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Oral Diseases Oct 2023
Topics: Humans; Dysgeusia; Antiviral Agents
PubMed: 35830268
DOI: 10.1111/odi.14312 -
JAMA Mar 2024Dry mouth, oral candidiasis, and recurrent aphthous ulcers are 3 of the most common oral conditions that may be associated with patient discomfort, decreased quality of... (Review)
Review
IMPORTANCE
Dry mouth, oral candidiasis, and recurrent aphthous ulcers are 3 of the most common oral conditions that may be associated with patient discomfort, decreased quality of life, and morbidity.
OBSERVATIONS
In a meta-analysis of 26 population-based cohort and cross-sectional studies, the global prevalence of dry mouth symptoms was 23% (95% CI, 18% to 28%), placing individuals at risk of oral candidiasis, dental caries, dysgeusia, masticatory/speech impairment, and oropharyngeal dysphagia. Dry mouth is associated with using more than 3 oral medications per day (odds ratio [OR], 2.9 [95% CI, 1.4 to 6.2]), head and neck radiation, and Sjögren disease. Symptoms may include difficulty swallowing and speaking, thirst, and halitosis. Dry mouth is associated with an 11.5% (95% CI, 3.6% to 27%) higher risk of oral candidiasis, based on a meta-analysis of 6 observational cohorts. Management of dry mouth includes mechanical salivary stimulants, oral moisturizers, and/or systemic sialagogues. Oral candidiasis is an opportunistic fungal infection caused by overgrowth of the Candida genus with C albicans, which accounts for 76.8% of infections. The prevalence of oral candidiasis is higher in patients who are immunosuppressed, for example, those with HIV (35% [95% CI, 28% to 42%]) and those with salivary gland hypofunction (OR, 3.02 [95% CI, 1.73 to 5.28]). Common risk factors associated with oral candidiasis include use of antibiotics (P = .04) and oral mucosal disorders such as lichen planus. Oral burning and dysgeusia are common symptoms of oral candidiasis. Treatment includes addressing risk factors and use of topical and/or systemic antifungal medications. Recurrent aphthous stomatitis is characterized by symptomatic round or oval oral ulcers, which are covered by a gray-white fibrin layer and encircled by an erythematous ring. A meta-analysis of 10 case-controlled studies revealed an increased risk of recurrent aphthous stomatitis associated with polymorphism of IL-1β (+3954C/T) (OR, 1.52 [95% CI, 1.07 to 2.17]) and IL-1β (-511C/T) (OR, 1.35 [95% CI, 1.09 to 1.67]). Another meta-analysis of 9 case-control studies reported that patients with recurrent aphthous stomatitis had a higher frequency of nutritional deficiencies, including vitamin B12 (OR, 3.75 [95% CI, 2.38 to 5.94]), folic acid (OR, 7.55 [95% CI, 3.91 to 14.60]), and ferritin (OR, 2.62 [95% CI, 1.69 to 4.06]). Recurrent aphthous stomatitis can be associated with systemic diseases. A meta-analysis of 21 case-control studies revealed that celiac disease is associated with a higher incidence of recurrent aphthous stomatitis (25% vs 11%; OR, 3.79 [95% CI, 2.67 to 5.39]; P <.001). Topical corticosteroids are first-line agents to manage recurrent aphthous stomatitis; however, systemic medications may be necessary in more severe cases.
CONCLUSIONS AND RELEVANCE
Dry mouth, oral candidiasis, and recurrent aphthous ulcers are common oral conditions that may be associated with patient discomfort, decreased quality of life, and morbidity. First-line treatment includes over-the-counter sialagogues for dry mouth, topical antifungals for oral candidiasis, and topical corticosteroids for aphthous ulcers. Oral conditions that do not improve with first-line treatment may require treatment with systemic medications.
Topics: Humans; Candidiasis, Oral; Cross-Sectional Studies; Dental Caries; Dysgeusia; Quality of Life; Stomatitis, Aphthous; Xerostomia; Glucocorticoids; Stomatognathic Diseases
PubMed: 38530258
DOI: 10.1001/jama.2024.0953 -
European Archives of... Feb 2023Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is the causative agent of COVID-19 which was detected in late 2019 in Wuhan, China. As of September... (Review)
Review
Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is the causative agent of COVID-19 which was detected in late 2019 in Wuhan, China. As of September 2022, there have been over 612 million confirmed cases of COVID-19 with over 6.5 million associated deaths. In many cases, anosmia and dysgeusia have been identified as primary symptoms of COVID-19 infection in patients. While the loss of smell (anosmia) and loss of taste (dysgeusia) due to COVID-19 infection is transient in most patients, many report that these symptoms persist following recovery. Understanding the pathogenesis of these symptoms is paramount to early treatment of the infection. We conducted a literature review of Google Scholar and PubMed to find and analyze studies discussing anosmia and dysgeusia in the context of COVID-19 to understand the progression and management of these symptoms. The mechanism for dysgeusia is largely unknown; however, pathogenesis of anosmia includes inflammation and cytokine release resulting from the infection that alters neuronal signaling, thus inducing the loss of smell that patients experience. Anosmia may be managed and potentially resolved sooner with a combination therapy of olfactory training and budesonide irrigation of the nasal cavity. It is important to note that the variants of SARS-CoV-2 are genetically distinguished from the original virion due to a mutation in their spike proteins, giving them a different symptom profile regarding anosmia and dysgeusia. This variability in symptomatology is an area of study that needs to be further explored.
Topics: Humans; COVID-19; Dysgeusia; Anosmia; SARS-CoV-2; Pandemics; Olfaction Disorders
PubMed: 36209486
DOI: 10.1007/s00405-022-07689-w -
Otolaryngology--head and Neck Surgery :... Jul 2020There is accumulating anecdotal evidence that anosmia and dysgeusia are associated with the COVID-19 pandemic. To investigate their relationship to SARS-CoV2 infection,... (Review)
Review
There is accumulating anecdotal evidence that anosmia and dysgeusia are associated with the COVID-19 pandemic. To investigate their relationship to SARS-CoV2 infection, the American Academy of Otolaryngology-Head and Neck Surgery developed the COVID-19 Anosmia Reporting Tool for Clinicians for the basis of this pilot study. This tool allows health care providers to confidentially submit cases of anosmia and dysgeusia related to COVID-19. We analyzed the first 237 entries, which revealed that anosmia was noted in 73% of patients prior to COVID-19 diagnosis and was the initial symptom in 26.6%. Some improvement was noted in 27% of patients, with a mean time to improvement of 7.2 days in this group (85% of this group improved within 10 days). Our findings suggest that anomia can be a presenting symptom of COVID-19, consistent with other emerging international reports. Anosmia may be critical in timely identification of individuals infected with SARS-CoV2 who may be unwittingly transmitting the virus.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Global Health; Humans; Incidence; Olfaction Disorders; Otolaryngology; Pandemics; Pneumonia, Viral; SARS-CoV-2; Smell
PubMed: 32340555
DOI: 10.1177/0194599820922992 -
Current Otorhinolaryngology Reports 2022This study aims to summarize the current state of the art of how taste disorders are clinically best managed. (Review)
Review
PURPOSE OF THE REVIEW
This study aims to summarize the current state of the art of how taste disorders are clinically best managed.
RECENT FINDINGS
Taste disorders are distressing for the concerned patients since eating and drinking become bothersome or impossible. Apart from nutritional problems, quality of life is impaired. Still, diagnosis and treatment of taste disorders are elusive, and general knowledge about taste and its affection is little within the population and the medical community. This review stresses the importance of accurate workup and diagnosis of taste disorders in order to offer an effective treatment. Yet unclear aspects of taste disorders are discussed, and interesting findings regarding the treatment of taste disorders are reviewed. A special focus is given to current pharmacological options on how to treat taste disorders.
SUMMARY
Despite impressive insights into the gustatory function and molecular logic of taste receptor cells, there is currently poor clinical knowledge on the pathophysiology of taste disorders in humans. Diagnosing, measuring, and treating gustatory disorders remain restricted to a handful of specialized smell and taste centers worldwide. Despite interesting work on potential drugs treating taste disorders, many of the reported medications lack controlled and randomized trials confirming their efficacy in taste dysfunction. Future efforts need to be focused on the treatment of taste disorders.
PubMed: 36158900
DOI: 10.1007/s40136-022-00428-z -
Journal of the American Dental... Mar 2022Taste disorders in general, and dysgeusia in particular, are relatively common disorders that may be a sign of a more complex acute or chronic medical condition. During... (Review)
Review
BACKGROUND
Taste disorders in general, and dysgeusia in particular, are relatively common disorders that may be a sign of a more complex acute or chronic medical condition. During the COVID-19 pandemic, taste disorders have found their way into the realm of general as well as specialty dentistry, with significance in screening for patients who potentially may have the virus.
TYPES OF STUDIES REVIEWED
The authors searched electronic databases (PubMed, Embase, Web of Science, Google Scholar) for studies focused on dysgeusia, ageusia, and other taste disorders and their relationship to local and systemic causes.
RESULTS
The authors found pertinent literature explaining the normal physiology of taste sensation, proposals for suggested new tastes, presence of gustatory receptors in remote tissues of the body, and etiology and pathophysiology of taste disorders, in addition to the valuable knowledge gained about gustatory disorders in the context of COVID-19. Along with olfactory disorders, taste disorders are one of the earliest suggestive symptoms of COVID-19 infection.
CONCLUSIONS
Gustatory disorders are the result of local or systemic etiology or both. Newer taste sensations, such as calcium and fat tastes, have been discovered, as well as taste receptors that are remote from the oropharyngeal area. Literature published during the COVID-19 pandemic to date reinforces the significance of early detection of potential patients with COVID-19 by means of screening for recent-onset taste disorders.
PRACTICAL IMPLICATIONS
Timely screening and identification of potential gustatory disorders are paramount for the dental care practitioner to aid in the early diagnosis of COVID-19 and other serious systemic disorders.
Topics: COVID-19; Dysgeusia; Humans; Pandemics; SARS-CoV-2; Smell
PubMed: 34799014
DOI: 10.1016/j.adaj.2021.08.009 -
Cancers Sep 2023Post-oropharyngeal cancer treatment complications include a multitude of oral side effects that impact overall survival and quality of life. These include acute and... (Review)
Review
Post-oropharyngeal cancer treatment complications include a multitude of oral side effects that impact overall survival and quality of life. These include acute and chronic conditions affecting the oral cavity and head and neck, such as mucositis, infection, xerostomia, dysgeusia, radiation caries, osteonecrosis, and trismus. This review will summarize the most common oral complications from oropharyngeal cancer therapy. The authors would like to point out that the literature cited frequently combines oropharyngeal and head and neck cancer results. If recommendations are made strictly related to oropharyngeal cancers, this will be highlighted.
PubMed: 37760517
DOI: 10.3390/cancers15184548 -
Journal of Renal Nutrition : the... May 2024Dysgeusia is a common altered taste perception in chronic kidney disease patients. The study aims to identify available treatments for educating, screening, and... (Review)
Review
Dysgeusia is a common altered taste perception in chronic kidney disease patients. The study aims to identify available treatments for educating, screening, and clinically managing dysgeusia in this population. A scoping review was conducted following the protocol of Arksey and O'Malley, incorporating the Joanna Briggs Institute methodology, and adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Among the 424 identified records, 13 studies were included. Screening methodologies, educational strategies, particularly a hospital-based program focusing on salt reduction, showed a significant improvement in dysgeusia (P < .001). The identified clinical treatments exclusively included oral zinc supplementation, with dosages ranging from 50 to 220 mg, reporting heterogeneous results not consistent across different studies. The personalized management of dysgeusia associated with chronic kidney disease is crucial, requiring targeted education and treatment protocols to prevent and address nutritional complications such as malnutrition.
PubMed: 38729584
DOI: 10.1053/j.jrn.2024.04.005 -
The Annals of Otology, Rhinology, and... Feb 2021We aimed to provide information on the effects of tonsillectomy, in particular, its effects on taste dysfunction; also known as dysgeusia, and provide direction for... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
We aimed to provide information on the effects of tonsillectomy, in particular, its effects on taste dysfunction; also known as dysgeusia, and provide direction for future research in this area.
METHODS
We independently searched five databases (PubMed, SCOPUS, Embase, the Web of Science, and the Cochrane database) for related studies published as recently as December 2019. From the included studies, we reviewed the findings on tonsillectomy and taste disturbance through the use of a questionnaire, chemogustometry, and electrogustometry. We analyzed other conditions that were measured in these studies that included; postoperative pain intensity and other morbidities (eg, postoperative bleeding, hemostasis, tongue numbness and zinc, copper, and iron hemoglobin levels measured).
RESULTS
Postoperative taste disturbance based on questionnaire (VAS) scores at 14 days (SMD = -0.31 [-0.50, -0.12], value = .0012) tended to decrease significantly in the post-tonsillectomy group compared to the pre-tonsillectomy group. Patients showed significantly decreased taste sensation after tonsillectomy than in the preoperative test. Postoperative electrogusmetry at 7 days (SMD = 0.60 [0.27, 0.94], = .0004) tended to increase significantly in the post-tonsillectomy group compared to the pre-tonsillectomy group.
CONCLUSION
Tonsillectomy is a commonly performed surgery, and taste disturbance occurs frequently as a post operative effect. Taste dysfunction is important to patients with regard to their quality of life and the overall effects of taste on their day-to-day life. This study can be a useful meta-analysis of dysgeusia in tonsillectomy.
Topics: Copper; Electrodiagnosis; Hemoglobins; Humans; Iron; Postoperative Complications; Taste Disorders; Tonsillectomy; Visual Analog Scale; Zinc
PubMed: 32741219
DOI: 10.1177/0003489420946770