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PubMed2003

A review of drug-induced oral reactions.

Every drug can produce untoward consequences, even when used according to standard or recommended methods of administration. Adverse drug reactions can involve every organ and system of the body and are frequently mistaken for signs of underlying disease. Similarly, the mouth and associated structures can be affected by many drugs or chemicals. Good oral health, including salivary function, is very important in maintaining whole body health. Regarding different parts of the oral system, these reactions can be categorized to oral mucosa and tongue, periodontal tissues, dental structures, salivary glands, cleft lip and palate, muscular and neurological disorders, taste disturbances, drug-induced oral infection, and facial edema. In this article, the drugs that may cause adverse effects in the mouth and related structures are reviewed. The knowledge about drug-induced oral adverse effects helps health professionals to better diagnose oral disease, administer drugs, improve patient compliance during drug therapy, and may influence a more rational use of drugs.

Burning Mouth Syndrome↗
PubMed2004

Hazardous events associated with impaired olfactory function.

OBJECTIVE: To evaluate the risk of olfactory-related hazardous events in patients with impaired olfactory function. DESIGN: Retrospective cohort study. SETTING: A university-based clinic for smell and taste disorders. PATIENTS: A total of 445 patients who underwent olfactory testing between 1983 and 2001. INTERVENTIONS: Patient interview, olfactory testing. MAIN OUTCOME MEASURES: (1) Frequency of olfactory-related hazardous events including cooking incidents (ie, burning pots or pans), undetected fires, undetected gas leaks, and ingestion of spoiled foods or toxic substances; (2) level of olfactory function (anosmia; severe, moderate, or mild hyposmia; or normosmia) as determined by olfactory testing. RESULTS: Olfactory testing revealed that 76% of patients had some degree of impairment; 30% had complete anosmia. Thirty-seven percent of patients with olfactory impairment but only 19% of patients without impairment experienced at least 1 olfactory-related hazardous event. Of the hazardous events reported by impaired patients, cooking-related incidents were most common, representing 45%, with ingestion of spoiled food (25%), inability to detect a gas leak (23%), and inability to smell a fire (7%) reported less frequently. There was a significant correlation between frequency of hazardous events and degree of olfactory impairment (Cochran-Armitage trend test, P<.001): at least 1 hazardous event was reported by 45.2% of patients with anosmia, 34.1% with severe hyposmia, 32.8% with moderate hyposmia, 24.2% with mild hyposmia, and 19.0% of patients with with normal olfaction by testing. CONCLUSION: Patients with impaired olfactory function are more likely to experience olfactory-related hazardous events than those with normal olfactory function.

Accidents, Home↗
PubMed1975

Abnormalities of taste sensation in cancer patients.

In fifty patients with cancer, subjective and objective correlates of anorexia of malignancy were studied. Decreased taste was reported by 25 patients, and an aversion for meat was reported by 16 patients. The decreased taste symptom correlated with an elevated taste threshold for sweet (sucrose), and the symptom of meat aversion correlated with a lowered taste threshold for bitter (urea). The likelihood of having a taste abnormality increased with increasing extent of disease, but not with histologic type of neoplasm. Patients with an abnormality of taste had an increased incidence of weight loss compared with patients with normal taste, even though many in the latter group had other causes of weight loss. These observations suggest that an abnormality of taste may be one determinant of the anorexia of malignancy. Better understanding of the anorexia in the cancer patient may contribute to the care of the patient.

Adult↗
PubMed1977

Posthypophysectomy taste abnormalities: their relationship to remote effects of cancer.

Abnormalities in taste sensation have been studied in 15 patients consisting of five normal controls, five patients with diffuse neoplasm and five patients post hypophysectomy. Threshold recognition for salt and HC1 in the three groups studied was the same. Sucrose and urea recognition was higher in patients with neoplasm as compared to normal controls. Patients post hypophysectomy had a lower threshold recognition for sucrose than both normal individuals and patients with neoplasm. The threshold recognition has markedly shifted for both sucrose (decreased) and urea (increased) post hypophysectomy. These observations are in support of previous findings and suggest that the pituitary plays at least a necessary permissible factor in the development of abnormalities in taste as observed in patients with disseminated cancer.

Breast Neoplasms↗
PubMed2004

Decreased taste sensitivity in cancer patients under chemotherapy.

GOALS OF WORK: The aim of the study was to measure taste thresholds among cancer patients under chemotherapy compared to controls. PATIENTS AND METHODS: The study was performed with 110 cancer patients and 170 healthy subjects of similar age distribution were included in the study. The electrogustometric detection threshold was evaluated as the lowest current intensity perceived by the subject in three tongue sites independently with a constant current generator. MAIN RESULTS: Taste thresholds for all cancer patients demonstrated significantly higher values compared to controls. CONCLUSIONS: Cancer patients treated by chemotherapy demonstrated a temporary taste sensitivity deficit. Associated with the illness due to the treatment, this deficit explains the patients complaining of "abnormal or bad tastes", which results in food aversion and has a negative impact on nutritional status and quality of life. In order to prevent the risk of anorexia and the enhanced morbidity related to this deficit, treatment should include relevant information to the subject for anticipating objective taste modifications and a psychological follow-up during the actual change of taste quality perceptions in everyday life.

Adult↗
PubMed1993

Taste perception and breast cancer: evidence of a role for diet.

Suprathreshold taste perception and nutrient intake were assessed for two groups of women aged 44 to 56 years: 24 mastectomized breast cancer outpatients and 24 matched controls. Salty and sweet taste intensity and pleasantness were evaluated in aqueous solutions and simple foods by unstructured line scaling. Dietary intakes were assessed by combined dietary recall (1 day) and food record (3 days). Suprathreshold taste intensity and pleasantness data did not differ between the breast cancer and control groups. Breast cancer subjects consumed less energy and were at greater overall nutritional risk than the controls. Compared with control subjects, breast cancer subjects were at greater risk of calcium and iron deficiency. Regression analysis was used to investigate relationships between diet and taste for a breast cancer subgroup (n = 7) with unusually low energy intake (< or = 1,300 kcal/day) and a high overall nutritional risk (25.6%). For the subgroup, significant relationships between taste and diet were found, although taste data did not differ from that of the controls. Percent risks of nutrient deficiency for vitamin B-12, thiamin, folacin, iron, and riboflavin were important predictors of taste-intensity slopes for the cancer subgroup. Findings suggest that for some of the breast cancer subjects, diet may be associated with unsatisfactory nutritional status and may be affected by suprathreshold taste perception.

Adult↗
PubMed1995

Taste performance in Sjogren's syndrome.

Sjogren's Syndrome (SS) patients have impaired salivary gland function and an elevated frequency of oral complaints. The taste complaints are thought to be due to sensory deficits that arise in the absence of sufficient saliva to maintain taste receptors. We assessed the subjective complaints, salivary production and taste functioning of SS patients and unaffected individuals. We found the expected decreased salivary gland function and increased frequency of taste complaints. Our taste assessment with weak stimuli confirmed and expanded the previous report of decreased taste threshold sensitivity in SS. However, perception of stronger taste stimuli was not impaired. In contrast with previous reports, patient judgments of intensity were not significantly reduced for any of the four taste qualities. Although the salivary gland function of all patients was markedly impaired relative to that of controls, patients lacking measurable salivary flow were no more likely than patients with residual function to exhibit subjective complaints or taste impairments. Our observations are inconsistent with a simple causal chain running from salivary gland dysfunction to sensory loss to taste complaints.

Adult↗
PubMed2005

Clinical and biological features associated with taste loss in internal medicine patients. A cross-sectional study of 100 cases.

Which are the main features associated with taste loss in patients exposed to a wide range of drugs and diseases? In 100 consecutive patients admitted to a ward of internal medicine, we assessed taste complaints, performance status, alcohol and tobacco consumptions, diseases, drugs and laboratory data, measuring the electrical taste threshold as primary outcome. After adjusting for age, taste thresholds were not associated with sex, body mass index, tobacco, thrush, drugs, aliageusia and phantogeusia. Features associated with threshold increase included alcohol intake>or=10 gd-1, impaired performance status, complaint of taste loss, atrophic glossitis, cerebral disease, and an erythrocyte mean corpuscular volume. A multivariate analysis identified age, alcohol intake, complaint of loss or altered taste, mean corpuscular volume, and performance status as independent factors associated with taste loss. Inpatients may be screened for taste loss by a few features, to identify those for whom a nutritional intervention should be focused.

Adult↗
PubMed2004

Evaluation of gustatory function after third molar removal.

The aim of this study was to determine the severity of taste changes after surgical removal of all four third molars in one session. Taste function in 27 patients was measured before and at 1 month and 6 months after surgery. In every patient all four third molars were removed using local anesthesia and sedation with midazolam and fentanyl. For testing gustatory function, two tests were administered: a whole-mouth, above threshold test and a spatial (localized) taste test. For this purpose, sucrose, NaCl, citric acid and quinine hydrochloride solutions were used. Taste intensity of quinine hydrochloride of the palate was significantly reduced 1 month after surgery (P < 0.05) but recovered and reach to preoperative values 6 months after surgery. The results showed that there were no significant changes in gustatory function after third molar surgery.

Adolescent↗
PubMed2005

Nerve injury caused by mandibular block analgesia.

Fifty-four injection injuries in 52 patients were caused by mandibular block analgesia affecting the lingual nerve (n=42) and/or the inferior alveolar nerve (n=12). All patients were examined with a standardized test of neurosensory functions. The perception of the following stimuli was assessed: feather light touch, pinprick, sharp/dull discrimination, warm, cold, point location, brush stroke direction, 2-point discrimination and pain perception. Gustation was tested for recognition of sweet, salt, sour and bitter. Mandibular block analgesia causes lingual nerve injury more frequently than inferior alveolar nerve injury. All grades of loss of neurosensory and gustatory functions were found, and a range of persisting neurogenic malfunctions was reported. Subjective complaints and neurosensory function tests indicate that lingual nerve lesions are more incapacitating than inferior alveolar nerve lesions. Unlike most mechanical injuries after surgery, injection injuries were not followed by a course of spontaneous improvement of neurosensory and/or gustatory function. This may indicate neurotoxicity as a central aetiological factor. Fifty-four percent of the nerve injuries were associated with Articaine 4%, and a substantial increase in the number of injection injuries followed its introduction to the Danish market.

Adult↗
PubMed1995

Changes in patients' taste acuity after Roux-en-Y gastric bypass for clinically severe obesity.

OBJECTIVE: Patients who have undergone Roux-en-Y gastric bypass (RYGB) for clinically severe obesity often report an aversion to sweet foods and meat. This study was designed to determine whether changes in taste acuity occur after RYGB. DESIGN: This prospective, repeated measures trial evaluated acuity for sweet (sucrose) and bitter (urea) tastes, zinc status, and reported changes in taste perceptions in patients undergoing RYGB for weight reduction. SUBJECTS: Taste acuity and serum zinc level were measured in 14 subjects, 6 men and 8 women (mean preoperative body mass index [calculated as kg/m2] = 60.8 +/- 11.8 and mean age = 38.4 +/- 6 years), before surgery and 6 and 12 weeks after surgery. Inquiries regarding taste preferences were made at each postoperative visit with specific reference to sweets and meat. Serum zinc level was measured at the same visit. A noncontrolled comparison group of 4 subjects who were consuming a very-low-calorie diet also underwent taste acuity testing at similar intervals. MAIN OUTCOME MEASURES: The main outcome measures were recognition taste thresholds, serum zinc levels, and taste preference changes. STATISTICAL ANALYSIS: Analysis of variance with repeated measures over time, Pearson correlation coefficients, and post hoc analysis of variance were used to analyze data. RESULTS: Mean recognition thresholds for sucrose were 0.047 +/- 0.03 mol/L preoperatively and fell significantly to 0.024 +/- 0.01 and 0.019 +/- 0.01 mol/L at 6 and 12 weeks postoperatively, respectively. Overall, there were no significant differences in taste thresholds for urea over time; a significant difference was noted, however, in the pattern of change for urea between patients who reported an aversion to meats and those who did not. Zinc concentrations did not change during the study. APPLICATION/CONCLUSIONS: At 6 weeks postoperatively, all patients reported that foods tasted sweeter, and they modified food selection accordingly. Six patients reported an aversion to meats associated with increased nausea and vomiting. Acuity for sweet and bitter tastes may need to be considered when planning dietary modifications for patients undergoing RYGB.

Adult↗