Oral mucosal blood flow in patients with burning mouth syndrome

The pathophysiology of burning mouth syndrome (BMS) is largely unknown. Thu s, the aim was to study oral mucosal blood how in BMS-patients using laser Doppler flowmetry (LDF). Thirteen EMS patients (11 female, two male; mean a ge +/- SD 64.3 +/- 7.9 years, mean disease duration 18.9 +/- 6.2 months) an d 13 healthy non-smoking controls matched for age and gender (11 female, tw o male; mean age 64.7 +/- 8.1 years) were investigated. Using the LDF techn ique mucosal blood flow (mBF) was measured at the hard palate, the tip of t he tongue, on the midline of the oral vestibule, and on the lip. Measuremen ts were made at rest and over 2 min following dry ice application of 10 s d uration using a pencil shaped apparatus. In addition, blood pressure (BP), heart rate (HR), peripheral cutaneous blood how, and transcutaneous pCO(2) were continuously recorded. Mucosal blood flow ((mBF) increased at all meas urement sites in response to dry ice application (P < 0.001) with peak flow at 0.5-1.5 min after stimulation onset. During the following 1.5-2 min, bl ood flow decreased at all sires with a tendency to return to baseline towar ds the end of the observation period. Except for BP and peripheral blood fl ow, all of the cardiovascular changes exhibited significant changes during the observation period; no differences between groups were detected. When c ompared to healthy controls BMS patients generally exhibited larger changes in mBF. These changes were significant for recordings made on the hard pal ate (F[1,24] = 13.9, P < 0.001). Dry ice stimulation appears to be an effec tive, non-invasive and reasonably tolerable means to investigate mucosal bl ood flow at different mucosal sites. In general, vasoreactivity in EMS pati ents was higher than in healthy controls. EMS patients exhibited a higher r esponse on the hard palate compared to controls. These changes in oral bloo d flow appear to be specifically related to EMS symptoms indicating a distu rbed vasoreactivity. (C) 2001 International Association for the Study of Pa in. Published by Elsevier Science B.V. All rights reserved.