J Oral Med Pain.  2022 Sep;47(3):126-134. 10.14476/jomp.2022.47.3.126.

Treatment Protocol for Secondary Burning Mouth Syndrome in Candida albicans- or Non-albicans-Positive Patients

• Ju HM
• Jeong SH
• Ahn YW
• Jeon HM
• Ok SM

• KMID: 2552188
• DOI: http://doi.org/10.14476/jomp.2022.47.3.126

Abstract

Purpose
This study aimed to propose an efficient treatment approach for infection with different candida species.
Methods
Fifty-three patients who presented with a chief complaint of oral mucosal pain and exhibited positive candida culture findings were divided into two groups (Candida albicans and non-albicans). Pain, mucosal manifestations, salivary flow rates, durations of disease and treatment, and responses to treatment (nystatin and clonazepam) were investigated in both groups.
Results
Patients in the C. albicans group exhibited more prominent clinical characteristics (erythematous lesions, tongue coatings, and hyperalgesia) than those in the non-albicans group. In total, 70% of patients in the non-albicans group showed no abnormalities in the oral mucosa. Patients in the C. albicans group showed increased resistance to nystatin treatment compared to those in the non-albicans group, especially with longer disease durations. The patients resistant to nystatin treatment showed positive responses to clonazepam.
Conclusions
Patients with oral mucosal pain should be tested for the presence of candida, even in the absence of mucosal abnormalities, especially those infected with non-albicans species. If no response to antifungal therapy is observed, treatment with clonazepam should be initiated, especially in patients infected with C. albicans .

Keyword

Burning mouth syndrome; Candida albicans; Candidiasis; Non-albicans Candida infection