Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
권호 표지

Clinical Characteristics of Patients with Taste Disorders

미각 장애 환자의 임상적 특성에 관한 연구

  • Lee, Eun-Jin (Dept. of Oral Medicine & Oral Diagnosis, School of Dentistry & Dental Research Institute, Seoul National University) ;
  • Park, Won-Kyu (Dept. of Oral Medicine & Oral Diagnosis, School of Dentistry & Dental Research Institute, Seoul National University) ;
  • Nam, Jin-Woo (Dept. of Oral Medicine & Oral Diagnosis, School of Dentistry & Dental Research Institute, Seoul National University) ;
  • Yun, Jong-Il (Dept. of Oral Medicine & Oral Diagnosis, School of Dentistry & Dental Research Institute, Seoul National University) ;
  • Kho, Hong-Seop (Dept. of Oral Medicine & Oral Diagnosis, School of Dentistry & Dental Research Institute, Seoul National University)
  • 이은진 (서울대학교 치의학대학원 구강내과.진단학 교실, 치학연구소) ;
  • 박원규 (서울대학교 치의학대학원 구강내과.진단학 교실, 치학연구소) ;
  • 남진우 (서울대학교 치의학대학원 구강내과.진단학 교실, 치학연구소) ;
  • 윤종일 (서울대학교 치의학대학원 구강내과.진단학 교실, 치학연구소) ;
  • 고홍섭 (서울대학교 치의학대학원 구강내과.진단학 교실, 치학연구소)
  • Published : 2009.12.30

Abstract

There is tremendous variability in the ways patients present with taste problems. Because of complex and multifactorial etiological background, it is not simple to evaluate patients with taste disorders. Accurate assessment of patients' status by prudent, thorough history taking and symptom analysis is the most essential for exact diagnosis of taste disorders. The aim of this study was to investigate the clinical characteristics of patients with taste problems as a primary complaint. Consecutive series of 50 patients (12 males and 38 females, mean age $53.6\;{\pm}\;14.7$ years) were included for the present study. All subjects were requested to complete a comprehensive questionnaire. Clinical evaluation procedures included oral examination, interview, questionnaire analysis, panoramic radiography, blood test and measurement of salivary flow rate. The obtained results were as follows: 1. Among the patients, 36 patients (72%) complained of oral mucosal pain or burning sensation. Of these patients, 18 patients (36%) were diagnosed as burning mouth syndrome. 2. Nineteen patients (38%) complained of subjective oral dryness. The flow rate of unstimulated whole saliva was less than 0.1 mL/min in 14 patients (28%) and 17 (34%) had a stimulated whole salivary flow rate of less than 0.5 mL/min. 3. Among the types of taste disorders, hypogeusia, the most frequently reported, was found in 25 patients (50%), dysgeusia in 18 patients (36%), phantogeusia in 15 patients (30%), hypergeusia in 10 patients (20%), and ageusia in 5 patients (10%). Nineteen patients (38%) reported more than one type of taste disorder and the most frequent combination was dysgeusia + hypogeusia (n=6, 12%). 4. Based on data from the medical and dental histories and examinations, the patients were assigned to 12 probable causal categories. Taste disorders due to oral mucosal diseases and idiopathic taste disorder were the most frequent (n=9; 18%, each), followed by psychogenic taste disorder (n=8; 16%), drug-induced taste disorder (n=7; 14%), and taste disorder due to dry mouth (n=6; 12%). These 5 categories of taste disorder accounted for 78% of all cases in this study.

Keywords

File

Download PDF

References

  1. Mattes RD. Nutritional implications of taste and smell. In Doty RL (Ed). Handbook of olfaction and gustation. New York, 2003, Dekker, pp. 881-903
  2. Scott AE. Clinical characteristics of taste and smell disorders. Ear Nose Throat J 1989;68:297-315
  3. Breslin PA, Huang L. Human taste: peripheral anatomy, taste transduction, and coding. Adv Otorhinolaryngol 2006;63:152-190 https://doi.org/10.1159/000093760
  4. Woods MP. Taste and flavour perception. Proc Nutr Soc. 1998;57:603-607 https://doi.org/10.1079/PNS19980088
  5. Bromley SM. Smell and taste disorders: a primary care approach. Am Fam Physician 2000;61:427-438
  6. Reiter ER, DiNardo LJ, Costanzo RM. Toxic effects on gustatory function. Adv Otorhinolaryngol 2006; 63:265-277 https://doi.org/10.1159/000093765
  7. Heckmann JG, Heckmann SM, Lang CJ, Hummel T. Neurological aspects of taste disorders. Arch Neurol 2003;60:667-671 https://doi.org/10.1001/archneur.60.5.667
  8. Landis BN, Lacroix JS. Postoperative/posttraumatic gustatory dysfunction. Adv Otorhinolaryngol 2006;63: 242-254 https://doi.org/10.1159/000093763
  9. Doty RL, Shah M, Bromley SM. Drug-induced taste disorders. Drug Saf 2008;31:199-215 https://doi.org/10.2165/00002018-200831030-00002
  10. Bromley S, Doty RL. Clinical disorders affecting taste:evaluation and management. In Doty RL (Ed). Handbook of olfaction and gustation. New York, 2003, Dekker, pp. 935-957
  11. Hamada N, Endo S, Tomita H. Characteristics of 2278 patients visiting the Nihon University Hospital Taste Clinic over a 10-year period with special reference to age and sex distributions. Acta Otolaryngol 2002; Suppl 546:7-15
  12. Deems DA, Doty RL, Settle RG, Moore-Gillon V, Shaman P, Mester AF, Kimmelman CP, Brightman VJ, Snow JB Jr. Smell and taste disorders, a study of 750 patients from the University of Pennsylvania Smell and Taste Center. Arch Otolaryngol Head Neck Surg 1991;117:519-528 https://doi.org/10.1001/archotol.1991.01870170065015
  13. Bergdahl M, Bergdahl J. Perceived taste disturbance in adults: prevalence and association with oral and psychological factors and medication. Clin Oral Investig 2002;6:145-149 https://doi.org/10.1007/s00784-002-0169-0
  14. Grushka M, Ching V, Epstein J. Burning mouth syndrome. Adv Otorhinolaryngol 2006;63:278-287 https://doi.org/10.1159/000093766
  15. Hershkovich O, Nagler RM. Biochemical analysis of saliva and taste acuity evaluation in patients with burning mouth syndrome, xerostomia and/or gustatory disturbances. Arch Oral Biol 2004;49:515-522 https://doi.org/10.1016/j.archoralbio.2004.01.012
  16. Formaker BK, Frank ME. Taste function in patients with oral burning. Chem Senses 2000;25:575-581 https://doi.org/10.1093/chemse/25.5.575
  17. Eliav E, Kamran B, Schaham R, Czerninski R, Gracely RH, Benoliel R. Evidence of chorda tympani dysfunction in patients with burning mouth syndrome. J Am Dent Assoc 2007;138:628-633 https://doi.org/10.14219/jada.archive.2007.0234
  18. Mese H, Matsuo R. Salivary secretion, taste and hyposalivation. J Oral Rehabil 2007;34:711-723 https://doi.org/10.1111/j.1365-2842.2007.01794.x
  19. Hutton JL, Baracos VE, Wismer WV. Chemosensory dysfunction is a primary factor in the evolution of declining nutritional status and quality of life in patients with advanced cancer. J Pain Symptom Manage 2007;33:156-165 https://doi.org/10.1016/j.jpainsymman.2006.07.017
  20. Scinska A, Jodkowska A, Korkosz A, Kukwa W, Sienkiewicz-Jarosz H. Post-tonsillectomy dysgeusia with weight loss: possible involvement of soft palate. J Laryngol Otol 2008;122:e5 https://doi.org/10.1017/S002221510700117X
  21. Osaki T, Ohshima M, Tomita Y, Matsugi N, Nomura Y. Clinical and physiological investigations in patients with taste abnormality. J Oral Pathol Med 1996;25:38-43 https://doi.org/10.1111/j.1600-0714.1996.tb01221.x
  22. Lehman CD, Bartoshuk LM, Catalanotto FC, Kveton JF, Lowlicht RA. Effect of anesthesia of the chorda tympani nerve on taste perception in humans. Physiol Behav 1995;57:943-951 https://doi.org/10.1016/0031-9384(95)91121-R
  23. Davidson HI, Pattison RM, Richardson RA. Clinical undernutrition states and their influence on taste. Proc Nutr Soc 1998;57:633-638 https://doi.org/10.1079/PNS19980092
  24. Madden AM, Bradbury W, Morgan MY. Taste perception in cirrhosis: its relationship to circulating micronutrients and food preferences. Hepatology 1997;26:40-48 https://doi.org/10.1002/hep.510260106
  25. Ikeda M, Ikui A, Komiyama A, Kobayashi D, Tanaka M. Causative factors of taste disorders in the elderly, and therapeutic effects of zinc. J Laryngol Otol 2008;122:155-160 https://doi.org/10.1017/S0022215107008833