A Preliminary Clinical Study Between Burning Mouth Syndrome Patients With Pain And Without Pain

Objective:The purpose of the present study is to initially compare the population distribution,inducing factors,and different manifestation between BMS patients with pain and without pain in past 1 year,then to investigate the significance of pain symptoms in various types of BMS,to provide new ideas for the diagnosis and treatment of BMS,and propel a basis for the subsequent clinical research.Methods:BMS patient questionnaire and patient anxiety & depression scale were prepared based on literature review.The clinical records and physical examination of patients diagnosed with BMS from October 2018 to April 2020 in our hospital were collected by questionnaires.The patients were divided into pain group and non-pain group according to pain symptom.Data information was integrated with Excel 2010 and with SPSS 25.0 statistically analyzed.Results:1.A total of 461 patients with BMS were reviewed,2 patients were excluded and 459 patients were included in the study based on the criteria.There were 347 patients in the pain group and 112 patients in the non-pain group.Among them,196 patients submitted a complete BMS information questionnaire,with 165 in the pain group and 31 in the non-pain group;169 anxiety & depressive questionnaires were collected,with 141 in the pain group and 28 in the non-pain group.2.The main populations of the two groups were similar in age(pain group: 51.01±13.08,non-pain group: 52.32±13.32,P = 0.800),and there was a difference in gender ratio(pain group: 1/4,non-pain group: 1/2,P <0.01).There was a difference in symptom scores between the two groups(pain group: 5.25 ± 2.48,non-pain group: 3.87 ± 2.50,P <0.01).There was no difference in anxiety scores between the two groups(pain group: 6.33±4.24,non-pain group: 5.11±4.46,P=0.978)and neither in depression scores(pain group: 5.79±3.88,non-pain group: 4.68±3.08,P=0.662).Patients in both groups experienced more dental treatment events(pain group: 16.9%,non-pain group: 22.6%,P = 0.449),and again personal or family stressful events(pain group: 9.7%,non-pain group: 22.6%,P = 0.062),and finally the injury-related events(pain group: 5.5%;non-pain group: 9.7%,P = 0.409),there was no statistical difference between the two groups.There was no difference in the proportion of known triggering events between the two groups(pain group: 32.1%,non-pain group: 54.9%,P = 0.096)and neither in the proportion of unknown triggering events(pain group: 67.9%,non-pain group: 45.1%,P = 0.096).3.The majority of patients in the two groups reported symptoms in the tongue(pain group: 79.4%,non-pain group: 54.8%,P <0.01),with a higher proportion in the pain group.There were more multiple sites than single sites in the two groups,and there was no difference(pain group: 55.2%,non-pain group: 64.5%,P = 0.222).The main symptom of patients in the pain group was burning sensation,the proportion was significantly larger than that in the non-pain group(pain group: 81.8%,non-pain group: 0%,P <0.01).The proportion of patients who complained of acupuncture was greater than the non-pain group(pain group: 24.8%,non-pain group: 0%,P <0.01).The main symptom of patients in the non-pain group was numbness,the proportion was larger than that in the pain group(non-pain group: 61.3%,pain group: 37.6%,P <0.05).4.The main daytime pattern of symptoms in the pain group was morning light and late severe(pain group: 40.0%,non-pain group: 19.4%,P <0.05).The main daytime pattern of symptoms in the non-pain group was degree-invariant(non-pain group: 58.0%,pain group: 33.9%,P <0.05).Most patients in the pain group showed relief when eating(pain group: 48.5%,non-pain group: 22.6%,P <0.05)and no change was found in symptoms of most patients in the pain group when speaking(pain group: 53.9%,nonpain group: 77.4%,P<0.05).There was no change in symptoms of most patients in the non-pain group when eating or speaking(non-pain group: 58.0%,77.4%,pain group: 36.4%,12.9%,P <0.05).Symptoms in the pain group were more likely to affect sleep(pain group: 35.2%,non-pain group: 12.9%,P <0.05).Conclusion:1.BMS with a similar age and gender distribution and involved factors: in this study,both groups were mainly middle-aged female patients.Dental treatment events,personal or family stressful events,and injury-related events could be inducing factors.Women were relatively more predominant in the pain group than the non-pain group.2.Symptom score and gender ration: in this study,the ratio of male to female in the pain group was 1:4 in the pain group which was 1:2 in the non-pain group,the ratio in the pain group was significantly lower than that in the non-pain group(P <0.01)and the symptom score in the non-pain group was lower than that in the pain group(P<0.01).3.Symptom pattern model: in this study,the pain group mainly presented with burning sensation,which mainly occurred in the tongue,and was more common in multiple sites.The symptom pattern of pain group was morning light and late severe,which could be relieved by eating and weakely affected sleep.Non-pain group mainly presented with numbness,which mainly occured in the tongue,and was more common in multiple sites.The symptom pattern of non-pain group was degree-invariant,which was consistent without change when eating and speaking,and affected sleep less.4.Complementary new classifications: symptoms of pain and non-pain in BMS patients can be considered as a devision way or strategy for three types: pain type of BMS,or typical BMS;non-pain type of BMS,or atypical BMS;mixed type of BMS: pain with numbness or others.