Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

104 questions · 107 findings · 10 reviews · Oral medicine and oral cancer

No studies found 10 · 9.3%GRADE not reported 77 · 72%Very low 19 · 17.8%Low 1 · 0.9%Moderate 0 · 0%High 0 · 0%

Levamisole (150 mg per day) vs placebo

Decrease in duration of attacks · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…

Levamisole (150 mg per day) showed no clear difference in decrease in duration of attacks compared with placebo; GRADE not reported.

1 finding from 1 review

Levamisole (150 mg per day) vs placebo

Decrease in number of ulcers · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…

Levamisole (150 mg per day) showed no clear difference in decrease in number of ulcers compared with placebo; GRADE not reported.

1 finding from 1 review

Cholinergics (bethanechol 15 mg/day) vs placebo

Adverse effects (narrative) · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
1 finding from 1 review
  • Interventions for treating burning mouth syndrome 2016 · Cochrane All outcomes
    short-term (up to 3 months)
    SoF4. Adverse effects: single study narratively reported 4 participants (20%) in the bethanechol arm experienced adverse events (nausea, dizziness, blood pressure fall, cold perspiration or sporadic abdominal pain);…
    1 study · 40 participants
    Very low

Cholinergics (bethanechol 15 mg/day) vs placebo

Relief of burning/discomfort (symptom relief; pain intensity) · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms

It is very uncertain whether cholinergics (bethanechol 15 mg/day) changes relief of burning/discomfort (symptom relief; pain intensity) compared with placebo (very low certainty).

1 finding from 1 review

Antidepressants (trazodone 200 mg/day) vs placebo

Frequency of adverse effects ‐ dizziness ( · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms

It is very uncertain whether antidepressants (trazodone 200 mg/day) changes adverse effects: dizziness compared with placebo (very low certainty).

1 finding from 1 review

Antidepressants (trazodone 200 mg/day) vs placebo

Adverse event: tremor · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms

It is very uncertain whether antidepressants (trazodone 200 mg/day) changes adverse effects: tremor compared with placebo (very low certainty).

1 finding from 1 review

Amisulpride (antipsychotic, 50 mg/day) vs placebo

Relief of burning/discomfort (symptom relief; pain intensity) · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
1 finding from 1 review
  • Interventions for treating burning mouth syndrome 2016 · Cochrane All outcomes
    short-term (up to 3 months)
    Bogetto 1999 (amisulpride) included in the antidepressants/antipsychotics comparison but data not presented due to excessive attrition (19/24; 79%) in the placebo arm.
    1 study
    GRADE not reported

Antidepressants (trazodone 200 mg/day) vs placebo

Relief of burning/discomfort (symptom relief; pain intensity) · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms

It is very uncertain whether antidepressants (trazodone 200 mg/day) changes relief of burning/discomfort (symptom relief; pain intensity) compared with placebo (very low certainty).

1 finding from 1 review

Antidepressants (trazodone 200 mg/day) vs placebo

Abdominal pain · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms

It is very uncertain whether antidepressants (trazodone 200 mg/day) changes adverse effects: abdominal pains compared with placebo (very low certainty).

1 finding from 1 review

Antidepressants (trazodone 200 mg/day) vs placebo

Adverse effects: headache · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms

It is very uncertain whether antidepressants (trazodone 200 mg/day) changes adverse effects: headache compared with placebo (very low certainty).

1 finding from 1 review

Antidepressants (trazodone 200 mg/day) vs placebo

Adverse effects: urinary incontinence · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms

It is very uncertain whether antidepressants (trazodone 200 mg/day) changes adverse effects: urinary incontinence compared with placebo (very low certainty).

1 finding from 1 review

Antidepressants (trazodone 200 mg/day) vs placebo

Somnolence · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms

It is very uncertain whether antidepressants (trazodone 200 mg/day) changes adverse effects: drowsiness compared with placebo (very low certainty).

1 finding from 1 review

Antidepressants (trazodone 200 mg/day) vs placebo

Adverse effects: palpitations · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms

It is very uncertain whether antidepressants (trazodone 200 mg/day) changes adverse effects: palpitations compared with placebo (very low certainty).

1 finding from 1 review

Antidepressants (trazodone 200 mg/day) vs placebo

Adverse effects: dry mouth · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms

It is very uncertain whether antidepressants (trazodone 200 mg/day) changes adverse effects: dry mouth compared with placebo (very low certainty).

1 finding from 1 review

Paroxetine vs placebo

Relief of burning/discomfort (symptom relief; pain intensity) · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
1 finding from 1 review

Antidepressants (trazodone 200 mg/day) vs placebo

QoL · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
1 finding from 1 review
  • Interventions for treating burning mouth syndrome 2016 · Cochrane All outcomes
    short-term (up to 3 months)
    SoF1. Change in QoL short-term (mean Beck Depression Inventory, 0-63, lower better): this single study narratively reported that both intervention and placebo participants were less depressed at trial completion, but…
    1 study · 37 participants
    Very low

Anticonvulsants (gabapentin 300 mg/day) vs placebo

Adverse effects: drowsiness (gabapentin alone) · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms

It is very uncertain whether anticonvulsants (gabapentin 300 mg/day) changes adverse effects: drowsiness (gabapentin alone) compared with placebo (very low certainty).

1 finding from 1 review

Colchicine (0.5 mg three times per day) vs placebo

Complete remission (no further aphthous episodes to 6 months) · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…
1 finding from 1 review
  • The trial by de Abreu 2009 (high risk of bias) also assessed colchicine (n=23) versus placebo (n=20). The number with no further aphthous episodes at 6 months was not significantly different from placebo (Fisher's…
    1 study · 43 participants
    GRADE not reported

Colchicine (0.5 mg three times per day) vs placebo

Adverse effects · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…
1 finding from 1 review
  • There was a greater percentage of treatment interruptions in the colchicine group due to gastrointestinal adverse effects (Fisher's exact test P=0.009). The review noted potential evidence of harm at a dose of 1.5 mg…
    1 study · 43 participants
    GRADE not reported

Amitriptyline vs placebo

Relief of burning/discomfort (symptom relief; pain intensity) · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
1 finding from 1 review