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Burning Mouth Syndrome: Exploring the Role of Central Sensitization and Neuropathic Pain Mechanisms in Bandung, Indonesia Muhammad Ashraf; Syaifudin Syaifudin; Andhika Kurnianta Kusuma; Duru Carissa Neuer; Eduardo Michael Perez
Sriwijaya Journal of Neurology Vol. 3 No. 1 (2025): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v2i2.170

Abstract

Introduction: Burning mouth syndrome (BMS) is a chronic pain condition characterized by a burning sensation in the oral cavity without any identifiable clinical or laboratory findings. While the etiology of BMS remains unclear, central sensitization and neuropathic pain mechanisms are increasingly recognized as potential contributors. This study aimed to investigate the role of central sensitization and neuropathic pain in BMS patients in Bandung, Indonesia. Methods: This cross-sectional study involved 40 participants diagnosed with BMS according to the International Association for the Study of Pain (IASP) criteria and 40 healthy controls. All participants underwent comprehensive assessments, including: (1) clinical oral examination, (2) quantitative sensory testing (QST) to assess thermal and mechanical sensitivity, (3) questionnaires to evaluate pain intensity, quality of life, anxiety, and depression, and (4) measurement of salivary cortisol levels as a marker of stress. Results: BMS patients exhibited significantly higher thermal and mechanical sensitivity compared to healthy controls (p<0.001). They also reported significantly higher pain intensity, poorer quality of life, and increased levels of anxiety and depression (p<0.001). Salivary cortisol levels were significantly elevated in the BMS group (p<0.05). Correlation analysis revealed significant associations between pain intensity and QST parameters, anxiety, depression, and salivary cortisol levels. Conclusion: The findings of this study suggest that central sensitization and neuropathic pain mechanisms play a significant role in the pathophysiology of BMS in Bandung, Indonesia. These findings highlight the need for a multidisciplinary approach to BMS management, incorporating strategies to address both peripheral and central factors contributing to pain.
The Impact of Severe Mental Illness (SMI) on Oral Health-Related Quality of Life (OHRQoL): A Mixed-Methods Study in Surabaya, Indonesia Syaifudin Syaifudin; Duru Carissa Neuer; Muhammad Ashraf; Aprilia Sari
Scientia Psychiatrica Vol. 6 No. 1 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i1.184

Abstract

Introduction: Severe Mental Illness (SMI) often leads to neglect of personal care, including oral hygiene, and may be associated with specific oral health challenges. This study aimed to comprehensively assess the impact of SMI on Oral Health-Related Quality of Life (OHRQoL) in a population in Surabaya, Indonesia. Methods: A cross-sectional study was conducted involving 120 participants with SMI (schizophrenia, bipolar disorder, and major depressive disorder with psychotic features) recruited from a tertiary psychiatric hospital and community mental health centers in Surabaya, and 120 age- and sex-matched controls without SMI. OHRQoL was assessed quantitatively using the Indonesian version of the Oral Health Impact Profile-14 (OHIP-14). Semi-structured interviews were conducted with a subset of 30 participants with SMI to explore their experiences and perceptions regarding oral health. Oral examinations were performed on all participants to assess Decayed, Missing, and Filled Teeth (DMFT) index, Community Periodontal Index (CPI), and presence of oral mucosal lesions. Results: Participants with SMI had significantly higher mean OHIP-14 scores (32.5 ± 8.2) compared to controls (14.1 ± 4.5) (p < 0.001), indicating poorer OHRQoL. The DMFT index was also significantly higher in the SMI group (12.8 ± 3.7) compared to controls (6.2 ± 2.1) (p < 0.001), and CPI scores indicated worse periodontal health in the SMI group. Qualitative analysis revealed key themes: barriers to accessing dental care (financial constraints, fear, lack of transportation), challenges with daily oral hygiene practices (forgetfulness, lack of motivation, side effects of medication), and limited awareness of the importance of oral health. Conclusion: Individuals with SMI in Surabaya, Indonesia, experience significantly poorer OHRQoL compared to the general population. This is associated with poorer objective oral health status and multiple, interlinked barriers to care. Integrated mental health and oral health services, tailored interventions to improve oral hygiene practices, and increased awareness campaigns are crucial to address this disparity.