Idiopathic dysgeusia; an open trial of alpha lipoic acid (ALA) therapy

doi:10.1054/ijom.2002.0276

International Journal of Oral and Maxillofacial Surgery

Volume 31, Issue 6, December 2002, Pages 625-628

https://doi.org/10.1054/ijom.2002.0276 Get rights and content

Abstract

We selected two homogenous groups, each of 22 patients with idiopathic dysgeusia, an altered perception of taste, matched for age and sex, for an open trial of alpha lipoic acid compared with placebo.

The 22 patients in the study group were treated with alpha lipoic acid for 2 months. The 22 patients in the control group were treated for 2 months with carboxymethylcellulose. The latter group was then treated with alpha lipoic acid for 2 months.

The results showed significant symptomatic improvements compared with placebo, in both groups of patients with dysgeusia treated with alpha lipoic acid, suggesting that idiopathic dysgeusia may be a neuropathy comparable to the burning mouth syndrome.

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Pain reduction in burning mouth syndrome (BMS) may be associated with selective improvement of taste: a retrospective study
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The aim of this study was to examine taste function in patients who reported improvement in their pain level after treatment to determine if pain reduction is associated with change in taste function in patients with burning mouth syndrome (BMS).
This retrospective study of patients with BMS was conducted at a private oral medicine clinic.
Thirty-nine patients with BMS (31 females and 8 males; mean age 56.1 ± 9.4 years) reported improvement in their pain in 1 to 22 months after the initial visit (mean 5.13 ± 4.18). The most commonly used medication was clonazepam 0.25 to 0.5 mg/day. Twenty-eight patients were treated with a combination of medications. “Salt” and “bitter” responses at the fungiform papillae were increased after treatment (P = .026 and P = .044, respectively). “Salt” responses at the circumvallate papillae also increased (P < .001). Pain reduction was significant after treatment in the morning (P = .002) and in the evening (P < .001).
Treatment of BMS can significantly decrease pain symptoms, resulting in improvement in taste function. Pain reduction often requires a combination of medications.
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Citation Excerpt :
While using chlorhexidine regularly can result in a large reduction in dental plaque as an adjunct therapy to proper oral hygiene, repeated use for more than 4 weeks can also result in extrinsic tooth scarring (James et al., 2017). Alpha lipoic acid (ALA)—a supplement commonly considered for neuropathies—may provide significant improvements over placebo in patients with idiopathic dysgeusia (Femiano et al., 2002). As noted earlier, excessive dryness (e.g., xerostomia) of the orolingual mucosa can be a major contributing factor for taste disturbances, and the use of artificial saliva (e.g., Xerolube™) may improve comfort and mucosal function.
Neurolocalization of taste disorders requires a knowledge of the functional anatomy involved in mediating taste information from the peripheral mucosal surfaces through numerous peripheral cranial nerves to complex subcortical and cortical brain regions. Our understanding of this functional anatomy has advanced in recent years. Taste is an experience that is both innate and learned, and the “taste” experience involves the integration of information from other sensory modalities, such as olfaction and somatosensation. Normal taste perception is influenced by different neurophysiologic states, which involve endocrine function, emotions, and even attitudes and expectations toward eating. At its core, the normal effective ability to taste is a reflection of the proper function of many organ systems within the body and may be considered a marker for good health. Clinical taste disorders, on the other hand, involve the dysfunction of the normal neural taste pathways and/or aberrant influences on multisensory integration and cortical taste processing. The number of disease processes, which can adversely affect taste, are numerous and quite varied in their presentation. There may be contributory involvement of other organ systems within the body, and the appropriate management of taste disorders often requires a multidisciplinary approach to fully understand the disorder. Depending on the underlying cause, taste disorders can be effectively managed when identified. Treatments may include correcting underlying metabolic disturbances, eliminating infections, changing offending medications, replenishing nutritional deficiencies, operating on structural impairments, calming autoimmune processes, and even stabilizing electrochemical interactions.
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Burning mouth syndrome is characterized by ongoing spontaneous pain, without direct organic cause, felt in the oral mucosa and associated with impaired quality of life. The prevalence of this condition in the general population is low (< 1%) but increases with age, especially among women during menopause. Long considered psychogenic pain due to its frequent association with an anxiety-depression context, this view has been challenged by psychophysical and neurophysiological studies that have objectified sensory alterations in most patients. Dysgeusia and xerostomia are often associated with somatosensory complaints suggesting a complex and multifactorial etiology. Available treatments are disappointing. This article reviews the different aspects of the condition.
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^f1: Address: Dr Femiano Felice, via Francesco Girardi 2, S. Antimo (NA), 80029, Italy, Tel: +39 081-8304248; Fax: +39 081-5665521; E-mail: [email protected]

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Clinical PapersIdiopathic dysgeusia; an open trial of alpha lipoic acid (ALA) therapy

Abstract

J Photochem Photobiol B

Pharmacol Res

Lancet

J Biol Chem

Pharmacol Biochem Behav

Physiol Behav

Disturbances of taste and smell induced by drugs

Pharmacotherapy

In vivo effect of lipoic acid on lipid peroxidation in patients with diabetic neuropathy

In Vivo

Genetic taste markers and food preferences

Drug Metab Dispos

Burning mouth syndrome (BMS): controlled open trial of the efficacy of alpha-lipoic acid (thioctic acid) on symptomatology

Oral Diseases