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THE INFLUENCE OF COMPLETE DENTURES UPON TASTE PERCEPTION JEROME C. STRAIN, D.D.S. D 0

THE

INFLUENCE

OF

COMPLETE

DENTURES

UPON

TASTE

PERCEPTION

JEROME

C.

STRAIN,

D.D.S.

D 0

Assistant

Clinical

Professor, Denture

Prosthesis ad

University

of California,

College of Dentistry,

Ore-Facial

San Francisco,

Prosthetics,

Caiif.

YOUR

patients

experience

an interruption

of taste

sensations

upon

the

insertion

of dentures ?

 

The

organs

of taste

were

first

discovered

in

mammals

in

the

year

1867.

Since that

time,

considerable

research has been done, principally

upon

the taste

areas on the tongue.

problem of ageusia as it relates to dentures.

taste and the influence

to originate

pulses are sent to the brain organs have been classified

mon sensibility

To

the

best of

my

knowledge,

My

no one has attackad

the

paper deals with

the sense of

Im-

These sense

to

the com-

that complete dentures

may have upon

it. of the body.

nature.

The ability

sensations is common to all parts

and recorded

regardless of their

into

two

main

groups,

those belonging

of the body and those forming

the special sense organs.

SPECIAL

SENSES

The special sense organs from a structural

standpoint

are

organs

whose

cells are so specialized that they are subject to stimulation

by only

a particular

category of external changes. These organs are ordinarily

arranged

under

five

heads, each with an adequate stimulus and productive of a special sensation. They are the organs of touch, taste, smell, sight, and hearing.“’ Some investigators

classify the senses of heat, cold, and pain as special senses separate from that of touch.

deficiencies

is commonly associated with need of efficient dental service. Continued oral

discomfort may seriously affect the general nervous system resulting

or impaired function of an organ of the body.” Thus, we have the first factors which may influence our taste perception.

in neurosis

Schuyler stated : “Systemic

evidence

of

dietary

and

vitamin

The physiologic

PHYSIOLOGY

mechanism involved

in the sense of taste includes the tongue,

the soft palate, the gustatory nerves (chorda tympani and glossopharyngeal and the lingual branch of the fifth), their cortical connections, and nerve cells in the gray matter of the fourth temporal convolutions. According to the literature, the investigators confined their discussions to the taste areas of the tongue but stated that in different individuals the taste area may

Read before the Pacific Coast Society of Prosthodontists, Bellingham, Received for publication Oct. 11, 1951.

Wash., June 22, 1951.

the Pacific Coast Society of Prosthodontists, Bellingham, Received for publication Oct. 11, 1951. Wash., June 22,
the Pacific Coast Society of Prosthodontists, Bellingham, Received for publication Oct. 11, 1951. Wash., June 22,

volume

Number

2

1

COMPLETE

DENTURES

AND

TASTE

PERCEPTION

61

be extended to the mucous membrane of the hard palate, anterior surface of the

soft palate,

anterior and posterior half arches. Parker4 stated : “When the mouth of a normal

sapid

adult

lips,

Accord-

the cheeks, and the

as the

and the

uvula,

the tonsils,

with

posterior

of

wall

of the pharynx,

substances,

many

epiglottis,

parts

such

is

explored

solutions

the gums, the floor,

hard

the lower

palate

surface of the tongue,

to

be insensitive

the inner

to

taste.

surfaces

of

are found

ing

to

the older

workers,

the uvula

was regarded

as haSing

a gustatory

func-

tion.

Kiesow

and Hahn

(1901)

have shown that

it is not concerned

with

taste.”

The

tonsils

and the pillars

of the

fauces have been under

dispute,

but Kiesow

and

Hahn

regarded

them

as usually

being

insensitive

to

taste.

According

to

Parker,’ the following parts are concerned with taste : the beginning of the gullet,

the region of the arytenoid cartilage within the larynx,

and particularly

the epiglottis,

the soft palate,

the tongue.

He also stated that

taste buds have been identified

within

these areas.

The

only

description

of taste buds found

thus

far

has been

of those located on the tongue.

 

ANATOMY

The tongue is covered by mucous membrane

continuous

with

that

lining

the

oral cavity.

The dorsum of the tongue presents a series of papillae

richly

supplied

with

blood

vessels and nerves.

Of these there are four

varieties,

the filiform,

the

fungiform,

the circumvallate,

and the foliate.

 
 

1.

The filiform

papillae

are the most numerous

and cover

the anterior

two-

thirds of the tongue.

They

are conical

or

filiform

in

shape and

covered

with

horny epithelium,

but they

do not contain

taste buds.

 
 

2.

The fungiform

papillae

are found

at the

tip

and sides of the tongue

and

are less numerous

but larger

than the filiform

papillae ; they resemble small knobs

and are deep red in color.

3. The circumvallate

papillae, in the form

usually of a V.

the base of the tongue

eight

to ten

in number,

are situated

at

4.

The foIi&e

papillaellie

on either

side of the edge of the human

tongue and

close to its root.

They

form

a series

of

%

three

to

eight

vertical

parallel

ridges.

Each ridge

is abundantly

supplied

with

taste buds which

open into

the

ditch

between the ridges.

Heindenhain”

has shown

that

the buds are arranged

in more or less vertical

rows on each papillar

fold.

 

HISTOLOGY

OF

TASTE

BUDS

Small

ovoid

bodies

are embedded

 

in

the

epithelium

covering

the

mucous

membrane

of these areas, and from

their

relation

to the gustatory

nerves

they

are regarded as their peripheral

The ovoid base rests on the tunica propria ; its apex comes to the epithelium

it presents a narrow funnel-shaped opening, the taste pore.

end organs and so are known

as the taste buds.

where

bud

The wall

of the

is composed of elongated curved epithelium.

The interior

contains narrow,

spindle-

shaped neuroepithelial

cells provided

at their

outer

extremity

with

stiff

hairIike

filaments

which

project

into

the

taste

pore.

The

neuroepithelial

cells

are

in

62

 

J. Pros.

Den.

 

STRAIN

January,

 

1952

physiologic

relation

with

the nerves of taste.

After

entering

the

taste bud

at

its

base, the terminal

branches

develop

fine tufts

which

come into

contact

with

the

cells. It is reasonable to assume that the taste buds are connected with the nerves

of taste are severed.

of taste from the fact that they degenerate after t-he nerves

Hermann

pointed

out

that

the cells

of

the taste buds are probably

undergoing

continued

change.

This

is indicated

by the presence of cells in all stages of growth

and of a considerable

number

of leukocytes.

The

taste buds on the tongue

are

found

in

conjunction

with

fungiform,

foliate,

and

circumvallate

papillae.

The

lingual

papillae

were first

described

by Malpighi

in

1664.

Loven

and Schwalbe

discovered

the taste buds in mammals

in

1867, but to Loven

belongs the distinc-

tion

of having

discovered

and described

the taste buds

in

man

in

1867.

It

was

also pointed

out

that

there

is

a much

wider

distribution

of

taste

buds

in

the

fetuses, infants,

1902 that

there

and children

than

in

the adult.

It

was emphasized

by Stahr

in

is a gradual

shift

of the center

of lingual

taste from

the

tip

of

the tongue to the region of the circumvallate

papillae.’

Study by Heiderich

in 1906

placed the number

of taste buds per circumvallate

papilla

at

248 ;

he also

found

an additional

thirty

in

the trench

wall.

The

work

by Weiderich

includes

speci-

mens only up to the age of 20 years.”

GUSTATORY

NERVES

The

nerves

of taste

are the

glossopharyngeal,

which

supplies

the

back of

the tongue, and the lingual

branch

of the

fifth

and the

chorda

tympani,

which

supply the front

part

of the tongue.

The posterior

palatine

branch of the palatine

nerve which

the

at this time which carries the sense of taste in the soft palate area.

originates

in the sphenopalatine

nerve

both

supply

the

gangliori

soft

and the lingual

We

are

glossopharyngeal

palate.

branch

of

not

certain

All

these fibers

are probably

connected

with

a continuous

column

of gray

matter

in

the brain

stem which

represents

the splanchnic

afferent

nucleus

of the

fifth

nerve,

the nervus

intermedius,

and the glossopharyngeal

nerve.’

Clark

stated that

the sympathetic

nervous

system cati be. disregarded

as

a

direct factor in the maintenance

of taste buds.

It

was brought

out by Olmsted

that taste buds tend to disappear

if

the nerves are severed or interrupted.

 

This

ciccurs I through phagocytic

action,

and

the

taste

buds

will

regenerate

or

re-

appear through

fission

if

the

nerves

are

restored.‘O

Thus

we

may

lose

some

taste sensation

for

a time

if

the nerves

are seriously

impaired.

All

the special

sense organs are closely allied.

While

each has its individual

function

to perform,

the interruption

of this

sense xi11 cause the retnaining

ones to

acute, probably

through

special training.

We have all observed this

become more at some time

or other.

Each

of our

other

special senses has a direct

bearing

upon

the sense

of taste, but

I

fail

to see where

any

one or

all

of them can substitute

for the sense

of taste.

TASTE

PERCEPTION

The sense of smell is very influential

the taste of the food

in the taste of foods.

If the smell pleases

our sense of

us, we anticipate

with

a great deal of relish,

li

s m e l l p l e a s e s o u r s

Volume

Number

2

1

COMPLETE

DENTURES

AND

TASTE

PERCEPTION

63

smell is impaired,

be designated as flavors, as they are not only dependent upon the gustatory

we

For

smell

it. The same is true of other volatile oils in some foods and other substances.

but on the sense of smell as well.

sometimes do not know whether we are smelling

instance, ether is an odorless substance.

so is our taste.

It has been stated that our so-called tastes should

Our

nerves,

senses here are so closely

or

We actually

tasting

taste

it

allied

substances.

than

that

rather

You can taste as well as smell fresh coffee when

it is being brewed.”

The

touch

also

on the string

of food

has its

influence ; for

instance,

our

wilted

lettuce

the

in

food.

a

salad or strings

Sight

manner, our appetite

beans may cause us to alter

taste for

influences

taste, for

if the food is prepared

in anticipation.

and served in a delicate pleasing

is whetted

Hearing

may influence

of ice in a glass in the next

taste also.

On a warm

day, when you

room, you can taste the contents.

hear the tinkle

Heat

and cold

also influence

the

taste

of certain

foods.

This

reaction

is

usually perceptible through the palatal area. A full palatal coverage, well in- sulated, may preclude this reaction. Metallic and alkaline tastes are considered

as separate taste sensations by some investigators.”

Tastes, like odors, are caused

by chemicals being

dissolved in liquids

about the sense organs.

A person cannot

taste a piece

of dry

sugar or salt unless a bit has been dissolved.

When

dissolved,

these liquids

can penetrate the taste pore, and the cell reacts to the chemical.

 

Different

parts of the tongue

may be a different

kind

are sensitive

to different

tastes.

This

suggests

that there

of organ for

each taste.

At

the tip

and front

edges, the

tongue is especially

sensitive to sweet and salty tastes.

On

the

side it

is more sensitive

to sour

and at

the

back to bitter.

Coffee with

sugar

first tastes

sweet, then bitter,

as it

proceeds posteriorly.

The

center

surface

of the tongue

is

particularly

effect of any chemical

not

as sensitive

to

as the sides.

Our

foods.

sense of taste lessens as we grow

doubt

older,

sweet and salty

There

is

no

that

the

stimulating

substance on the taste nerves has a relation

to its chemical

constitution.

A

sour taste is determined

by the presence

of

H

ions,

an alkali

taste by the

OH

ions.

We

do not

know

or understand

the law which

determines

whether

any given

substance shall

have a taste

at

al!

or what

the taste shall

be.>*

to several members of this

group

for

information

and

I am indeed indebted experiences volunteered

on the subject.

It

was pretty

much the consensus that

the mastication

of foods upon the anterior

teeth is inadequate,

and therefore

the

juices or flavors

do not penetrate

the taste pores.

Stahr

has observed that

there

is a gradual

shift of the centers of taste to the posterior

side of the mouth.

The

principal

taste

centers

are

on

the

lateral

and

dorsal

surfaces

of

the

tongue.‘l

It

is

quite

possible

then

that

an

irritation,

pressure,

or

substance

on the surface

of the lower

denture

may interfere

with

the sense of taste.

Some

of you will

hasten to remark,

“But

what

about

the single

upper

denture ?”

We

know that there has been loss of taste sensations when a single upper denture

has

been placed.

What

has caused it?

Any

foreign

substance on the surface of the

denture which

stings or has an odor may interfere

with

the normal

taste of foods.

The thickness

of the denture,

lack of rugae, insulation

against

h&at and cold,

all

interfere with the sense of taste.

Manes”

wrote

a year

ago that

in

his

opinion

64

 

J.

Pros.

Den.

 

STRAIN

January,

1932

Jacobson’s organ was partly

responsible

for some of the taste sensations.

 

Imme-

diately

over the incisive

foramen

at the lower

edge of the septal cartilage

is

a de-

pression, the nasopalatne

recess.

In

the septum

close to

this

recess a minute

orifice

son.

of

“taste

Because a barrier

struction,

may be seen.

This

is known

lower

It

leads into

a blind

pouch,

organ;

known

it

as the organ

of Jacob-

also as the vomeronasal

but

rudimentary

in

is well

Manes

developed in some

also

stated

that

the

is

buds are also distributed

animals

rnan.~~”

on the soft palate, epiglottis the palatal. taste buds is present

and even the larynx.

in

full

denture

con-

obstructing

it necessarily follows

that some loss of taste must be resultant.“l’

We unconsciously

rub our food against

the hard palate with

the tongue while

tasting foods.

This

brings

the

food

substance

into

intimate

contact

with

the

taste pores on the tongue.

The

hard

palate is covered

with

stratified

squamous

epithelium.

The

fibrous

tissue

beneath

it

contains

many

mucous

glands,

the

palatine g1ands.l

These glands also extend

through

the region

of the soft palate.

This unconscious

act plus the presence of glands within

the area may cause some

to mistake it for a taste area.

rEtfTuREs AGE SEX WORN

19

29F

34F

36F

36M

39M

39M

F

YES

e

.

49F

El!‘:

58F

:

*

TASTE

-TED

NO

YES

%!S

.

.

.

.

.

I

.

I

3

60M

64F

6SF

3:

73M

.

m

I

s

NOTE-it

Ii0

YES

.

;0

.

.

I= SWkT

29 SALT

Chart

1 .-Taste

perception

N&i?0

P&ATE

NONE

.

3

.

.

I

.

TASTE

AREAS

SOFT

PALATE

NONE

*;*z

.

.

.

BUGCAL

FOLD

NONE

I

m

*

.

.

.

II

.

,

.

(I

.

.

I

.

3*

SO;,

of

.

kONE

SALT

EiF

SOUR

NONE

. SOUR

I

:

.

.

*

. ”

.

4&TER

denture

wearers.

REMARKS

CLEFT

am

PALATE

PALATE

CLINICAL

INVEST[CATION

A limited

amount

of clinical

investigation

has been done by

Dr.

John

Horan

of the Department

self. The purpose of this investigation was to determine the presence or absence

of taste buds in the hard and soft palatal

clinical material included both male and female, dentulous and edentulous pa-

tients, and all were over the age of 18 years. Some had experienced interference in taste perception upon the insertion of dentures.

of Neurology,

University

of California

Medical

School, and my-

areas and the mucobuccal folds. Our

The materials used for determining

taste perception were of the standard type,

i.e., sweet, salty,

The materials were : sweet, 2 Gm. of sugar in 1@ c.c. of distilled

sour, and bitter,

and were

made up

in

the hospital

pharmacy.

water ; salt, 1 Gm.

2 Gm. of sugar in 1@ c.c. of distilled sour, and bitter, and were made up

Volume

2

1 COMPLETE

DENTURES

 

AND

TASTE

PERCEPTION

 

65

Number

of sodium

chloride

in

100 C.C. of distilled

water;

sour,

0.4 per

cent

solution

of

muriatic

acid ; bitter,

0.005 Gm. of quinine

in 100 C.C.of distilled

water.

 

Our

clinical

material

is divided

for

the purpose

of study

into

two

groups,

denture

wearers

and nondenture

wearers.

Of

the

denture

wearers,

a majority

reported taste

interference

(Chart

1) .

It

will

be noted that

there

was no taste

perception

over one-third

reacted principally

noted.

on the

hard

palate

or mucobuccal

on the

folds.

soft palate

It

will

also be noted

The

that

had no taste perception

to sour.

remainder

In only three instances were sweet and salt reactions

either.

TASTE

AREAS

DENTURES AGE SEX WORN

I8

10

I8

IS

IS

TASTE

HARD

SOFT

EUCCAL

INTERRUPTED

PALATE

PALATE

FOLD

REMARKS

NONE

*I

2 3 4

NONE

 

123

1234

I234

I23

1234

I234

123

123

1234

1234

123

123

1234

123

1234

2= SALT

IE

123

123

123

I23

I

12

1234

I23

123

I23

I23

123

123

123

1%

N20N3E

1234

N”fNE

1223

23

N:NE

.

39 SOUR

4=9lTTER

NEUROSIS

YIQRANE

EPILEPSY

LEPROSY

M

M

F

M

M

M

NO

l

n

m

l

*

II

l

:

m

m

I

a

*

m

.

I

.

l

l

ISF

I9

20F

20M

20F

20M

20M

21

21

21

21

21

21

23F

23M

24F

Eli

26F

26F

26M

26M

26M

26M

26M

29M

29

31

33

X4?

35

36F

36

36

43F

43F

44

47F

40

54

58

61

75

M

M

M

M

M

M

M

F

F

M

M

M

M

M

M

F

F

M

NOTE-*

m

I= SWEET

Chart

2.-Taste

peroeption

of

nondenture

wearers.

Of

those patients

tested

who

were

not

per cent had no taste perception

fold

(Chart

2).

Approximately

on the hard

25 per

cent

denture

wearers,

approximately

12

or soft palate or on the mucobuccal

reacted to all

four

taste sensations.

66

STRAIN

The majority

as age increased, taste percepti.on on the soft palate decreased.

however

reacted to sweet, salt, and sour.

It

will

J. Pros.

January,

Den.

1953

also be noted that

SUMMARY

1. Taste,

senses.

as we ordinarily

think

of

it,

is dependent

upon

all

our

2. Without

the sense of smell we have only

salty, sour, and bitter,

our basic tastes, namely,

special

sweet,

3.

In addition,

taste perception

is influenced

by

the

age, health,

attitude,

or hunger of the individual.

 

1.

The sense of touch and temperature

are also closely allied

with

the sense

of taste.

5.

There

wider

distribution

of taste

buds in

the fetus,

infant,

and

children

than

is a much the adult.

in

Our

sense of taste diminishes,

therefore,

as we grow

older.

6.

There is a gradual

shift

of taste from

the tip

of the tongue

to the region

of the circumvallate

papillae.

Our

sense of taste of sweet and salt diminishes,

and

the sour is more pronounced.

 

7.

Complete loss of taste! or ageusia, is known to accompany hysterical

and

other abnormal nervous states. It may be temporary, or, in cases of certain lesions,

the sense of taste may be permanently

destroyed.

S.

The

sense of taste may

interjection

9.

of an outside

or pain

Pressure

stimulus

acting

be interfered

with

such as a denture as a counterirritant

or

or dentures.

even interrupted

by

the

mav

interrupt

the sense of

taste.

10.

Mastication

of food

on the anterior

teeth

of the material

may preclude the actual penetration taste pore.

or

undermastication

or food

in

solution

of food

the

into

\Ve have been unable to find any evidence to substantiate

the contention

that

there are taste buds within

the denture

base area, upper

or lower.

It

is entirely

possible that

in some individuals,

where the denture

has been overextended

onto

the soft palate, taste perception

may be interfered

with

due to the pressure,

pain,

or the actual covering of taste buds in the area.

date, we have not

demonstrated the presence of taste buds this close to the distal border of the

hard palate.

However,

to

1.

Wiggers,

Carl

J. :

Physiology

REFERENCES

in Health

and Disease, ed. 3, Philadelphia,

1939, Lea K-

2. Parker,

Febiger, p. 201.

George IT.:

Smell,

Taste,

and Allied

Senses in the Vertebrates.

Philadelphia,

1922,J. El. Lippincott

Full

3. Schuyler, Clyde H.:

Company, pp. 13-14.

Denture

Service as Iufluenced by Tooth

Forms and Materials,

J. PROS. DEN.

4. Parker. George IX:

1:33-37,19Sl.

Smell, Taste, and Allied

Senses in the Vertebrates,

Philadelphia,

1922,

1:33-37,19Sl. Smell, Taste, and Allied Senses in the Vertebrates, Philadelphia, 1922, J. B. Lippincott Company, p.

J. B. Lippincott

Company, p. 132.

1:33-37,19Sl. Smell, Taste, and Allied Senses in the Vertebrates, Philadelphia, 1922, J. B. Lippincott Company, p.

volulne

Number

2

1 COMPLETE

DENTURES

AND

TASTE

PERCEPTION

67

2

i d.

Ibid., p. 133. Ibid., pp. 111-113. Ibid., pp. 110-111. Ibid., pp. 114-115. Howell, William

H. :

A Textbook of Physiology for Medical Students and Physicians,

1930, W. B. Saunders Company, pp. 2952%.

ed. 11, Philadelphia,

10. Parker, George H. : Smell, Taste, and Allied Senses in the Vertebrates, Philadelphia, 1922,

J. B. Lippincott Company, p. 127.

11. Howell, William H.: A Textbook of Physiology for Medical Students and Physicians, ed. 11, Philadelphia, 1930, W. B. Saunders Company, pp. 297-298.

12. Parker, George H.: Smell, Taste, and Allied Senses in the Vertebrates, Philadelphia, 1922, J. B. Lippincott Company,. p. 134.

13. Starling, Ernest H. : Starling’s Prmciples of Human Physiology, ed. 5, Philadelphia, 1930,Lea & Febiger, pp. 487-489.

14. Greisheimer, Esther M.: Physiology and Anatomy, ed. 3, Philadelphia, 1936, J. B. Lippin- cott Company, p. 310.

15. Spitzka, Edward A. :

Edition

of Gray, Henry:

Anatomy,

Descriptive

and Applied,

Phila-

delphia and New York, 1913, Lea & Febiger, p. 1083.

16. Parker, George H.:

Smell, Taste, and Allied Senses in the Vertebrates, Philadelphia,

1922, J. B. Lippincott Company, pp. 92-100.

17. Mones, Jerome: Jacobson’s Organ-Why Do Full Upper Denture Wearers Experience

Loss of Taste and Smell?

D. Survey 26:185-186, 1950.

of Anatomy,

18. Cunningham, Daniel J. :

Company, p. 999.

Textbook

ed. 3, New York,

1909, William

Wood &

426 17TH ST.

Cunningham, Daniel J. : Company, p. 999. Textbook ed. 3, New York, 1909, William Wood &

OAKLAND,

CALIF.