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Original Article
Altered taste perception among
complete denture patients
HP Srinath, Rajesh Akula, Sohani Maroli1, A Venkat Reddy, Siva Kiran Babu Yarlagadda,
K Sitaram Prasad
Departments of Prosthodontics, 1Conservative Dentistry and Endodontics, St. Joseph Dental College, Eluru,
Andhra Pradesh, India

ABSTRACT

Aims: The purpose of this study was to evaluate the effect of upper complete denture on
gustatory sense in denture wearers.
Materials and Methods: Gustatory senses in 60 subjects were evaluated with four different
solutions containing sucrose, NaCl, acetic acid, and quinine dissolved in water. Means and
standard deviations were calculated and then compared between the different time intervals.
Results: The mean taste identification time was found to increase at compared intervals.
Conclusion: Difference between mean identification times between four sessions was sta-
tistically not significant.

Key words: Complete denture, gustatory, taste analysis

Introduction to evaluate the possible influence of upper

Address for Correspondence:
Dr. HP Srinath,
Department of Prosthodontics,
St Joseph Dental College,
Eluru, Andhra Pradesh, India.
E-mail: srinath_hp@yahoo.com
Date of Submission: 07-12-2013
Date of Acceptance: 09-03-2014
Access this article online
Website:
www.indjos.com
DOI:
10.4103/0976-6944.136845
Quick Response Code:
The sense organs for taste or gustatory
sensation are the taste buds. These are
ovoid bodies with a diameter of 50 to
70 microns. Taste receptors found within
taste buds are located not only on the
tongue but also on the palate, pharynx,
epiglottis, uvula, and at the beginning of
the esophagus.[1] When in the pharynx and
larynx, the admitted functions are related
with aspiration protection.[2] In adults, about
1000 taste buds are present. The number
is more in children. In old age, many taste
buds degenerate and the sensitivity to taste
become less.[1] The cells live approximately
10 days and then regenerate. Common causes
of taste disturbance include oral and perioral
infections, oral appliances, Bell’s palsy, aging,
Gastric reflux, systemic conditions such
as diabetes mellitus, Sjögren’s syndrome,
pernicious anemia, and Crohn’s disease.[3]
Other causes are pesticide,[4] drug[5] and metal
exposure,[6,7] trauma, surgical procedures,[8]
and radiation.[3] Clinical experience suggests
that an upper removable denture might affect
taste because it prevents regular contact
between the palatal receptor sites and taste
samples.[9] The present study was designed
complete dentures on the taste sense.
Materials and Methods
A completely edentulous group (60 subjects)
was selected from patients attending the
graduate clinics of the Department of
Prosthetic Dentistry in St. Joseph dental
college according to the following criteria;
all subjects were free of systemic diseases,
45 to 79 years old, at least one year of
complete edentulism, and no history of
prosthesis wearing. During the course
of the study all subjects were free from
fever and respiratory infection, not on any
medication and were right handed.
Each subject received a series of twelve
2 ml samples representing sweet, salt, sour,
and bitter tastes. All samples were served
in disposable cups at room temperature.
Samples were prepared having the following
composition [Table 1].
The samples were presented to the subjects
in an individual, randomized sequence.
In each session, the participants were

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Srinath, et al.: Effect of complete denture on taste

requested to do the following:
1. All the patients were instructed to drink with left
hand and hold the stop watch in the right hand and
asked to record the time duration of taste perception.
Taste perception time was recorded by the patient and
documented by the operator
2. To write down the description of the taste in their own
words (verbal labeling)
3. To mark the intensity on a visual analogous scale (VAS).
The participants were asked to mark their answers on forms
with 10-cm VAS. The VAS was used to record intensity
estimates with end-points marked by anchor statements
of ‘strongest’ on the right and ‘weakest’ on the left.
Between tasting of each of the samples, the subjects
rinsed their mouth with purified water. The mean duration
between tasting any two samples was 20 minutes.
The mean taste identification time was 3.6 seconds before
denture insertion and increased immediately after insertion,
1 week after insertion of denture, and 1 month after use;
however, these changes were not significant (P = 0.6)
[Figure 2].
Standard deviation and probability of taste stimuli for the
experimental groups of four testing sessions were shown
in Tables 4 and 5.
Upper complete denture wearing influenced the mean
identification time, but statistically was not significant.
Discussion
Many clinical reports have raised the possibility that
a removable prosthesis covering the palate may cause

Tests were performed in four sessions [Table 2]. Table 1: Test samples composition
Sample Stimuli Composition Concentration
Only patients who replied correct answers in T0 session A Sweet sucrose 0.032 M
passed T1, T2, and T3. Based on this criterion, five subjects B Sweet sucrose 0.5 M
are excluded from study because of inconsistency. C Sweet sucrose 1M
D Salt NaCl 0.032 M
Data was evaluated by comparative statistical methods E Salt NaCl 0.5 M
(percentage, mean and standard deviation). F Salt NaCl 1M
G Sour Acetic acid 0.0010 M
Accuracy of data was analyzed by ANOVA. The means H Sour Acetic acid 0.0016 M
and standard deviations in taste times were calculated. The I Sour Acetic acid 0.032 M
confidence level was established at P < 0.05. J Bitter Quinine 0.00032 M
K Bitter Quinine 0.00064 M
Results L Bitter Quinine 0.001 M

In this study, 60 complete denture patients were selected.

Patients who had not worn upper complete denture were Table 2: Representation of four testing sessions
chosen. The study group comprised of 30 (50%) men T0 Before denture insertion
T1 Immediately after denture insertion
with a mean age of 55.64 ± 0.17 years and 30 women with
T2 One week after denture insertion
54.21 ± 0.12 years, with no statistically significant difference.
T3 One month after denture use

Verbal labeling of taste

Almost all stimuli were correctly labeled by subjects. Most Table 3: Mean identification time in seconds for the
accurate identification was for sweet and salt stimuli, while 12 samples in the subjects of the four testing sessions
erroneous identification was found for low concentrations Sample T0 T1 T2 T3
sour and bitter (G and J). However, regarding correct A 3.64 4.13 4.96 6.03
labeling of stimuli, no significant differences were found B 3.72 4.12 4.95 5.98
between the four sessions [Figure 1]. C 3.83 4.04 4.75 5.92
D 2.56 3.02 3.43 4.83
Reaction time E 2.42 2.83 3.52 4.60
The duration of reaction time elapsing between the F 2.34 2.64 3.23 4.42
stimulus presentation and identification was measured. G 3.78 3.99 4.32 5.12
Here, reaction time was recorded by the patient itself with H 3.69 3.94 4.42 5.53
stop watch and showed marked inter-individual variations. I 3.62 3.88 4.50 5.69
J 4.38 4.84 5.32 6.62
Table 3 indicates mean identification time in seconds for K 4.65 4.90 5.40 6.61
the taste stimuli in the subjects of the four testing sessions. L 4.67 4.93 5.55 6.68

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Srinath, et al.: Effect of complete denture on taste

100

90

80

70

60
Percentage

T0
50
T1
40 T2
T3
30

20

10

0
A B C D E F G H I J K L
Samples

Figure 1: Mean percentage of correct verbal labeling for the taste stimuli in the subjects of four testing sessions

5
Seconds

T0
4
T1
3 T2
T3
2

0
A B C D E F G H I J K L
Samples

Figure 2: Mean identification time in seconds for the 12 samples in the subjects of the four testing sessions

Table 4: Standard deviation for mean identification times Table 5: Probability for mean identification times
Taste T0-T1 T0-T2 T0-T3 Taste Probability
Sweet 0.10 0.46 1.04 Sweet 0.60
Salt 0.15 0.44 1.03 Salt 0.65
Sour 0.12 0.43 1.00 Sour 0.58
Bitter 0.12 0.44 1.03 Bitter 0.61

alteration in sense of taste and smell.[10,11] But, it has taste buds are to be found in that areas, while others claim
not been proved conclusively due to the controversy that on the border between soft and hard palates, there
regarding the location of taste buds in the area covered is gustatory sense.[13] Contact between the tongue and
by upper complete denture. Schiffmann[12] states that no palate is disturbed by the presence of upper complete

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Srinath, et al.: Effect of complete denture on taste
denture. This contact helps in dispersing the taste sample
and bringing it into a closer contact with taste buds. Since
the bulk of upper complete denture interferes with the
normal mobile movement of tongue and cheeks, it may be
considered that it also affects release of food flavors and
the movement of these flavors via warm humid air in the
oral and nasal cavities, affecting retronasal olfaction.[14-16]
Nilsson found no statistically significant difference in taste
threshold values between women and men on human
palate.[17] The same author admitted that there was a
tendency to lower thresholds for women compared to
men for all four tastes on human palate.[18,19] Sato et al.
state that women display more sensitive performance to
sour taste on the tongue tip and to salty and bitter tastes
on the soft palate.[20] Although 50% of the subjects in
this study were women, we were not able to identify any
different performance in identification of taste between
women and men. Thus, gender may not be considered
as a variable. Yoshinaka found that taste bud and cell
density in the older age groups were lower than that
in the younger age groups, which may influence taste
systems.[21] To avoid this variability, here all subjects were
selected from the age range of 45-79 years. Based on
the clinical reports in the literature,[22-26] the single most
common etiologic factor contributing to taste dysfunction
is medication usage. This may be the result of the direct
impact of medications on taste receptor function or of
residual tastes associated with either the drug’s presence
in saliva or in the blood, since tastes can be perceived
intravascularly,[27] (a phenomenon that has been used to
assess both blood circulation time and taste dysfunction).
During the course of this study, the subjects were not
on any medications. Repeated mechanical stimulation
by upper complete denture results in the loss of taste
nerve endings in the palate.[28] Therefore, patients with no
previous complete denture treatment were selected in the
present study. All subjects were free of systemic diseases
because systemic conditions such as diabetes mellitus,
Sjögren’s syndrome, pernicious anemia, and Crohn’s
disease cause taste dysfunction.[3] Head trauma and upper
respiratory tract infections in some cases contribute to
taste distortion.[29] So, patients with no recent history of
head injury and upper respiratory tract were chosen in
this study. Here, patients were instructed to hold the stop
watch in the right hand and record the taste perception
time. Hence, right-handed people were chosen because
they are more dexterous with their right hands when
performing tasks. The used volume and concentrations
of the four basic solutions (sweet, salt, sour, and bitter)
could be considered adequate to classify the basic taste
identification.[30] In general, however, mean identification
time was increased between the four sessions, indicating
that an upper complete denture influences the patient’s
ability to detect and identify taste.
Indian Journal of Oral Sciences y Vol. 5 y Issue 2 y May-Aug 2014
In the present study, taste identification time increased from
T0 to T3, but in Ghaffari et al. study, taste identification time
decreased from T0-T3.[31] In general, among the four taste
samples, the minimum mean identification time is related
to 0.032 M salt taste in first session (T0) and maximum
mean identification time was related to 0.001 M bitter
taste in last session (T3). In our study, identification times
in all the specimens decreased as concentration increased,
but in their study, taste identification time decreased as
concentration decreased.[31]
In Har-zion et al. study,[9] the longest taste identification
time was related to T0. But, in our study, longest taste
identification time was related to T3.
In Nilsson’s study,[13] the mean taste identification times
in men were greater than that in women because women’s
gustatory ability is stronger than men. In this study, the
mean identification time of four taste stimuli was increased
from T0-T3 because upper removable denture might affect
taste because it prevents regular contact between the palatal
receptor sites and taste samples. However, a difference
between mean identification times between four sessions
was statistically not significant.
Conclusion
Results from the above study indicate that as the denture
wearing period increases, the taste identification time
increases and as the concentration of the given samples
increases, the identification time decreases.
According to the statistical analysis limited to the time
period of this study done, difference between the mean
identification times of four testing sessions was not
significant, but it may become significant over a long
period of denture wearing provided study should be
prolonged.
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How to cite this article: Srinath HP, Akula R, Maroli S, Reddy AV,
Yarlagadda S, Prasad KS. Altered taste perception among complete
denture patients. Indian J Oral Sci 2014;5:78-82.
Source of Support: Nil, Conflict of Interest: None declared
Indian Journal of Oral Sciences y Vol. 5 y Issue 2 y May-Aug 2014