Individual oral symptoms in burning mouth syndrome may be associated differentially with depression and anxiety.
BACKGROUND
Burning mouth syndrome (BMS) is an idiopathic disease characterized by the feeling of burning in the oral cavity. Ten per cent of patients presenting to oral medicine clinics have BMS. Anxiety and depression are common co-morbidities in BMS, but it is not known if they are associated with specific BMS symptoms.


OBJECTIVE
In an exploratory analysis, this study examined the association of generalized anxiety and depression with individual BMS symptoms.


METHODS
Forty-one patients were recruited from a dental outpatient clinic (30 with BMS and 11 with other oral conditions), evaluating specific BMS symptoms and their intensity. Anxiety and depression symptoms were assessed using a standardized measure (Clinical Interview Schedule-Revised).


RESULTS
Taste change (p = 0.007), fear of serious illness (p = 0.011), metallic taste (p = 0.018) and sensation of a film on the gums (p = 0.047) were associated with an excess of psychiatric symptoms. More specifically, metallic taste (coefficient = 0.497, 95% CI = 0.149-0.845; p = 0.006) and sensation of film on gums (coefficient = 0.625, 95% CI = 0.148-1.103; p = 0.012) were associated significantly with higher scores for depressive symptoms; taste change (coefficient = 0.269, 95% CI = 0.077-0.461; p = 0.007), bad breath (coefficient = 0.273, 95% CI = 0.065-0.482; p = 0.012) and fear of serious illness (coefficient = 0.242, 95% CI = 0.036-0.448; p = 0.023) were associated with higher anxiety scores.


CONCLUSIONS
Specific BMS symptoms are associated differentially with generalized anxiety and depression. Dental practitioners should ascertain which BMS symptoms are predominant and be mindful of the association of certain symptoms with anxiety or depression and, where necessary, consider medical consultation.
a School of Social and Community Medicine , University of Bristol , Bristol , UK.|b Centre for Addiction and Mental Health , and University of Toronto , Toronto , Canada.
Simon J C
SJ
Davies
c School of Oral & Dental Sciences , University of Bristol , Bristol , UK.
Helen C
HC
Underhill
c School of Oral & Dental Sciences , University of Bristol , Bristol , UK.
Amina
A
Abdel-Karim
a School of Social and Community Medicine , University of Bristol , Bristol , UK.
David M
DM
Christmas
a School of Social and Community Medicine , University of Bristol , Bristol , UK.
Blanca M
BM
Bolea-Alamanac
a School of Social and Community Medicine , University of Bristol , Bristol , UK.
John
J
Potokar
d The Rosa Burden Centre for Neuropsychiatry , Southmead Hospital , Bristol , UK.
Johanna
J
Herrod
c School of Oral & Dental Sciences , University of Bristol , Bristol , UK.
Stephen S
SS
Prime
D001007:Anxiety / Q000523:psychology*; D001008:Anxiety Disorders / Q000523:psychology; D001294:Attitude to Health; D002012:Bruxism / Q000523:psychology; D002054:Burning Mouth Syndrome / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology; D005239:Fear / Q000523:psychology; D005260:Female; D005882:Gingival Diseases / Q000523:psychology; D006209:Halitosis / Q000523:psychology; D006801:Humans; D006987:Hypesthesia / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010292:Paresthesia / Q000523:psychology; D013651:Taste Disorders / Q000523:psychology; D014061:Tongue Habits / Q000523:psychology; D014987:Xerostomia / Q000523:psychology
Oral dysestesia; anxiety; depression; glossodynia; stomatodynia