Božana Brzak

Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology which affects the oral mucosa. OLP varies in its clinical features from a reticular form that is, in most cases, asymptomatic, to atrophic–erosive, and is accompanied by symptoms of burning sensation and pain followed by difficulty in eating. Given the fact that OLP is a disease of unknown etiology, the treatment is symptomatic and involves suppressing the signs and symptoms of the disease using various topical and systemic drugs. The first line of therapy for treating symptomatic OLP is topical corticosteroids, whereas systemic corticosteroids are used for treating persistent lesions that do not respond to local treatment. However, the lack of convincing evidence on the efficacy of previous therapies, including topical corticosteroids, and numerous side effects that have appeared over recent years has resulted in the emergence and development of new therapeutic options. Some of the therapies mentioned are tacrolimus, efalizumab, dapson, interferon, retinoic acid, photochemotherapy with psoralen and ultraviolet A rays (PUVA), aloe vera, antimalarials, antibiotics and others. These therapies only partially meet the properties of efficacy and safety of use, thus justifying the continuous search and testing of new treatment methods.

Background: The objective of this study was to determine the most effective treatment option for burning mouth syndrome. Methods: Informative treatment alone, B vitamin injections, oral cavity probiotics, and low-level laser therapy were evaluated and compared. The study included new patients diagnosed with burning mouth syndrome, who were randomly allocated into one of four treatment groups. The primary outcome was improvement in patient’s quality of life as determined by a self-perceived Oral Health Impact Profile-14 (OHIP-14) quality of life questionnaire before and after therapy. The secondary outcome was determination of mucosal symptom intensity according to visual analog scale (VAS) grading from 0 to 10. Data were submitted to statistical analysis. Results: A total of 62 patients completed the study. Oral cavity probiotics and LLLT scores for OHIP-14 resulted in a statistically significant difference before and after therapy. Standardized effect sizes between OHIP scores before and after treatment were the greatest for patients who had received oral cavity probiotics. Conclusions: Oral cavity probiotics and LLLT were the most effective treatment for improvement in quality of life. Further investigation on a larger group of patients is required.