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Therapeutic use of alpha lipoic acid in burning mouth syndrome: A meta-analysis

Introduction: Primary burning mouth syndrome (BMS) is a chronic pain disorder of the oral cavity without any apparent local or systemic etiologic factor. There is no specific therapy for primary BMS and treatment is basically supportive or symptomatic. There are many pharmacological and nonpharmacological approaches reported by different studies to alleviate pain in primary BMS. Alpha lipoic acid (ALA) has also been used as a therapeutic agent in BMS by many clinicians and researchers. Aims: The aim of this review and meta-analysis was to evaluate the double-blinded placebo controlled randomized clinical trials of ALA to determine its efficacy and potential as therapeutic agent in primary BMS. Six studies were selected for the systematic review after a thorough manual and electronic searching of the databases. Methods: Five out of the 6 selected studies were used for quantitative data synthesis. Results and discussion: The ALA therapy for 2 months provided symptomatic relief to more people in the study groups than in the placebo groups (risk ratio 2.34, 95% confidence interval [CI]: 1.71–3.19). The mean visual analog scale (VAS) scores of the test groups improved (decreased) after 2 months of ALA therapy (standardised mean difference [SMD] 0.72, 95% CI 0.20–1.24). When compared with placebo therapy, mean VAS scores improved (decreased) more with placebo than with ALA after 2 months of treatment (SMD −0.23, 95% CI: −0.70–0.24). The positive responders in the ALA groups presented less incidence of deterioration than the positive responders in placebo groups during the follow-up period. Conclusion: It was concluded from this meta-analysis that ALA could be used as a potential therapeutic agent in primary BMS. It should be administered in proper therapeutic doses and for sufficient time to elicit positive outcome. ALA can be used for a long time without any severe side effect and very few recipients complained about worsening of the situation. It certainly improves pain symptoms in a considerable number of patients when compared with placebo therapy.