New research suggests oral microbiome differences in patients with Burning Mouth Syndrome

The study

Comparative analysis of the oral microbiome of burning mouth syndrome patients

Where: Seoul National University, Seoul, Republic of Korea

Published: March 20, 2022, Journal of Oral Microbiology

The takeaway

Burning mouth syndrome (BMS) is the medical term for chronic or recurrent burning in the mouth without an obvious cause. This discomfort may affect the tongue, gums, lips, inside of your cheeks, roof of your mouth (palate) or widespread areas of your whole mouth. A new study suggests it may be correlated with certain oral microbes.

What it looked at

This study investigated the oral microbiota signatures of BMS patients to assess the potential role of the oral microbiota as a cause of BMS. Participants included 27 adults recruited from the Department of Oral Medicine at Seoul National University Dental Hospital with complaints of burning sensation and dysesthesia (abnormal sensation) in their mouths,  with no objective abnormalities of the mucosa (the membrane lining the mouth, cheeks, and lips). These were compared to 22 age and sex-matched healthy volunteers as controls with the same list of exclusion criteria, excluding all patients with documented gum disease on exam to remove confounding from gum disease-related microbes. 

Saliva samples were collected, DNA was isolated, and the oral bacteria were analyzed using 16S rRNA sequencing. After excluding 8 study patients with signs of chronic gum disease, a total of 19 BMS patients vs. 22 controls were studied. Ages range from 32 to 83 in the study group and 44 to 80 in the controls. 

What it found

Statistically significant differences in the dominant bacteria were found, with Streptococcus, Rothia, Bergeyella, and Granulicatella genus being more prevalent in the BMS group and Prevotella, Haemophilus, Fusobacterium, Campylobacter, and Allorevotella in the healthy control group. These differences suggest a possible correlation between certain oral microbiomes and BMS. 

Why it matters

Similar to other neuropathic pain conditions without any clear objective lesions or exam findings, BMS can cause significant physical and psychological distress to patients. As demonstrated in studies assessing the connection between the gut microbiome and several systemic immunologic, neuropathic and metabolic disorders, the potential role of the oral microbiome has also come into the spotlight as another contributor to local and systemic disease processes. As demonstrated in this study, the finding of distinct differences in the microbiome of BMS patients compared to controls may suggest a potential role of oral bacteria in the development of BMS pathophysiology for the disease process. 

This is a relatively small study based on the number of subjects, and further research is needed to validate these findings, but the notable differences in microbiome composition are promising. While this may be a small study based on study population size, there are notable differences in dominant strains. With this finding, If further studies validate these signatures, the utility of diagnostic testing tools to determine oral microbiome signatures can potentially have significant implications for early identification and possible treatment of this disorder. 

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