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What Causes An Altered Sense Of Taste?

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Posted on Tue, 3 Jun 2014
Question: I have had an unusual taste in my mouth for weeks which I cannot describe.
doctor
Answered by Dr. Shafi Ullah Khan (1 hour later)
Brief Answer:
Oral hygienist will sort it out

Detailed Answer:
Thank you for asking!
Unusual indescribable taste is quite a vague presentation.Let me help the best i can but it will need more than that. Stomach problems like GERD and gastritis may cause it. It needs diet and lifestyle modifications like eating healthy non spicy non chilly foods, avoiding hot and carbonated beverages and alcohol, keeping time frame of 3 hours between meals and lying down, preferring small meals over heavy ones, avoiding sweets like chocolate etc and tomatoes products , keeping the head of the bed 8 inches minimum above the body , avoiding NSAIDs or any painkillers to maximum extent, Using some proton pump inhibitors like omeprazole etc, seeking a gastroenterologist for further management,
Now discussing the major likely cause , here are some other issue need to be addressed too to sort out this taste dysfunctions prophylactically.
-Address any nasal pathology causing decreased olfaction and thus affecting flavor perception.

-Treat mucosal disorders (eg, infections, inflammations). Treat oral candidiasis and other local factors, and replete any vitamin deficiency that may cause glossitis.

-Aid in eliminating local irritants (eg, mouthwashes, ill-fitting dentures) will resolve this salty taste too.

-In mucositis or dry mouth as a result of radiation therapy, artificial saliva or salivary stimulants and local anti-inflammatory medications may improve some taste dysfunction.

-Correcting endocrine disorders if any with the appropriate hormone replacement may improve the taste disorder.

-Consider eliminating a medication suspected of causing dysgeusia/ bad taste unless the medication is crucial in treating another medical problem and cannot be substituted.


-Some gustatory deficits are untreatable (eg, some cases of nerve or CNS damage, end-stage diabetic neuropathy, multiple sclerosis). This does not apply to your case but wanted you to keep updated about all the possible cause of such taste troubles.

Advise patients that chewing food well increases the release of the tastant and increases saliva production to further distribute the chemicals. Switching foods during the meal decreases the phenomenon of adaptation and can improve detection of the tastes.

Finally, for those who are anosmic/ can't smell anything or hyposmia/ decrease smell sensation (including many elderly people), simulated odors are available to use while cooking to augment the sensation of flavor. A drawback of these simulated odors is that, to normosmic people, the smell is quite pungent. Thus, these odors cannot be used in mixed groups of anosmic and normosmic individuals.

Let discuss some general measures which will help this taste issue
-regular sips frequently up to 2 litres of water a day minimum to keep mouth hydrated.
-avoid irritants such as smoking, alcohol and caffeine intake.
-keep good oral hygiene, treat oral candidiasis or caries precautions to stay safe as dry mouth predisposes to oral troubles, stay in touch with the dentist for further oral management.
-Anxiety and stress should be avoided as they themselves are causative agents.
-Try some salivary substitutes as Artificial saliva can provide relief of dry mouth. They are manufactured with a neutral pH and contain electrolytes that approximately correspond to normal saliva. They are either mucin or methycellulose based preparations. The mucin based products are better tolerated and have a longer duration of action. Preparations are available in the form of sprays, gel and lozenges.
-Mouth washes with garlic water etc.
-Try salivary stimulants , here are some
a-Chewing Gum
Sugar free chewing gum enhances salivary flow by stimulating taste receptors, and its use is usually not associated with side effects. A combination of regular mouthwash and chewing gum is proved helpful.
b-Ascorbic Acid (Vitamin C)
Vitamin C tablets are used to treat xerostomia in palliative care. In a study, the effectiveness of ascorbic acid was compared against artificial saliva and other stimulants in patients with xerostomia. Vitamin C was shown to be subjectively more effective than artificial saliva, but less effective than other salivary stimulants. The main disadvantage of using ascorbic acid long term is its detrimental effect on teeth enamel.
c-Malic Acid
Malic acid is effective in the treatment of xerostomia and is naturally found in fruits such as pears and apples. Its main disadvantage is that it causes demineralisation of teeth enamel, which limits its long-term use.
d-Pilocarpine
Pilocarpine is a muscarinic receptor agonist and has been shown to improve symptoms of xerostomia.It is available as 5 mg tablets and can be administered up to a maximum dose of 30 mg/day in divided doses. The effects of Pilocarpine are usually immediate; The increase in saliva production generally lasts for 4 h. Its undesirable side effects include perspiration, flushing, lacrimation, urinary frequency and gastrointestinal disturbances. As a result of its cholinergic effect, it is contraindicated in patients with asthma, chronic obstructive airway disease, heart diseases, epilepsy, hyperthyroidism and Parkinson's disease..
e-Other Parasympathomimetic Drugs
carbachol. pyridostigmine,Cevimeline etc are proved helpful.
f-Radiprotectants
Cytoprotective agents such as amifostine have shown to minimise tissue damage secondary to radiotherapy and decrease the incidence of radiation-induced xerostomia
g-Acupuncture
Acupuncture as a treatment for xerostomia is increasingly being recognised in the West. In a study from Sweden, subjects who received traditional acupuncture demonstrated a significant increase in salivary flow rate lasting up to a year as opposed to those in the placebo group.
In nut shell it needs a little modifications and consult to an oral hygienist if the issue persists.There is not much to worry about.It will resolve spontaneously.It needs a little work up and connecting dots.
I hope it helps.DOnt forget to close the discussion please.
Regards
S Khan
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
Dr.
Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3613 Questions

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What Causes An Altered Sense Of Taste?

Brief Answer: Oral hygienist will sort it out Detailed Answer: Thank you for asking! Unusual indescribable taste is quite a vague presentation.Let me help the best i can but it will need more than that. Stomach problems like GERD and gastritis may cause it. It needs diet and lifestyle modifications like eating healthy non spicy non chilly foods, avoiding hot and carbonated beverages and alcohol, keeping time frame of 3 hours between meals and lying down, preferring small meals over heavy ones, avoiding sweets like chocolate etc and tomatoes products , keeping the head of the bed 8 inches minimum above the body , avoiding NSAIDs or any painkillers to maximum extent, Using some proton pump inhibitors like omeprazole etc, seeking a gastroenterologist for further management, Now discussing the major likely cause , here are some other issue need to be addressed too to sort out this taste dysfunctions prophylactically. -Address any nasal pathology causing decreased olfaction and thus affecting flavor perception. -Treat mucosal disorders (eg, infections, inflammations). Treat oral candidiasis and other local factors, and replete any vitamin deficiency that may cause glossitis. -Aid in eliminating local irritants (eg, mouthwashes, ill-fitting dentures) will resolve this salty taste too. -In mucositis or dry mouth as a result of radiation therapy, artificial saliva or salivary stimulants and local anti-inflammatory medications may improve some taste dysfunction. -Correcting endocrine disorders if any with the appropriate hormone replacement may improve the taste disorder. -Consider eliminating a medication suspected of causing dysgeusia/ bad taste unless the medication is crucial in treating another medical problem and cannot be substituted. -Some gustatory deficits are untreatable (eg, some cases of nerve or CNS damage, end-stage diabetic neuropathy, multiple sclerosis). This does not apply to your case but wanted you to keep updated about all the possible cause of such taste troubles. Advise patients that chewing food well increases the release of the tastant and increases saliva production to further distribute the chemicals. Switching foods during the meal decreases the phenomenon of adaptation and can improve detection of the tastes. Finally, for those who are anosmic/ can't smell anything or hyposmia/ decrease smell sensation (including many elderly people), simulated odors are available to use while cooking to augment the sensation of flavor. A drawback of these simulated odors is that, to normosmic people, the smell is quite pungent. Thus, these odors cannot be used in mixed groups of anosmic and normosmic individuals. Let discuss some general measures which will help this taste issue -regular sips frequently up to 2 litres of water a day minimum to keep mouth hydrated. -avoid irritants such as smoking, alcohol and caffeine intake. -keep good oral hygiene, treat oral candidiasis or caries precautions to stay safe as dry mouth predisposes to oral troubles, stay in touch with the dentist for further oral management. -Anxiety and stress should be avoided as they themselves are causative agents. -Try some salivary substitutes as Artificial saliva can provide relief of dry mouth. They are manufactured with a neutral pH and contain electrolytes that approximately correspond to normal saliva. They are either mucin or methycellulose based preparations. The mucin based products are better tolerated and have a longer duration of action. Preparations are available in the form of sprays, gel and lozenges. -Mouth washes with garlic water etc. -Try salivary stimulants , here are some a-Chewing Gum Sugar free chewing gum enhances salivary flow by stimulating taste receptors, and its use is usually not associated with side effects. A combination of regular mouthwash and chewing gum is proved helpful. b-Ascorbic Acid (Vitamin C) Vitamin C tablets are used to treat xerostomia in palliative care. In a study, the effectiveness of ascorbic acid was compared against artificial saliva and other stimulants in patients with xerostomia. Vitamin C was shown to be subjectively more effective than artificial saliva, but less effective than other salivary stimulants. The main disadvantage of using ascorbic acid long term is its detrimental effect on teeth enamel. c-Malic Acid Malic acid is effective in the treatment of xerostomia and is naturally found in fruits such as pears and apples. Its main disadvantage is that it causes demineralisation of teeth enamel, which limits its long-term use. d-Pilocarpine Pilocarpine is a muscarinic receptor agonist and has been shown to improve symptoms of xerostomia.It is available as 5 mg tablets and can be administered up to a maximum dose of 30 mg/day in divided doses. The effects of Pilocarpine are usually immediate; The increase in saliva production generally lasts for 4 h. Its undesirable side effects include perspiration, flushing, lacrimation, urinary frequency and gastrointestinal disturbances. As a result of its cholinergic effect, it is contraindicated in patients with asthma, chronic obstructive airway disease, heart diseases, epilepsy, hyperthyroidism and Parkinson's disease.. e-Other Parasympathomimetic Drugs carbachol. pyridostigmine,Cevimeline etc are proved helpful. f-Radiprotectants Cytoprotective agents such as amifostine have shown to minimise tissue damage secondary to radiotherapy and decrease the incidence of radiation-induced xerostomia g-Acupuncture Acupuncture as a treatment for xerostomia is increasingly being recognised in the West. In a study from Sweden, subjects who received traditional acupuncture demonstrated a significant increase in salivary flow rate lasting up to a year as opposed to those in the placebo group. In nut shell it needs a little modifications and consult to an oral hygienist if the issue persists.There is not much to worry about.It will resolve spontaneously.It needs a little work up and connecting dots. I hope it helps.DOnt forget to close the discussion please. Regards S Khan