Diagnosis and management of taste disorders and burning mouth syndrome

Clinically significant taste loss is less common than abnormal tastes (dysgeusias). Both may be caused by a previous viral upper respiratory infection, head trauma, iatrogenic causation (medication, irradiation, surgery), neurologic or psychiatric disorders, toxic chemical exposure, systemic conditions, xerostomia, severe nutritional deficiencies, and some oral or dental disorders. Beyond treatment targeted toward causative conditions, there is no proven intervention to either enhance taste acuity or abolish dysgeusia. The prevalence of oral burning sensations has been estimated at 2.6% for the general population. The burning typically increases throughout the day, and may be associated with taste alterations and psychological effects. Differential diagnoses considered include psychiatric illness, menopause, nutritional disorders, oral and dental conditions, and diabetes mellitus. Low doses of tricyclic antidepressants may be effective in some patients with idiopathic oral burning, and spontaneous remissions without intervention have been reported.