Taste change associated with a dental procedure: case report and review of literature.

Abstract

Loss or alteration of taste is a rare phenomenon that may be idiopathic or may be caused by head trauma, medication use or systemic and local factors including various invasive dental procedures resulting in nerve damage. We present an unusual case of generalized taste change following an oral surgical procedure. The case is presented to enhance understanding of taste disorders and their relation to a localized traumatic event. Causative factors and management strategies are also reviewed. Taste change, encompassing loss (ageusia) or alteration (dysgeusia) of taste, is a rare phenomenon that may be idiopathic or may result from head trauma; endocrine, metabolic, sinus, autoimmune and salivary gland disorders; medication use; cancer treatment (radiation or chemotherapy); viral, bacterial and fungal infections; certain oral conditions; or peripheral nerve damage due to invasive procedures including dental interventions. Some factors thought to be responsible for nerve injuries associated with dental procedures are proximity of the chorda tympani nerve to the surgical site, retraction of the lingual flap, extraction of unerupted teeth especially third mandibular molars, and experience of the operator. Nerve damage may also be a result of local anesthetic injection due to direct needle trauma causing hemorrhage within the epineurium or a neurotoxic effect of the anesthetic. The sensation of taste is mediated by three cranial nerves: facial (VII), glossopharyngeal (IX) and vagus (X). The trigeminal nerve (V) provides general sensory innervation to a region that overlaps the areas served by these other cranial nerves (Table 1). Because of their anatomic proximity, the possibility exists for iatrogenic injury to the chorda tympani, lingual nerve or both during surgical procedures in the posterior mandible. This may result in irreversible gustatory deficits and somatosensory dysfunction. The purpose of this article is to review the possible causes and management of taste disorders. An unusual case of generalized taste change following an oral surgical procedure is presented to enhance understanding of taste disorders and their possible relation to a localized traumatic event.