth syndrome before and after treatment with low-level laser therapy. Lasers Med Sci 28:297–301. https://doi.org/10.1007/s10103-012-1149-5

    Article  PubMed  Google Scholar 

  38. Valenzuela S, Lopez-Jornet P (2017) Effects of low-level laser therapy on burning mouth syndrome. J Oral Rehabil 44:125–132. https://doi.org/10.1111/joor.12463

    Article  PubMed  Google Scholar 

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Acknowledgements

We thank the Stomatology Service, Department of Dentistry, Federal University of Rio Grande do Norte, for providing the resources necessary for the study.

Ethical responsibilities of authors

All authors confirm that this study is original and not has been published alsewhere in any form or language (partially or full); that its publication was approved by all authors and by the responsible authorities where the work was carried out.

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Authors and Affiliations

  1. Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil

    Cristianne Kalinne Santos Medeiros & Maria do Carmo Pessoa Nogueira Serrão

  2. Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil

    Cristianne Kalinne Santos Medeiros, Éricka Janine Dantas da Silveira & Patrícia Teixeira de Oliveira

  3. Department of Stomatology, Graduate School of Dentistry, Federal University of Paraná, Rua Prefeito Lothário Meissner, 632, Campus Jardim Botânico, Curitiba, PR, 80210-170, Brazil

    Antonio Adilson Soares de Lima

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Cristianne Kalinne Santos Medeiros and Maria do Carmo Pessoa Nogueira Serrão. The first draft of the manuscript was written by Cristianne Kalinne Santos Medeiros and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Cristianne Kalinne Santos Medeiros.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (No. 4.066.032).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent to publish

Patients signed informed consent regarding publishing their data.

Clinical trial registration

This clinical trial was registered at http://clinicaltrials.gov (Number: NCT05816200).

This standards of reporting

This clinical trial followed the Consort Statement (http://www.consort-statement.org).

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The data that support the findings of this study are available on request from authors.

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The authors declare no competing interests.

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Medeiros, C.K.S., Serrão, M.d.C.P.N., de Lima, A.A.S. et al. Comparative analysis of photobiomodulation therapy and transcutaneous electrical nerve stimulation for burning mouth: a randomized clinical trial. Clin Oral Invest 27, 6157–6165 (2023). https://doi.org/10.1007/s00784-023-05232-7

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  • DOI: https://doi.org/10.1007/s00784-023-05232-7

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