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238 de Almeida et al. | Journal of Clinical and Translational Research 2024; 10(4): 237-245
Although its etiology is unknown, BMS appears to patients with BMS treated with a non-pharmacological and/or
be multifactorial, associated with local, systemic, and/ placebo approaches; the primary (O)utcome refers to symptom
or psychological factors [10,11]. Local factors include reduction, and the secondary outcome refers to discomfort
parafunctional habits, allergic reactions, infection, chemical and burning sensation; and the (T)ype of publication refers
factors, galvanism, taste alterations, and xerostomia [10,11]. to systematic reviews published between January 2010 and
Systemic factors include endocrine changes (hypothyroidism, November 2023.
diabetes, and menopause), nutritional deficiencies, anemia, The selection of systematic reviews was based on the
Sjögren’s syndrome, and esophageal reflux [8-11]. Psychological PICOT question and the following eligibility criteria.
factors include anxiety, depression, compulsive disorders, and Inclusion criteria were systematic reviews of randomized and
psychosocial stress [9,11]. non-randomized clinical trials addressing pharmacological
The clinical condition is bilateral and is usually accompanied and non-pharmacological treatment for BMS; diagnosis of
by dry mouth, changes in taste, constant pain in the oral mucosa, BMS based on the International Association for the Study of
and a burning sensation [12-14]. Burning may be accompanied Pain definition and published in any language. The exclusion
by tingling or numbness, and a bitter or metallic taste, though criteria were duplicate studies and those not in article formats,
the oral mucosa and salivary flow remain normal [9-12]. The such as editorials, guides, letters, conference abstracts, theses,
current basic therapeutic strategy is focused on pain reduction and dissertations. Two independent researchers (H.C.R.A.
and elimination of concomitant symptoms of BMS [1,2,3,9,10]. and J.S.V.) performed a literature search from August to
Healthcare professionals treating patients with BMS face December 2023 and updated the literature search results in
challenges in selecting and applying drug or non-drug therapies June 2024.
to treat BMS. This challenge arises because published clinical
trials report symptomatic relief through various protocols, such 2.3. Information sources
as the use of clonazepam, capsaicin, pramipexole, cyclosporine, An electronic search was independently performed by two
venlafaxine, duloxetine, fluoxetine, pregabalin, α-lipoic acid, authors (H.C.R.A. and J.S.V.) in the following databases:
acupuncture, low-intensity laser, repetitive transcranial magnetic PubMed/MEDLINE, Scopus, Embase, Cochrane Library, Web
stimulation of the prefrontal cortex (rTMS), chamomile, and of Science, and grey literature (Open Gray), using the following
cognitive behavioral therapy [5-14]. A therapeutic protocol search strategy: ((burning mouth syndrome*) AND (treatment
for MSB has not yet been established, so the current strategy OR therapeutics OR therapy)) AND (systematic review*).
focuses on reducing the patient’s pain and symptoms [12-14]. The search strategy in the PubMed/MEDLINE database
Due to the challenges dental surgeons face in understanding
the etiology of BMS, providing adequate treatment becomes included (“burning mouth syndrome”[MeSH Terms] OR
“burning mouth syndrome”[MeSH Terms] OR ((“burning”[All
difficult. Systematic reviews describe several clinical
management approaches for BMS, with some indicating the Fields] OR “burns”[MeSH Terms] OR “burns”[All Fields]
efficacy of pharmacological approaches [15-17], while others OR “burned”[All Fields] OR “burnings”[All Fields])
report the efficacy of non-pharmacological therapies [5,18]. AND (“mouth”[MeSH Terms] OR “mouth”[All Fields]
However, some studies have found no significant difference OR “mouths”[All Fields] OR “mouth s”[All Fields] OR
between the two treatment approaches [19,20]. Herein, we “mouthed”[All Fields] OR “mouthful”[All Fields] OR
aim to provide evidence comparing therapeutic approaches “mouthfuls”[All Fields] OR “mouthing”[All Fields]))) AND
(pharmacological and non-pharmacological) for BMS treatment, (“therapeutics”[MeSH Terms] OR “therapeutics”[All Fields]
as reported in systematic reviews. OR “treatments”[All Fields] OR “therapy”[MeSH Subheading]
OR “therapy”[All Fields] OR “treatment”[All Fields] OR
2. Methods “treatments”[All Fields]) AND “systematic review”[Publication
Type]. The detailed search strategy for each platform can be
2.1. Review protocol and registration found in Table A1 (Appendix).
This study was registered in the Prospective Register In each database, studies were selected based on the title
of Systematic Reviews (PROSPERO; registration number and abstract. Each article was subjected to a full-text review
CRD42021257222). Our systematic review was developed to determine inclusion. The choices made by the two authors
following other papers in the literature, the Cochrane manual, (H.C.R.A. and J.S.V.) were analyzed by a third author
and Preferred Reporting for Systematic Reviews and Meta- (A.M.I.B.), and a consensus was reached through discussion.
analyses (PRISMA) guidelines [21].
2.4. Data collection process
2.2. Eligibility criteria
All articles were imported into the Rayyan QCRI reference
The PICOT question is: “For the relief of symptoms, manager (RRID: SCR_017584) for the removal of duplicates
discomfort, and burning sensation caused by BMS, what is the and subsequent analysis. One author (H.C.R.A.) collected
best strategy?” The (P)opulation refers to patients with BMS; data regarding author/year, registry/guide, quality assessment,
the (I)ntervention refers to patients with BMS treated with local/ number of articles included, databases analyzed, and study
systemic pharmacologic therapy; the (C)omparison refers to conclusion. A second author (A.M.I.B.) evaluated all the

DOI: http://doi.org/10.36922/jctr.24.00018