Thermal quantitative sensory testing in burning mouth syndrome
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ORIGINAL ARTICLE
Thermal quantitative sensory testing in burning mouth syndrome Anne Wolowski 1
&
N. Schwarzbach 1 & H. Hörning 2
Received: 11 June 2020 / Accepted: 7 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objectives Subjects with burning mouth syndrome (BMS) have altered sensitivity and pain thresholds for thermal stimuli compared to a control group. Materials and methods Fourteen women and 6 men (average age = 62.60 years, median = 63.50) with BMS and a control group were tested using the method of thermal quantitative sensory testing (tQST) (tip, right, and left lateral border of the tongue, left thumb) to determine their heat/cold detection threshold (WDT/CDT) and heat/cold pain threshold (HPT/CPT). Results Only the CPT values at the tip and both lateral border of the tongue show a statistically significant difference: tip of the tongue: sick = 12.0 ± 5.5 °C, median 14.2°C; healthy = 4.5 ± 2.9 °C; median = 6.4 °C; p = 0.000; right lateral border: sick = 8.55 ± 3.34 °C; healthy = 4.46 ± 1.90 °C; median 5.8 °C; p < 0.001; left lateral border: sick = 10.18 ± 3.94 °C¸ healthy = 4.15 ± 2.18 °C; median = 6.0 °C; p < 0.001. Conclusions BMS may be a combination of a dysfunction of free nociceptive nerve endings in the peripheral nervous system and impaired pain processing in the central nervous system. Clinical relevance This preliminary study provides hints to other causes of BMS. This offers the possibility of further therapeutic options. Keywords Burning mouth syndrome . BMS . Thermal quantitative sensory testing . tQST . Pain threshold
Introduction The current definitions (WHO (2018), International Association for the Study of Pain (2016); International Headache Society (2018)) of burning mouth syndrome (BMS) establish [1] the diagnosis, when other explanations for the symptoms can be ruled out. Hence, BMS is seen as an idiopathic condition. Discrepancies between definitions result from different specifications of duration and diurnal variations of intensity. For the patients concerned, getting diagnosed with BMS implies that a symptomatic treatment is possible at best. However, this approach shows only little effect, so that the level of suffering is very high. In this light, efforts in dealing with BMS should be
* Anne Wolowski [email protected] 1
Poliklinik für Prothetische Zahnmedizin und Biomaterialien, Bereich Psychosomatik und Psychopathologie in der Zahnheilkunde, Universitätsklinikum Münster – Zentrum ZMK, Albert-Schweitzer-Campus 1/W30, 48149 Münster, Germany
2
Private Dental Office Bielefeld, Bielefeld, Germany
directed towards identifying further causes in order to provide additional causal treatment options on this basis. Studies of a neuropathological cause are valuable in this respect. As early as 1987, Grushka et al. [2] determined that the pain threshold at the tip of the tongue, and therefore, also sensory perception is significantly reduced in BMS patients. Ito et al. analyzed the pain tolerance on the tongue using thermal stimuli [3].
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