Comparative analysis of pain experience and quality of life in patients with oral lichen planus and burning mouth syndrome

Abstract

Background: Oral lichen planus (OLP) and burning mouth syndrome (BMS) are chronic oral conditions associated with persistent pain, but direct comparisons of their pain profiles and contributing factors remain limited. This study compared factors influencing pain perception between OLP and BMS. Methods: This cross-sectional study included 46 patients with OLP and 50 with BMS. Pain characteristics, pain catastrophizing, and quality of life were assessed using the Brief Pain Inventory-Korean version, Pain Catastrophizing Scale-Korean version, and a Korean-language Oral Potentially Malignant Disorders Quality of Life questionnaire. Normality was assessed using the Shapiro-Wilk test; Mann-Whitney U or independent t-tests were applied accordingly, and effect sizes were calculated using Cohen’s d. Pain intensity predictors were identified using stepwise multiple linear regression. Results: Patients with BMS reported higher pain intensity (p ≤ 0.003, d = −1.22 to −0.63) and catastrophizing (p = 0.005, d = −0.56) than those with OLP, whereas patients with OLP showed greater mastication-related pain interference (p = 0.002, d = 0.74) and poorer quality of life (p = 0.020, d = 0.50). Regression identified mastication and rumination in OLP (adjusted R2 = 0.419) and sleep disturbance, rumination, and magnification in BMS (adjusted R2 = 0.454) as primary predictors. Age stratification revealed an opposite age–pain relationship: older patients with BMS (>60 years) had higher pain intensity (p < 0.001), whereas younger patients with OLP (≤60 years) reported higher pain intensity (p = 0.037). Pain interference was more interconnected across life domains in OLP (27 correlations with |r| > 0.5) than in BMS (6 correlations). Conclusions: OLP and BMS exhibit distinct pain profiles, with OLP characterized by widespread functional interference influenced by mastication-related and cognitive factors, and BMS marked by higher pain intensity with prominent psychological contributors. Condition-specific strategies incorporating cognitive behavioral therapy targeting rumination may improve pain-related outcomes.