How is gustatory dysfunction in taste and smell disorders treated?

Updated: Oct 01, 2019
  • Author: Eric H Holbrook, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

As with olfactory problems, direct initial treatment of gustatory dysfunction toward the causative abnormality, if possible.

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 patients in eliminating local irritants (eg, mouthwashes, ill-fitting dentures)

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 with the appropriate hormone replacement may improve the taste disorder.

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

In the case of familial dysautonomia, in which patients have a complete lack of lingual taste buds, subcutaneous administration of methacholine has been reported to normalize previously elevated taste thresholds for all taste qualities. The cholinergic mechanism is probably related to taste transduction via free nerve endings because these patients have no taste receptors.

Some gustatory deficits are untreatable (eg, some cases of nerve or CNS damage, end-stage diabetic neuropathy, multiple sclerosis).

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 patients who are anosmic or hyposmic (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.


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