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Published on: June 4, 2014
A case-control evaluation of fungiform papillae density in burning mouth syndrome
Jason M Naud1, Laura Benca2, Mark T Drangsholt3
1Mayo Clinic, Department of Periodontics, Rochester, Minnesota, U.S.A.
Hypothesis:
It has been hypothesized that high fungiform papillae density may be a risk factor for developing the taste and pain alterations characteristic of burning mouth syndrome.
Objective:
Evaluate whether fungiform papillae density, taste sensitivity, and mechanical pain sensitivity differ between burning mouth syndrome cases and controls.
Study Design:
This case-control study compared cases diagnosed with primary burning mouth syndrome with pain-free controls.
Methods:
Participants (17 female cases and 23 female controls) rated the intensity of sucrose, sodium chloride, citric acid, and quinine applied separately to each side of the anterior tongue and sampled whole mouth. Mechanical pain sensitivity was assessed separately for each side of the tongue using weighted pins. Digital photographs of participants' tongues were used to count fungiform papillae.
Results:
Burning mouth syndrome cases had increased whole mouth taste intensity. Cases also had increased sensitivity to quinine on the anterior tongue, as well as increased mechanical pain sensitivity on the anterior tongue. Fungiform papillae density did not differ significantly between cases and controls. Fungiform papillae density on the left and right sides of the tongue were correlated in controls; however, there was no left/right side correlation in cases.
Conclusion:
Cases had increased pain and taste perception on the anterior tongue. The lack of correlation between left and right fungiform papillae density in cases may be an indication of asymmetrical lingual innervation in these patients.
Level Of Evidence:
3b. Laryngoscope, 128:841-846, 2018.
Insights
Burning mouth syndrome patients exhibit heightened taste and pain sensitivity, but not increased fungiform papillae density. This suggests altered sensory processing, not papillae count, may underlie the condition.
Area of Science:
- Oral medicine
- Neuroscience
- Sensory science
Background:
- Burning mouth syndrome (BMS) is characterized by taste and pain alterations.
- High fungiform papillae density has been hypothesized as a potential risk factor for BMS.
Purpose of the Study:
- To investigate differences in fungiform papillae density, taste sensitivity, and mechanical pain sensitivity between BMS cases and controls.
- To explore the relationship between these factors and the development of BMS.
Main Methods:
- A case-control study comparing 17 female BMS cases with 23 female pain-free controls.
- Assessment of taste sensitivity (sucrose, NaCl, citric acid, quinine) and mechanical pain sensitivity on the anterior tongue.
- Quantification of fungiform papillae density using digital photography.
Main Results:
- BMS cases showed increased whole mouth taste intensity and heightened sensitivity to quinine on the anterior tongue.
- Increased mechanical pain sensitivity was observed on the anterior tongue in BMS cases.
- No significant difference in fungiform papillae density was found between cases and controls.
Conclusions:
- BMS cases exhibit enhanced pain and taste perception, particularly on the anterior tongue.
- The absence of correlation in fungiform papillae density between tongue sides in cases may suggest asymmetrical lingual innervation.
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