From the Research
The management of glossodynia typically follows a stepwise approach, with first-line therapy including topical treatments, second-line therapy consisting of systemic medications, and third-line therapy involving alternative interventions. The most recent and highest quality study 1 suggests that treatment should be comprehensive, differentiated, and personalized, addressing the underlying causes of glossodynia. Some key points to consider in the management of glossodynia include:
- First-line therapy: topical treatments such as clonazepam, topical lidocaine, or capsaicin rinses
- Second-line therapy: systemic medications including low-dose tricyclic antidepressants, gabapentin, or pregabalin
- Third-line therapy: alpha-lipoic acid, cognitive behavioral therapy, or referral to pain management specialists
- Addressing contributing factors such as dry mouth, nutritional deficiencies, and psychological factors is essential throughout treatment
- Treatment should be individualized based on patient response, with each medication trial lasting 6-8 weeks before considering alternatives. The study by 1 emphasizes the importance of a comprehensive approach to diagnosis and treatment, taking into account the patient's overall health and well-being. Another study 2 suggests that topiramate may be a useful therapeutic option in the treatment of glossodynia, due to its ability to act on different neural transmission levels. However, the most recent study 1 provides the most up-to-date guidance on the management of glossodynia, and its recommendations should be prioritized. Overall, the management of glossodynia requires a thoughtful and individualized approach, taking into account the patient's unique needs and circumstances.