# Changes in salivary biomarkers of burning mouth syndrome patients after clonazepam treatment

## TL;DR

This study found that changes in salivary α-amylase activity may help assess treatment response in burning mouth syndrome patients after clonazepam use.

## Contribution

The study identifies salivary α-amylase activity as a potential biomarker for evaluating treatment response in burning mouth syndrome.

## Key findings

- Salivary biomarker levels showed no significant differences between responders and non-responders.
- Change in salivary α-amylase activity after treatment differed significantly between responders and non-responders (p = 0.039).
- Salivary α-amylase activity may be a potential biomarker for burning mouth syndrome due to its link with orofacial pain and stress.

## Abstract

There is a lack of objective indicators to evaluate the treatment effect of
burning mouth syndrome, a neuropathic pain of unknown causes. Therefore, this
study aimed to evaluate potential salivary biomarkers by analyzing saliva before
and after clonazepam treatment in patients with burning mouth syndrome. Saliva
was collected from 23 patients with burning mouth syndrome before and 4 weeks
after the topical administration of clonazepam. Patients were classified as
responders (pain relief of 50% or more, n = 10) or non-responders (n = 13) based
on pain relief after treatment. Clinical examination data of responders and
non-responders were compared using Mann-Whitney U test and Fisher’s exact test.
Changes in the level of salivary biomarkers (salivary α-amylase,
cortisol, calmodulin, α-enolase and interleukin-18) were evaluated
before and after treatment using Wilcoxon signed-rank sum test, and their
association with treatment response was examined using Fisher’s exact test. The
salivary biomarker levels showed no significant differences between the
responders and non-responders. However, the change in salivary α-amylase
activity after treatment revealed a significant difference between the two groups
(p = 0.039). Although not all patients showed the same pattern, there
was a difference in the alteration of salivary α-amylase activity before
and after treatment between responders and non-responders. Further study is
required to clarify whether there is a causal relationship between salivary
α-amylase activity and treatment response. However, considering that
salivary α-amylase activity is related to orofacial pain and
psychological stress, this suggests the potential use of salivary
α-amylase as a biomarker for burning mouth syndrome.