Untreated Caries in Persons with Taste or Smell Dysfunction

We examined whether taste or smell dysfunction was associated with untreated caries and if sugar intake modified the association.

We used cross-sectional National Health and Nutrition Examination Survey (NHANES) data from 5,882 adults aged 40+ who completed the dental examination and Taste and Smell protocols in 2011-2014. Self-reported dysfunction was defined as reporting at least 1 problem with taste and smell. Objectively measured dysfunctions (2013-2014 only) included inability to identify bitter and salty solutions on whole-mouth taste tests and ≤5 odorants correctly identified on the 8-item Pocket Smell Test (PST). Caries was assessed by calibrated dental examiners. Logistic regression estimated the odds and 95% confidence intervals (CIs) for untreated caries among persons with dysfunction compared with those without dysfunction. Covariates included age, sex, race/ethnicity, smoking, flossing frequency, alcohol use, dry mouth, and diabetes. Effect modification by added sugar level (<10% vs. ≥10% of calories) was examined. Results were weighted to account for the NHANES survey design.

Fourteen percent of participants self-reported problems with smell, 9% with taste, and 9% with both. Measured taste dysfunction prevalence was 11% to 17%, and 12% had significant smell loss on the PST. Adjusted odds of untreated caries were higher in participants who self-reported both taste and smell problems compared to neither (odds ratio [OR] = 1.38; 95% CI, 1.03-1.84). Added sugar level modified the association between measured ability to taste bitterness and caries: nontasters with high added sugar intake had twice the odds of caries as tasters with low added sugar intake (OR = 2.03; 95% CI, 1.35-3.05). Smell dysfunction alone, self-reported or measured, was not significantly associated with caries.

Perceived dysfunction of taste and smell and inability to taste bitterness at high added sugar intakes were associated with increased odds of untreated caries. Screening for chemosensory dysfunction may identify persons with greater risk of dental caries and facilitate referral to a dentist.Knowledge Transfer Statement:Screening for taste dysfunction in primary care and community-based settings may identify persons with greater risk of dental caries and facilitate referral to a dentist.