Smell and Taste Disorders

Problems With Taste: Frequently Asked Questions

Taste is the ability to detect different sensations in the mouth, such as sweet or salty. It is part of the chemical sensing system or the "chemosenses." Taste -- along with smell and the common chemical sense -- is what allows us to perceive flavor.

There is a small decline in taste in people over 60. Most older people will not notice it, because normal aging does not greatly affect our sense of taste. Problems with taste occur less frequently than problems with smell.

Roughly 200,000 people each year visit a doctor for a problem with their sense of taste or smell. Some studies estimate that more than two million people in the United States have problems with smell and taste. The number may be much higher, because many cases are not reported.

Taste contributes greatly to our ability to enjoy food and beverages. Problems with taste can have a big impact on older people's lives. When taste is impaired we tend to eat poorly, socialize less, and generally feel worse.

Normal taste occurs when tiny molecules released by the food we eat stimulate special cells in the mouth or throat. These special sensory or gustatory cells send messages through nerves to the brain, where specific tastes are recognized.

We can identify five different taste sensations: sweet, sour, bitter, salty, and umami or "savory." Umami was discovered by a Japanese scientist in the early part of the twentieth century. Umami is the taste of glutamate, a building block of protein found in chicken broth, meat extracts, and some cheeses.

There are several types of taste disorders depending on how the sense of taste is affected. If you have a taste disorder, you may experience a loss in your ability to taste or changes in the way you perceive taste sensations. Or you may not be able to detect any taste at all. The most common true taste complaint is called "phantom taste perception" or tasting something when nothing is in the mouth.

The most common causes of taste disorders are medications, infections, head trauma, and dental problems. Most people who have a problem with taste are taking medications or have had a head or neck injury. Gum disease, dry mouth, and dentures can contribute to taste problems, too. Other causes are radiation therapy for head and neck cancers, heavy smoking, vitamin deficiencies, Bell's palsy, and Sjogren's syndrome.

Sometimes. Problems with taste that occur with aging cannot be prevented. Loss of taste due to a respiratory infection can be prevented by washing your hands frequently, especially during the winter months. Quitting smoking and good oral hygiene also can prevent loss of taste.

Yes. Certain medicines can cause a change in our ability to taste. The medicines that most frequently do this are medications to lower cholesterol, antibiotics, blood pressure pills, medications to lower anxiety, and antidepressants. If you are taking any of these and notice a change in your sense of taste, see your doctor. You may be able to adjust or change your medicine to one that will not cause a problem with taste.

In some cases, loss of taste can accompany or signal conditions such as malnutrition or diabetes. Sometimes a problem with taste can be a sign of a more serious health problem, such as multiple sclerosis and other diseases of the nervous system.

Total loss of taste is rare, but can occur. It may result from radiation treatment to the mouth area, and has been associated with head trauma, severe oral health problems, upper respiratory infection, and exposure to chemicals.

Yes. Losing your sense of taste can be more than a quality-of-life issue. Loss of taste deprives us of an early warning system that most of us take for granted. Taste helps us detect spoiled food or beverages and, for some, the presence of food to which they are allergic. Perhaps more serious, loss of the sense of taste also can lead to depression and a reduced desire to eat.

If you lose some or all of your sense of taste, there are things you can do to make your food taste better:

• Prepare foods with a variety of colors, shapes, and textures

• Use aromatic herbs and hot spices to add more flavor

• If your diet permits, use cheese sauces, bacon bits, or small amounts of butter on vegetables

• Add sharp cheese, olive oil, or toasted nuts

• Avoid combination dishes that can hide individual flavors and dilute taste

Doctors can diagnose a taste disorder by measuring the lowest concentration of a chemical that a person can detect. The doctor may also ask a patient to compare the tastes of different chemicals or to note how the intensity of a taste grows when a chemical's concentration is increased.

Scientists have developed taste testing in which a person responds to different chemical concentrations. This may involve a simple "sip, spit, and rinse" test, or chemicals may be applied directly to the tongue.

Depending on the cause of your taste disorder, your doctor may be able to treat your problem or suggest ways to cope with it. If a certain medication is the cause of the problem, stopping or changing the medicine may help eliminate the problem.

Some patients with respiratory infections regain their sense of taste when the illness is over. Often, correcting a general medical problem can restore the sense of taste. Occasionally, the sense of taste returns to normal on its own without any treatment.

If your medicine is causing a problem with your sense of taste, your doctor may be able to adjust or change your medicine. If not, he or she may suggest ways to manage your problem. Do not stop taking your medications unless directed by your doctor. Your doctor will work with you to get the medicine you need while trying to reduce unwanted side effects.

The best thing you can do is see your doctor. Proper diagnosis by a trained professional, such as an otolaryngologist, is important. These physicians specialize in disorders of the head and neck, especially those related to the ear, nose, and throat. Diagnosis may lead to an effective treatment of the underlying cause of your taste disorder. Many types of taste disorders are curable, and for those that are not, counseling is available to help older people cope.

You can help your doctor make a diagnosis by writing down important information about your problem beforehand and giving the information to your doctor during your visit.

Write down answers to the following questions:

• When did I first become aware of my taste problem?

• What changes in my sense of taste did I notice?

• Do all foods and drinks taste the same?

• Have there been any changes in my sense of smell?

• Does the change in taste affect my ability to eat normally?

• What medicines do I take? What are the names of the medicines? How much do I take? What is the health condition for which I take the medicine?

• Have I recently had the cold or flu?

The National Institute on Deafness and Other Communication Disorders supports basic and clinical studies on smell and taste disorders. This type of research is leading to a fuller understanding of how our sense of taste works and how we detect and taste sensations at the molecular level. Findings from this work may result in the development of medicines and artificial food products that will allow older adults with taste disorders to enjoy food again.

Also, scientists are working to discover why certain medications can have a harmful effect on our sense of taste. They are looking at why and how this takes place in order to develop more effective ways to help older people cope better with taste problems.    

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