Cochrane · intervention · CD002779
Interventions for treating burning mouth syndrome
McMillan, R, Forssell, H, Buchanan, JAG, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.
Questions
84
current version
GRADE rated
54
No studies
20
Included studies
23
as reported
No studies 20 · 23.8%Ungraded 10 · 11.9%Very low 53 · 63.1%Low 1 · 1.2%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms; trials recruiting participants with other types of pain included only if data on BMS participants could be separated out | 1285 patients randomised, 1121 analysed; 83% female (1061 women, 221 men); age 22 to 85 years; studies published 1995 to 2015 |
| Intervention | All treatments evaluated in placebo-controlled RCTs | Antidepressants and antipsychotics (n=2); Anticonvulsants (n=1); Benzodiazepines (n=4); Cholinergics (n=1); Dietary supplements (n=12); Electromagnetic radiation (n=1); Physical barriers (n=1); Psychological therapies (n=1); Topical treatments (n=5) |
| Comparison | Placebo | Placebo (n=23) |
| Outcomes | Primary: relief of burning or discomfort (symptom relief); change in quality of life (e.g. depression, anxiety); Secondary: change in taste; change in feeling of dryness; adverse effects | Symptom relief short-term (n=21); Symptom relief long-term (n=4); Change in QoL (n=7); Change in taste (n=2); Change in feeling of dryness (n=2); Adverse effects (n=17) |
| Study designs | All randomised controlled trials (RCTs) comparing any treatment against placebo | RCT (n=23) |
| Timing | Short-term (up to 3 months from baseline) or long-term (>3 to 6 months from baseline) outcome assessment | Short-term assessment (n=21); Long-term assessment (n=4) |
Search date: 2015-12. Databases: Cochrane Oral Health's Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE Ovid; Embase Ovid; ClinicalTrials.gov; World Health Organization International Clinical Trials Registry Platform
Questions and results
Show all 3 versionsAntidepressants (trazodone 200 mg/day) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Adverse effects: dizziness short-term (up to 3 months) | RR 11.61 [1.66, 81.04] | 1 study · 37 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse effects: tremor short-term (up to 3 months) | RR 2.11 [0.21, 21.32] | 1 study · 37 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse effects: abdominal pains short-term (up to 3 months) | RR 1.32 [0.42, 4.15] | 1 study · 37 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Relief of burning/discomfort (symptom relief; pain intensity) short-term (up to 3 months) | MD 1.26 [-0.24, 2.76] 4.66 (placebo mean VAS pain, scale 0-10, lower better) vs 5.92 (1.26 higher) | 1 study · 37 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse effects: headache short-term (up to 3 months) | RR 1.58 [0.30, 8.40] | 1 study · 37 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse effects: urinary incontinence short-term (up to 3 months) | RR 3.16 [0.14, 72.84] | 1 study · 37 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse effects: drowsiness short-term (up to 3 months) | RR 4.75 [1.18, 19.07] | 1 study · 37 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse effects: palpitations short-term (up to 3 months) | RR 1.06 [0.17, 6.72] | 1 study · 37 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse effects: dry mouth short-term (up to 3 months) | RR 3.17 [0.36, 27.72] | 1 study · 37 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Change in taste short-term (up to 3 months) | SoF1: No included studies reported change in taste. | 0 studies | No studies |
Change in feeling of dryness short-term (up to 3 months) | SoF1: No included studies reported change in feeling of dryness. | 0 studies | No studies |
Change in quality of life (QoL) 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 Downgraded: risk of bias, imprecision, indirectness |
Psychological therapies (cognitive therapy) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in feeling of dryness short-term (up to 3 months) | SoF8: No included study reported change in feeling of dryness. | 0 studies | No studies |
Change in quality of life (QoL) short-term (up to 3 months) | SoF8: No included study reported change in QoL. | 0 studies | No studies |
Change in taste short-term (up to 3 months) | SoF8: No included study reported change in taste. | 0 studies | No studies |
Adverse effects short-term (up to 3 months) | SoF8: No included study reported the occurrence of adverse events. | 0 studies | No studies |
Relief of burning/discomfort (symptom relief; pain intensity) long-term (>3 to 6 months) | MD -3.20 [-4.22, -2.18] 4.6 (placebo mean VAS pain, 1-7, lower better) vs 1.4 (3.20 lower) | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Topical treatments (benzydamine hydrochloride oral rinse) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Relief of burning/discomfort (symptom relief; pain intensity) short-term (up to 3 months) · benzydamine hydrochloride | SoF9 Topical treatments vs placebo. Symptom relief short-term: insufficient or contradictory evidence regarding benefit of any evaluated topical treatment; 150 participants (4 RCTs); very low. Subgroups: benzydamine (1… | 4 studies · 150 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Adverse effects short-term (up to 3 months) · benzydamine hydrochloride | SoF9. Adverse effects: single study narratively reported that no adverse effects occurred from benzydamine hydrochloride oral rinse; 20 participants (1 RCT); very low. | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Dietary supplements (alpha lipoic acid +/- vitamins/lycopene/green tea; hypericum; Catuama; lycopene) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Relief of burning/discomfort (symptom relief; pain intensity) short-term (up to 3 months) | SoF5 Dietary supplements vs placebo. Symptom relief short-term: insufficient or contradictory evidence regarding benefit of any evaluated dietary supplement; 628 participants (12 RCTs); very low. Subgroups: ALA without… | 12 studies · 628 participants | Very low Downgraded: risk of bias, inconsistency |
Adverse effects: intermittent facial skin rash short-term (up to 3 months) | RR 8.71 [0.37, 205.80] | 1 study · 80 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Change in feeling of dryness short-term (up to 3 months) | SoF5: No included studies reported change in feeling of dryness. | 0 studies | No studies |
Adverse effects: gastrointestinal complaints short-term (up to 3 months) | RR 4.00 [1.21, 13.27] | 3 studies · 138 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Adverse effects: drowsiness short-term (up to 3 months) | RR 1.00 [0.07, 14.85] | 1 study · 38 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Adverse effects: headache short-term (up to 3 months) | RR 10.87 [1.36, 87.03] | 2 studies · 118 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Change in taste short-term (up to 3 months) | SoF5: No included studies reported change in taste. | 0 studies | No studies |
Relief of burning/discomfort (symptom relief; pain intensity) long-term (>3 to 6 months) | MD -0.89 [-2.37, 0.59] | 2 studies · 94 participants | Very low Downgraded: risk of bias, inconsistency |
Adverse effects: increase in blood pressure short-term (up to 3 months) | RR 1.00 [0.07, 14.85] | 1 study · 38 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Amisulpride (antipsychotic, 50 mg/day) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Relief of burning/discomfort (symptom relief; pain intensity) 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 | Ungraded |
Paroxetine (antidepressant, 20 mg/day) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Relief of burning/discomfort (symptom relief; pain intensity) short-term (up to 3 months) | Bogetto 1999 (paroxetine) included but data not presented (79% placebo-arm attrition). | 1 study | Ungraded |
Benzodiazepines (systemic clordemetildiazepam 1 mg/day) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Relief of burning/discomfort (symptom relief; pain intensity) short-term (up to 3 months) · clordemetildiazepam | Bogetto 1999 (clordemetildiazepam) included in the benzodiazepine comparison but data not presented (79% placebo-arm attrition). | 1 study | Ungraded |
Amitriptyline (antidepressant, 25 mg/day) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Relief of burning/discomfort (symptom relief; pain intensity) short-term (up to 3 months) | Bogetto 1999 (amitriptyline) included but data not presented (79% placebo-arm attrition). | 1 study | Ungraded |
Benzodiazepines (topical clonazepam) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in feeling of dryness short-term (up to 3 months) | SoF3: No included studies reported change in feeling of dryness. | 0 studies | No studies |
Adverse effects: dry mouth short-term (up to 3 months) · topical clonazepam | RR 3.00 [0.13, 70.16] | 1 study · 48 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse effects: drowsiness short-term (up to 3 months) · topical clonazepam | RR 2.71 [0.84, 8.74] | 2 studies · 114 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Relief of burning/discomfort (symptom relief; pain intensity) short-term (up to 3 months) · topical clonazepam | MD -1.89 [-2.19, -1.59] 4.76 (placebo mean VAS pain, 0-10, lower better) vs 2.87 (1.89 lower) | 2 studies · 111 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Adverse effects: spasmophilia short-term (up to 3 months) · topical clonazepam | RR 3.00 [0.13, 70.16] | 1 study · 48 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Relief of burning/discomfort (symptom relief; pain intensity) long-term (>3 to 6 months) · topical clonazepam | MD -1.39 [-1.96, -0.83] | 1 study · 66 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse effects: euphoric behaviour short-term (up to 3 months) · topical clonazepam | RR 3.00 [0.13, 70.16] | 1 study · 48 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Anticonvulsants (gabapentin 300 mg/day, +/- alpha lipoic acid) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Relief of burning/discomfort (symptom relief; pain intensity) short-term (up to 3 months) | RR 4.00 [2.09, 7.67] 450 [163, 850] more per 1000 | 1 study · 100 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Change in taste short-term (up to 3 months) | SoF2: No included studies reported change in taste. | 0 studies | No studies |
Change in quality of life (QoL) short-term (up to 3 months) | SoF2: No included studies reported change in QoL. | 0 studies | No studies |
Adverse effects: drowsiness (gabapentin alone) short-term (up to 3 months) | RR 31.95 [1.84, 553.64] | 1 study · 80 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Change in feeling of dryness short-term (up to 3 months) | SoF2: No included studies reported change in feeling of dryness. | 0 studies | No studies |
Anticonvulsants (gabapentin + alpha lipoic acid) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Adverse effects: drowsiness short-term (up to 3 months) | RR 14.52 [0.73, 290.44] | 1 study · 80 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse effects: mild headache short-term (up to 3 months) · gabapentin with adjunctive ALA | RR 8.71 [0.37, 205.80] | 1 study · 80 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Relief of burning/discomfort (symptom relief; pain intensity) short-term (up to 3 months) · gabapentin with adjunctive ALA | SoF2 subgroup. Gabapentin + adjunctive ALA vs placebo forms one of two subgroups of the anticonvulsant symptom-relief estimate (RR 4.00, 2.09 to 7.67); no between-subgroup difference vs gabapentin alone; 100… | 1 study · 40 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Benzodiazepines (systemic clonazepam 0.5 mg/day) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Relief of burning/discomfort (symptom relief; pain intensity) short-term (up to 3 months) · systemic clonazepam | MD 0.00 [-1.86, 1.86] | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Change in QoL - depression (surrogate marker) short-term (up to 3 months) · systemic clonazepam | MD -0.20 [-0.95, 0.55] | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Change in taste short-term (up to 3 months) · systemic clonazepam | MD -1.00 [-3.11, 1.11] | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Cholinergics (bethanechol 15 mg/day) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Adverse effects (narrative) 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 Downgraded: risk of bias, imprecision, indirectness |
Relief of burning/discomfort (symptom relief; pain intensity) short-term (up to 3 months) | RR 5.00 [0.26, 98.00] 150 per 1000 vs 750 per 1000 | 1 study · 40 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Change in feeling of dryness short-term (up to 3 months) | SoF4: No included studies reported change in feeling of dryness. | 0 studies | No studies |
Change in quality of life (QoL) short-term (up to 3 months) | SoF4: No included studies reported change in QoL. | 0 studies | No studies |
Change in taste short-term (up to 3 months) | SoF4: No included studies reported change in taste. | 0 studies | No studies |
Dietary supplements (lycopene) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Relief of burning/discomfort (symptom relief; pain intensity) short-term (up to 3 months) · lycopene | Lycopene (Cano-Carrillo 2014) contributes to the dietary supplements short-term symptom-relief comparison (12 RCTs, insufficient/contradictory); no separate lycopene symptom-relief estimate reported. | 1 study · 50 participants | Ungraded |
Change in QoL - depression (surrogate marker) short-term (up to 3 months) · lycopene | MD -1.87 [-4.23, 0.49] | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Change in quality of life (QoL) short-term (up to 3 months) · lycopene | MD 0.93 [-3.14, 5.00] | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Change in QoL - anxiety (surrogate marker) short-term (up to 3 months) · lycopene | MD -2.85 [-5.28, -0.42] | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Dietary supplements (hypericum perforatum / St John's Wort) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Relief of burning/discomfort (symptom relief; pain intensity) short-term (up to 3 months) · hypericum perforatum | Hypericum perforatum extract (Sardella 2008, the only low-risk-of-bias study) contributes to the dietary supplements short-term symptom-relief comparison (insufficient/contradictory); no separate estimate reported. | 1 study · 43 participants | Ungraded |
Change in quality of life (QoL) short-term (up to 3 months) · hypericum perforatum | Sardella 2008 (43 participants) evaluated QoL from patient self-reports and narratively indicated that both intervention and placebo participants were better able to cope at trial completion. | 1 study · 43 participants | Ungraded |
Dietary supplements (Catuama herbal compound) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Adverse effects: insomnia short-term (up to 3 months) · Catuama | RR 2.69 [0.11, 63.96] | 1 study · 72 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Adverse effects: drowsiness short-term (up to 3 months) · Catuama | RR 2.69 [0.11, 63.96] | 1 study · 72 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Relief of burning/discomfort (symptom relief; pain intensity) short-term (up to 3 months) · Catuama | 'Catuama' herbal compound (Spanemberg 2012) contributes to the dietary supplements short-term symptom-relief comparison (insufficient/contradictory); no separate estimate reported. | 1 study · 72 participants | Ungraded |
Adverse effects: weight gain short-term (up to 3 months) · Catuama | RR 2.69 [0.11, 63.96] | 1 study · 72 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Adverse effects: exacerbation of symptoms short-term (up to 3 months) · Catuama | RR 1.12 [0.33, 3.83] | 1 study · 72 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Electromagnetic radiation (low-level laser therapy) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Relief of burning/discomfort (symptom relief; pain intensity) short-term (up to 3 months) | MD -30.36 [-44.22, -16.50] 62.84 (placebo mean VAS pain, 0-100, lower better) vs 32.48 (30.36 lower) | 1 study · 58 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Change in quality of life (QoL) short-term (up to 3 months) | MD -5.24 [-7.38, -3.09] | 1 study · 58 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Change in feeling of dryness short-term (up to 3 months) | SoF6: No included study reported change in feeling of dryness. | 0 studies | No studies |
Adverse effects short-term (up to 3 months) | SoF6: No included study reported the occurrence of adverse events. | 0 studies | No studies |
Change in taste short-term (up to 3 months) | SoF6: No included study reported change in taste. | 0 studies | No studies |
Physical barriers (tongue protector) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in taste short-term (up to 3 months) | SoF7: No included studies reported change in taste. | 0 studies | No studies |
Change in QoL - anxiety (surrogate marker) short-term (up to 3 months) | MD 0.16 [-3.19, 3.51] | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse effects (narrative) short-term (up to 3 months) | SoF7. Adverse effects: single study narratively reported that no adverse events occurred from the use of tongue protectors; 50 participants (1 RCT); low. | 1 study · 50 participants | Low Downgraded: risk of bias, imprecision |
Relief of burning/discomfort (symptom relief; pain intensity) short-term (up to 3 months) | MD -1.10 [-2.14, -0.06] 5.6 (placebo mean VAS pain, 0-10, lower better) vs 4.5 (1.10 lower) | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision |
Change in feeling of dryness short-term (up to 3 months) | SoF7: No included studies reported change in feeling of dryness. | 0 studies | No studies |
Change in quality of life (QoL) short-term (up to 3 months) | MD -9.20 [-26.90, 8.50] | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision |
Change in QoL - depression (surrogate marker) short-term (up to 3 months) | MD -0.64 [-3.98, 2.70] | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Topical treatments (lactoperoxidase oral rinse / Biotene) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Relief of burning/discomfort (symptom relief; pain intensity) long-term (>3 to 6 months) · lactoperoxidase (Biotene) | MD -1.50 [-3.91, 0.91] | 1 study · 18 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Topical treatments (topical urea 10%) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Relief of burning/discomfort (symptom relief; pain intensity) short-term (up to 3 months) · topical urea 10% | Topical urea 10% (Alvarenga da Silva 2014) contributes to the topical treatments short-term symptom-relief comparison (insufficient/contradictory); no separate estimate reported. | 1 study · 38 participants | Ungraded |
Change in feeling of dryness short-term (up to 3 months) · topical urea 10% | SoF9. Change in feeling of dryness short-term (xerostomia questionnaire, 1-5, lower better): single study narratively reported no difference before or after treatment; 38 participants (1 RCT, topical urea); very low. | 1 study · 38 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Change in taste short-term (up to 3 months) · topical urea 10% | SoF9. Change in taste short-term (Quantitative Sensory Testing gustative threshold): single study narratively reported no difference in short-term gustation thresholds; 38 participants (1 RCT, topical urea); very low. | 1 study · 38 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Topical treatments (capsaicin oral rinse) vs Placebo
Population: People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Relief of burning/discomfort (symptom relief; pain intensity) short-term (up to 3 months) · capsaicin oral rinse | Capsaicin oral rinse (Marino 2010; Silvestre 2012) contributes to the topical treatments short-term symptom-relief comparison (insufficient/contradictory). Silvestre 2012 data not presented due to 23% first-phase… | 1 study | Ungraded |
Relief of burning/discomfort (symptom relief; pain intensity) long-term (>3 to 6 months) · capsaicin oral rinse | MD -2.60 [-5.11, -0.09] | 1 study · 18 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |