# Support Group as a Management Modality for Burning Mouth Syndrome: A Randomized Prospective Study
## 4 Discussion
\begin{table}
\begin{tabular}{c c c c c c c} \hline \hline \multirow{2}{*}{**Study Parameter**} & \multicolumn{2}{c}{**Study Group**} & \multicolumn{2}{c}{**Control Group**} & \multirow{2}{*}{\(p\) **Value \({}^{*}\)**} \\ \cline{2-2} \cline{4-7}  & **Before Interv.** & & & & **Before Interv.** & **After Interv.** & \\ \hline Total pain score & 2.36 (1.027) & 2 (1) & 0.046 & 1.73 (1.009) & 1.6 (0.516) & 0.655 \\ Medication use & 2 (1.612) & 1.55 (0.688) & 0.276 & 1 (0) & 1.2 (0.632) & 0.317 \\ Swallowing problems & 1.64 (1.286) & 1.27 (0.647) & 0.194 & 1.55 (1.293) & 1.7 (1.160) & 0.180 \\ Avoidance of certain foods & 2.36 (1.690) & 1.64 (1.027) & 0.129 & 2.18 (1.601) & 2.5 (1.434) & 0.336 \\ Difficulty enjoying food & 2.55 (1.809) & 1.64 (0.924) & 0.026 & 2.45 (1.440) & 1.8 (0.789) & 0.131 \\ Difficulty talking & 1.64 (0.924) & 1.64 (0.924) & 0.063 & 1.64 (1.206) & 1.3 (0.949) & 0.317 \\ Sleep deprivation & 2.09 (1.700) & 1.09 (0.302) & 0.066 & 1.55 (1.036) & 1.4 (0.843) & 0.705 \\ Inability to work & 1.36 (1.206) & 1 (0) & 0.317 & 1 (0) & 1 (0) & 1.000 \\ Difficulty performing everyday activities & 1.18 (0.405) & 1.09 (0.302) & 0.317 & 1 (0) & 1 (0) & 1.000 \\ Change in taste or odor sensation & 2.55 (1.572) & 2.09 (1.514) & 0.461 & 2.55 (1.695) & 2.4 (0.966) & 0.864 \\ Malaise & 2.64 (1.502) & 1.82 (1.079) & 0.041 & 2.18 (1.537) & 2.1 (1.101) & 0.854 \\ \hline \hline \end{tabular} Note: Parameters were evaluated by questionnaire before onset of group therapy and 3 months after its completion. All values are mean (SD). \({}^{*}\) Wilcoxon sum-rank test. Values in bold are statistically significant. BMS, burning mouth syndrome; Interv., intervention. \(p\) value (probability value) \(\leq\) 0.05 was considered statistically significant.  
\end{table} 
Table 1: Change in study parameters in patients with BMS who attended a support group (study group) and patients who did not (control group). with some of our patients as well. Among the issues discussed in the group sessions were death of a brother or sister (2 patients), a son who became religious and was estranged from the family (1 patient), and cancer in a significant other (2 patients). Although these events may have triggered the patients' symptoms, it should be noted that BMS generally occurs in the fifth to seventh decades of life when the likelihood of loss or illness of an older family member considerably increases. Further studies are needed establish the possible association between BMS and stressful life events. Several studies have focused on the effect of mental support on pain and anxiety in patients with BMS. [PERSON] et al. [21] reported a significant reduction in pain intensity in patients with BMS who underwent cognitive therapy compared to patients who did not (15 in each group). Using a similar design with a slightly larger cohort, [PERSON] et al. [20] reported significant improvement of pain symptoms in the study group. [PERSON] et al. [25] compared the effect of cognitive-behavioral group therapy between patients with BMS and healthy controls (24 in each group). The results suggested that the intervention led to a reduction in pain intensity and anxiety in the patients. By contrast, in the present study, we used a unique evaluation tool based on the validated questionnaire developed by [PERSON] et al. [27] (see Appendix A). In addition to pain, we examined the manner in which BMS symptoms interfere with different aspects of everyday life activities such as swallowing, enjoying food, speaking, sleeping, studying or working, and general well-being. An improvement was noted in all tested parameters after the intervention, with statistically significant reductions in pain intensity, difficulty enjoying food, and malaise. Studies have shown that self-efficacy as well as sense of control are important for effective coping with chronic pain [44] and that changing patients' approach to pain from passive to active helps them to better deal with it [45]. The major limitation of this study was the small number of participants.