Capsaicin drops—a new strategy for treating burning mouth syndrome

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capsaicin drops burning mouth syndrome
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Burning mouth syndrome (BMS) is a chronic condition characterised by a burning pain in the mouth, sometimes accompanied by numbness. The clinical features of this condition closely resemble other neuropathic pain disorders.

There has been limited research on this phenomenon, but a research project by a team in the Faculty of Dentistry at the University of Oslo may contribute to the establishment of a new treatment method.

BMS is often considered a perplexing condition because the intensity of pain rarely corresponds to the clinical signs of the disease.

“Pain lasting at least four to six months with an intense burning sensation in the mouth, that cannot be explained by a medical or dental condition, is what leads to the diagnosis of BMS,” A/Prof Preet Bano Singh said.

“Since there has been so little research on BMS, patients often feel dismissed, with their complaints being trivialised. However, by scanning the brains of patients with BMS, we detected pathology in the pain matrix in the brain …indicating that patients with BMS have cerebral neuropathy in the pain area, which could be a cause of the burning sensation in the mouth.”

Medical and dental interventions, as well as the use of certain medications, can lead to burning mouth pain, with various medications used to treat it, including benzodiazepines, gabapentin, tricyclic antidepressants, antipsychotics, antioxidants, and behavioural therapies.

“However, none of these treatments are optimal or particularly effective, and patients experience despair when there are no options to treat or alleviate their chronic pain,” A/Prof Singh said.

BMS can also be effectively treated with capsaicin gel, which is commonly used in other countries.

But as it is not possible to purchase intraoral capsaicin gel or ointment in Norway, A/Prof Singh and collaborators decided to explore ways to create a substance that could effectively deliver the correct concentration of capsaicin to oral mucosa.

Capsaicin is a chemical compound naturally found in chili peppers. It acts as an ‘awakener’ for specific receptors in the body that transmit pain and temperature signals. These receptors are called ‘TRPV1 receptors’.

The challenge is how to keep the active substance where it should be. When capsaicin is applied to the mouth, it is often washed away by saliva and quickly disappears when the tongue moves. Therefore, the researchers are working on finding a way to prolong the presence of capsaicin in the mouth.

In this research project, the idea is to develop a kind of ‘carrier’ that can keep capsaicin in place in the mouth. This carrier must have sufficient stickiness to adhere to the mucous membrane.

However, before such a treatment strategy can be implemented, it must be investigated whether the new carrier is safe for the cells in the mouth.

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