Glossodynia from Candida-associated lesions, burning mouth syndrome, or mixed causes

Candida-associated lesions (CALs) and burning mouth syndrome (BMS) may induce glossodynia without objective manifestations. We investigated patients with glossodynia to examine the relationship between CAL and BMS.

A visual analog scale was used to divide 95 patients with glossodynia into three groups according to intensity of pain at rest and when eating. Group A was the functional pain group; group B was the nonfunctional pain group; and group C was a mixed pain group. Antifungal treatment was scheduled for patients with suspected Candida infection by clinical, mycological, or cytological criteria.

Culture tests and direct examination results indicated that group A had high Candida positivity (73.0% by culture and 59.5% by direct examination), and showed a good response to antifungal treatment (75.7%). Antifungal treatment was not useful in group B. This was supported by a low Candida infection rate, as determined by direct examination (3.1%). For group C, Candida positivity and antifungal treatment effectiveness were between groups A and B. Furthermore, six patients in group C showed complete remission of functional pain by antifungal treatment only. Favorable outcomes were obtained for 23 patients (10 in group B and 13 in group C), who received antidepressant treatment.

These results suggested that glossodynia was Candida-associated in group A, and BMS-induced in group B, while group C contained patients with both CAL and BMS.