Glossodynia from Candida-associated lesions, burning mouth syndrome, or mixed causes.
OBJECTIVE
Candida-associated lesions (CALs) and burning mouth syndrome (BMS) may induce glossodynia without objective manifestations. We investigated patients with glossodynia to examine the relationship between CAL and BMS.


METHODS
A visual analog scale was used to divide 95 patients with glossodynia into three groups according to intensity of pain at rest and when eating. Group A was the functional pain group; group B was the nonfunctional pain group; and group C was a mixed pain group. Antifungal treatment was scheduled for patients with suspected Candida infection by clinical, mycological, or cytological criteria.


RESULTS
Culture tests and direct examination results indicated that group A had high Candida positivity (73.0% by culture and 59.5% by direct examination), and showed a good response to antifungal treatment (75.7%). Antifungal treatment was not useful in group B. This was supported by a low Candida infection rate, as determined by direct examination (3.1%). For group C, Candida positivity and antifungal treatment effectiveness were between groups A and B. Furthermore, six patients in group C showed complete remission of functional pain by antifungal treatment only. Favorable outcomes were obtained for 23 patients (10 in group B and 13 in group C), who received antidepressant treatment.


CONCLUSIONS
These results suggested that glossodynia was Candida-associated in group A, and BMS-induced in group B, while group C contained patients with both CAL and BMS.
Terai
Haruhiko
H
Department of Oral Surgery, Osaka Medical College, Osaka, Japan. ora007@poh.osaka-med.ac.jp
Shimahara
Masashi
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002054:Burning Mouth Syndrome / Q000150:complications*; D002175:Candida / Q000472:pathogenicity*; D002177:Candidiasis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D005926:Glossalgia / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D016896:Treatment Outcome; D055815:Young Adult
D000928:Antidepressive Agents; D000935:Antifungal Agents