title: Pain and pain behavior in burning mouth syndrome: a pain diary study.
abstract: OBJECTIVE
  To characterize pain related to primary burning mouth syndrome (BMS) in terms of intensity, interference, and distress caused by the pain, as well as factors influencing the pain across a period of 2 weeks, and to study the use of coping and management strategies on a daily basis.
  
  
  METHODS
  Fifty-two female patients with primary BMS completed a 2-week pain diary. Pain intensity, interference, distress, and mood on a 0 to 10 numeric rating scale (NRS), as well as pain amplifying and alleviating factors, were recorded three times a day. The use of treatments (medication or other means) and coping strategies were recorded at the end of each day. Coefficient of variation, repeated measures analysis of variance, and correlative methods were used to assess the between- and within-subject variation, pain patterns, and associations between various pain scores.
  
  
  RESULTS
  The overall mean pain intensity score of the 14 diary days was 3.1 (SD: 1.7); there was considerable variation in pain intensity between patients. Most patients experienced intermittent pain. On average, pain intensity increased from the morning to the evening. Intercorrelations between pain intensity, interference, distress, and mood were high, varying between rs = .75 and rs = .93 (P < .001). Pungent or hot food or beverages, stress, and tiredness were the most frequently mentioned pain-amplifying factors. The corresponding pain-alleviating factors were eating, sucking pastilles, drinking cold beverages, and relaxation. Thirty (58%) patients used pain medication and 35% reported using other means to alleviate their BMS pain. There was large variation in the use of coping strategies -between subjects.
  
  
  CONCLUSIONS
  There were considerable differences in pain, in factors influencing the pain, and in pain behavior across BMS patients. This indicates that patient information and education as well as treatment of BMS pain should be individualized.
authors.affiliation: Department of Oral Diseases and Pain Clinic, Turku University Hospital, Turku, Finland. heli.forssell@tyks.fi
authors.forename: Heli
authors.initials: H
authors.lastname: Forssell
authors.forename: Tuija
authors.initials: T
authors.lastname: Teerijoki-Oksa
authors.forename: Ulla
authors.initials: U
authors.lastname: Kotiranta
authors.forename: Rosita
authors.initials: R
authors.lastname: Kantola
authors.forename: Marjaliina
authors.initials: M
authors.lastname: Bäck
authors.forename: Tiina-Riitta
authors.initials: TR
authors.lastname: Vuorjoki-Ranta
authors.forename: Maria
authors.initials: M
authors.lastname: Siponen
authors.forename: Ari
authors.initials: A
authors.lastname: Leino
authors.forename: Pauli
authors.initials: P
authors.lastname: Puukka
authors.forename: Ann-Mari
authors.initials: AM
authors.lastname: Estlander
mesh_terms: D000223:Adaptation, Psychological; D000700:Analgesics / Q000627:therapeutic use; D000704:Analysis of Variance; D000927:Anticonvulsants / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D002054:Burning Mouth Syndrome / Q000150:complications / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D002940:Circadian Rhythm; D002998:Clonazepam / Q000627:therapeutic use; D015331:Cohort Studies; D004338:Drug Combinations; D005157:Facial Pain / Q000209:etiology* / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D010147:Pain Measurement; D000069583:Pregabalin; D011446:Prospective Studies; D012648:Self Care; D057566:Self Report; D012890:Sleep; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000700:Analgesics; D000927:Anticonvulsants; D000929:Antidepressive Agents, Tricyclic; D004338:Drug Combinations; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D002998:Clonazepam