A propolis-based nano-formulated bioadhesive oral gel (NBF gel) containing vitamins C and E has been proposed as a supportive topical therapy for oral mucosal lesions. The aim of this study was to evaluate clinical outcomes associated with the use of the gel during a 15-year institutional clinical experience and to assess its adjunctive effect on periodontal status in patients with intellectual disabilities. The study consisted of two components: a retrospective observational case series and a non-randomized controlled clinical study. In the retrospective component, 295 patients (219 females and 76 males) received topical NBF gel treatment for various oral mucosal conditions, including xerostomia-associated mucositis, inflammatory lesions, aphthous ulcers, herpes infections, glossodynia, leukoplakia, erythroplakia, and post-surgical conditions. Treatment response was assessed descriptively using patient-reported symptom improvement combined with clinical evaluation. Overall, treatment was considered successful in 265/295 patients (89.8%), while 14/295 patients (4.7%) were classified as ineffective and 16/295 patients (5.4%) as inconclusive. More favorable responses were observed in inflammatory and post-treatment lesions than in potentially premalignant or neuropathic conditions. In the controlled periodontal component, 40 patients with mild to moderate intellectual disabilities were allocated into a control group performing toothbrushing alone and a test group additionally receiving topical NBF gel application. Periodontal status was assessed using the Basic Periodontal Examination (BPE) index at baseline and after 1 and 2 weeks. Adjunctive gel application was associated with greater improvement in periodontal status compared with toothbrushing alone. No clinically relevant adverse effects were documented during the observation period; however, because adverse events were not assessed using a predefined safety-monitoring protocol, these findings should be interpreted cautiously. The present findings suggest that the investigated nano-formulated bioadhesive oral gel may represent a potentially useful adjunctive topical therapy in selected oral mucosal and periodontal conditions. Further randomized controlled studies with standardized objective outcome measures are required to confirm these preliminary findings.

Oral manifestations are a frequent yet underrecognized feature of systemic lupus erythematosus (SLE), contributing substantially to patient morbidity and reduced quality of life. They are insufficiently represented in clinical outcome measures and therapeutic guidelines, despite their clinical relevance. We report the case of a 39-year-old woman with SLE who developed severe, refractory tongue ulcers and glossodynia persisting for three years, unresponsive to hydroxychloroquine (HCQ), azathioprine (AZA), colchicine, methotrexate (MTX), and glucocorticoids (GC). Belimumab was discontinued due to gastrointestinal intolerance and lack of efficacy on oral lesions. The patient was subsequently treated with anifrolumab 300 mg intravenously every four weeks. After the first infusion, oral ulcers resolved, arthritis improved, and corticosteroids were discontinued. Within three months, the tongue lesions had completely healed, enabling unrestricted oral intake and full resumption of professional activities. Clinical remission was maintained on anifrolumab and hydroxychloroquine alone at four months of follow-up. This case highlights the therapeutic challenge of refractory oral lesions in SLE, a manifestation not adequately addressed in current EULAR (2023 update) or ACR (2025) guidelines. While conventional immunosuppressants such as azathioprine, methotrexate, and mycophenolate mofetil remain options, their efficacy for isolated oral lesions is limited. Emerging evidence, including case reports and small series, suggests that anifrolumab may provide significant benefit for mucosal involvement. The key learning point is that refractory tongue involvement may represent a dominant and treatment-resistant manifestation of SLE, yet it can respond to targeted biologic therapy such as anifrolumab and our report adds to this growing body of evidence. Prospective comparative studies and registry analyses are required to define anifrolumab's effectiveness specifically for refractory oral manifestations and to compare outcomes with other biologics.

Background and Clinical Significance: Extrapulmonary tuberculosis (TB) remains a diagnostic challenge, particularly when affecting rare sites such as the oral cavity and digestive tract. We report the case of a 55-year-old woman with disseminated (miliary) tuberculosis presenting with atypical oral lesions initially suspected to represent a malignant tumor. Case Presentation: The patient had a history of recurrent depressive disorder, cognitive impairment, sleep disturbances, and nicotine/alcohol dependence. She presented with painful ulcerations of the oral cavity, dysphagia, odynophagia, and glossodynia. Otolaryngologic examination revealed reduced tongue mobility and an ulceroinfiltrative lesion involving the floor of the mouth and the lower alveolar ridge. Fibroscopic evaluation confirmed infiltrative ulcerative lesions, and biopsy samples were obtained. Histopathologic examination revealed a chronic necrotizing granulomatous inflammation with multinucleated giant cells, consistent with a mycobacterial infection. Further investigations confirmed disseminated (miliary) tuberculosis with oral and digestive involvement. Antituberculous therapy was initiated; however, despite temporary stabilization, the patient's condition progressively worsened and the outcome was fatal. Conclusions: Oral and digestive tuberculosis, although rare, should be considered in the differential diagnosis of ulceroinfiltrative lesions of the oral cavity, particularly in patients with systemic symptoms or risk factors for TB. Early histopathologic confirmation and initiation of specific therapy are essential for favorable outcomes and prevention of misdiagnosis as malignant disease.

Glossodynia-related pain refers to persistent, chronic pain occurring on the oral mucosal surface. Various medications are prescribed depending on symptom profiles and have demonstrated therapeutic benefits; however, these agents are often associated with adverse effects such as drowsiness or dizziness. Goreisan, a traditional Japanese Kampo medicine, has long been used empirically for glossodynia-related pain, particularly in patients reporting symptom fluctuation associated with weather changes. Nevertheless, high-quality clinical evidence supporting its efficacy remains limited. This multicenter, randomized, open-label preliminary exploratory study enrolled patients receiving treatment for glossodynia-related pain. Participants were assigned to receive either Goreisan (7.5 g/day for 12 weeks) in addition to standard therapy or standard therapy alone. Pain intensity was assessed using the visual analog scale (VAS) at baseline and at 4, 8, and 12 weeks. Salivary amylase activity was measured as an exploratory stress-related biomarker, and atmospheric pressure was recorded at each outpatient visit. Owing to insufficient enrollment, all analyses were descriptive and exploratory. Pain intensity improved from baseline in both groups. However, the proportion of patients achieving ≥ 20% improvement in VAS at week 12 was not higher in the Goreisan group than in the control group. Weak negative correlations between VAS scores and barometric pressure were observed in both groups (r ≈ - 0.2). No clinically relevant adverse events or hepatic dysfunction related to Goreisan were identified. This preliminary exploratory study did not confirm a clear analgesic efficacy of Goreisan for glossodynia. However, the findings provide descriptive data on pain trajectories, safety, and potential meteorological associations, supporting the need for future large-scale, double-blind, placebo-controlled trials.

The objective of the study was to determine the relationship between burning, xerostomia, dysgeusia and other subjective symptoms in patients with burning mouth syndrome (BMS). This cross-sectional study was conducted at the Dental Polyclinic Split, Split, Croatia. A total of 71 patients with BMS, i.e., 60 women and 11 men, were included in the study. The patients were divided into four subgroups: burning (B), burning and xerostomia (BX), burning and dysgeusia (BD), burning, xerostomia and dysgeusia (BXD). The following data were collected from all patients: sociodemographic status, comorbidities, medications, characteristics of the burning, presence of other subjective symptoms, topography of the burning. The majority of patients with BMS were women (86.0%) with an average age of about 65 years. Gastrointestinal diseases were the most common comorbidity (48.35%), and the most commonly used medications were proton pump inhibitors (PPIs) (29.8%). In the largest number of patients (N = 34), the burning symptom worsened in the evening hours (p = 0.059). The majority of BMS patients suffered from burning symptoms that occurred continuously (N = 54, 75.13%) and from an improvement (reduction/cessation) of symptoms during meals (N = 54, 76.65%). Of the other subjective symptoms, changes in the morphology of the tongue (10.6%) and a feeling of swelling (9.1%) were the most common. The tongue was the most common localization (67.35%). The multivariable logistic regression analysis showed a statistically significant effect of female gender (p = 0.049) as a potential positive predictor in subgroup B. The sociodemographic and medical data collected cannot explain the different occurrence of symptoms in the four subgroups of patients with BMS.

Burning mouth syndrome (BMS) is a debilitating intraoral burning or dysesthesia sensation without any evident causative lesions on clinical examination and investigations. The etiopathogenesis of BMS remains uncertain, with proposed mechanisms including psychological, peripheral neuropathic, and central neuropathological factors. Management of BMS is generally symptomatic and often met with poor response. Published data on the successful pain management interventions are inadequate. This report describes the successful management of a 43-year-old patient with severe glossodynia, diagnosed as BMS, using ultrasound-guided suprazygomatic sphenopalatine ganglion block after poor response to the conventional therapies as well as stellate ganglion block.

The aim of this literature review was to provide a brief perspective over the scientific research of the condition known as burning mouth syndrome. Information from review articles, original studies, and dissertations was gathered using keywords describing etiological factors, clinical, laboratory findings and treatment protocols. We compiled information on potential etiological factors, symptoms, and potential treatments from the fifty-three included studies on dental and general health issues in patients complaining of burning sensations in their mouths. Despite the numerous attempts by dental and medical professionals to diagnose and treat mouth burning, the etiology and pathogenesis of this disorder remain rather unclear. In most cases, it is concluded that further research is needed with the inclusion of more patients, administering a long-term therapy, and monitoring the results.