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Otolaryngology Open Access Journal Research Article 3 min read

Alteration of Dopamine Receptors as a Possible Etiology in Burning Mouth Syndrome

Arellano Bárcenas A*
* Corresponding author
ISSN: 2476-2490  10.23880/ooaj-16000284  Received: January 11, 2024  Published: February 12, 2024
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Keywords
Dopamine Receptors Syndrome Etiology Oral Mucosa
Abstract

Burning mouth syndrome continues to be a diagnostic and therapeutic challenge today. New horizons in etiology and management have opened the door for a new therapeutic option that we will mention in this article.

Development

Burning mouth syndrome is characterized by chronic pain in the oral cavity, without clinical lesions on physical examination and with normal laboratory findings, which is why it is called primary or idiopathic [1]. Due to the lack of clarity in the pathophysiology, there is no effective treatment to dates, which causes anxiety, depression, sleep disturbances in patients and significantly affects the quality of life [2].

It more frequently affects the female sex, and the average age is around 50 years.

It is estimated that the prevalence ranges between 3-4% of the population [3].

There is a series of diagnostic criteria proposed by Scala et al in 2003 [4]:

  • Burning sensation in the oral mucosa daily and constantly
  • Burning sensation for at least 4 to 6 months
  • Pain of constant intensity or that may increase during the day
  • Pain present without exacerbation, or that improves during the intake of food and liquids
  • No interference during sleep

Additional criteria

  • Dysgeusia (altered taste perception), xerostomia (feeling of dry mouth)
  • Sensory alterations
  • Psychopathological or mood changes Within the etiology it is believed to be multifactorial, based mainly on three alterations: psychological, hormonal and nervous system disorders [5]. Recently, theories of neuropathy are gaining strength: peripheral neuropathy with fine fiber dysfunction, possible significant subclinical central trigeminal neuropathy, and alteration in inhibitory dopaminergic activity [6, 7, 8, 9].

This last area is where alterations in dopamine receptors have been proposed with good results after the corresponding medication.

Du Q and colleagues [6], published a series of 8 patients with the pathology and with a good response to pramipexole hydrochloride tablets, with a dose between 0.25 mg to 0.5

mg per day, without reports of adverse effects and with remission of symptoms on average at 8 weeks.

Neurotransmitter positron emission tomography (PET) study has demonstrated the hypofunction of the nigrostriatal dopaminergic system in these patients that prompts the hypothesis of reduced efficacy of endogenous pain inhibitory control in the brain dopamine-opioid system [7].

Cárcamo Fonfría and collaborators [8], published a series of 6 cases, treated with pramipexole, with a clear improvement in symptoms and 4-year follow-up.

Discussion

Burning mouth syndrome continues to be a diagnostic and therapeutic challenge, significantly affecting the quality of life of affected patients, which is why advances in the knowledge of the pathophysiology of the disease provide new treatments that are being studied.

References

  1. Feller L, Fourie J, Bouckaert M, Khammissa RAG, Ballyram R, et al. (2017) Burning Mouth Syndrome: Aetiopathogenesis and Principles of Management. Pain Research Management 2017: 1-6.
  2. Kim JY, Kim YS, Ko I, Kim DK (2020) Association Between Burning Mouth Syndrome and the Development of Depression, Anxiety, Dementia, and Parkinson Disease. JAMA Otolaryngol Head Neck Surg 146(6): 561–569.
  3. Bergdahl M, Bergdahl J (2007) Burning mouth syndrome: prevalence and associated factors. J Oral Pathol Med 28(8):350-354.
  4. Scala A, Checchi L, Montevecchi M, Marini I, Giamberardino M (2003) Update on Burning Mouth Syndrome: Overview and Patient management. Crit Rev Oral Biol Med 14(4): 275-291.
  5. Wardrop R, Hailes J, Burger H, Reade P (1989) Oral discomfort at menopause. Oral Surgery Oral Medicine Oral Pathology 67(5): 535-540.
  6. Du QC, Ge YY, Xiao WL, Wang WF (2021) Dopamine agonist responsive burning mouth syndrome: Report of eight cases. World J Clin Cases 9(23): 6916-6921.
  7. Jääskeläinen SK, Rinne JO, Forssell H, Tenovuo O, Kaasinen V, et al. (2001) Role of the dopaminergic system in chronic pain – a fluorodopa – PET study. Pain 90(3): 257-260.
  8. Fonfria AC, Vicente LG, Pedraza MI, Cuadrado-Pérez ML, Guerrero Peral AL, et al. (2017) Burning mouth syndrome: clinical description, pathophysiological approach, and a new therapeutic option. Neurology 32(4): 219-223.
  9. Jornet PL, Pagan DM, Perez PP, Valenzuela S (2017) Neuropathic Pain in Patients with Burning Mouth Syndrome Evaluated Using pain DETECT. Pain medicine 18(8): 1528-1533.
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@article{arellano2024,
  title   = {Alteration of Dopamine Receptors as a Possible Etiology in Burning Mouth Syndrome},
  author  = {Arellano Bárcenas A},
  journal = {Otolaryngology Open Access Journal},
  year    = {2024},
  volume  = {9},
  number  = {1},
  doi     = {10.23880/ooaj-16000284}
}
Arellano Bárcenas A (2024). Alteration of Dopamine Receptors as a Possible Etiology in Burning Mouth Syndrome. Otolaryngology Open Access Journal, 9(1). https://doi.org/10.23880/ooaj-16000284
TY  - JOUR
TI  - Alteration of Dopamine Receptors as a Possible Etiology in Burning Mouth Syndrome
AU  - Arellano Bárcenas A
JO  - Otolaryngology Open Access Journal
PY  - 2024
VL  - 9
IS  - 1
DO  - 10.23880/ooaj-16000284
ER  -