Taste - impaired

Definition

Taste impairment means there is a problem with your sense of taste. Problems range from distorted taste to a complete loss of the sense of taste. A complete inability to taste is rare.

Alternative Names

Loss of taste; Metallic taste; Dysgeusia

Considerations

The tongue can detect only sweet, salty, sour, and bitter tastes. Much of what is perceived as "taste" is actually smell. People who have taste problems often have a smell disorder that can make it hard to identify a food's flavor. (Flavor is a combination of taste and smell.)

Taste problems can be caused by anything that interrupts the transfer of taste sensations to the brain, or by conditions that affect the way the brain interprets these sensations.

Causes

The sensation of taste often decreases after age 60. Most often, salty and sweet tastes are lost first. Bitter and sour tastes last slightly longer.

Causes of impaired taste include:

Bell's palsy
Common cold
Flu
Nasal infection, nasal polyps, sinusitis
Pharyngitis and strep throat
Salivary gland infections

Other causes are:

Ear surgery
Heavy smoking (especially pipe smoking)
Injury to the mouth, nose, or head
Mouth dryness
Medicines, such as thyroid drugs, captopril, griseofulvin, lithium, penicillamine, procarbazine, rifampin, and some drugs used to treat cancer
Swollen or inflamed gums (gingivitis)
Vitamin B12 or zinc deficiency

Home Care

Follow prescribed therapy, which may include a changing your diet. For taste problems due to the common cold or flu, normal taste should return when the illness passes. If you smoke, stop smoking.

When to Contact a Medical Professional

Make an appointment with your doctor if your taste problems do not go away, or if abnormal tastes occur with other symptoms.

What to Expect at Your Office Visit

The doctor will perform a physical examination and ask questions, including:

Do all foods and drinks taste the same?
Do you smoke?
Does this change in taste affect the ability to eat normally?
Have you noticed any problems with your sense of smell?
Have you recently changed toothpaste or mouthwash?
How long has the taste problem lasted?
Have you been sick or injured recently?
What medicines do you take?
What other symptoms do you have? (For example, appetite loss or breathing problems?)
When is the last time you went to the dentist?

If the taste problem is due to allergies or sinusitis, the doctor may give you medicine to relieve the stuffy nose. If a medicine you are taking is to blame, your doctor may recommend that you change your dose or switch to a different drug.

A CT scan or MRI scan may be done to look at the sinuses or the part of the brain that controls the sense of smell.

References

Reamy BV, Derby R, Bunt CW. Common tongue conditions in primary care. Am Fam Physician. 2010;81(5):627-634.

Finelli PF, Mair RG. Disturbances of smell and taste. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, PA: Butterworth-Heinemann; 2008:chap 19.

Travers JB, Travers SP, Christian JM. Physiology of the oral cavity. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Elsevier Mosby; 2010:chap 89.