A Bad Taste in Her Mouth

Content provided by:

Q. My wife has been having a bad taste in her mouth for a few weeks now. She said none of her food tastes good and sometimes she gets a metallic taste in her mouth. Is this a concern and, if so, what is her next step?

A. Your question reminds me of a recent patient visit. Martha told me she felt really bad because her boyfriend took her to a fancy restaurant and "everything tasted the same." Even the chocolate-covered special dessert didn’t have much flavor. It turned out her taste problem was temporary and due to a side effect from a recent medication. Within a week her sense of taste and enjoyment of foods returned to normal.

In general, when a person’s ability to taste is altered, there is a problem with their taste perception and/or sense of smell (olfactory system). Most often it is a temporary nuisance, but sometimes it can be a long-lasting concern. To figure out what is going on with your wife, let’s go over some "tasty" facts.

Your mouth contains around 10,000 taste buds, most of which are located on and around the tiny bumps on your tongue. However, there are others under the tongue, inside the cheeks, on the roof of the mouth, on the lips and even in the back of the throat. Every taste bud detects five primary tastes:

Sour
Sweet
Bitter
Salty
Umami--salts of certain acids (for example, monosodium glutamate or MSG)

All tastes come from a combination of these basic taste sensations.

Your wife is experiencing an altered sense of taste (dysgeusia). This can be disguised as metallic, foul tasting or some other sensation. Since you didn’t provide too much information about her, we will need to do some detective work. If your wife has damaged her taste buds (smoking) or has a vitamin or mineral deficiency (B-12 or zinc), she will have an altered sense of taste. In order for foods to have taste, they must be dissolved in water. So, if your wife has a dry mouth, her ability to taste will be decreased. It’s also important to know there are nerve endings on the tongue that sense irritating or unpleasant sensations located in the nasal region. In your wife’s case, this may be where that metallic sensation is located.

And speaking about the nose, many of us don’t realize that most of what we perceive as taste is really due to our ability to smell. So even if her taste buds are working well, her sense of taste may be impaired if she has a cold, nasal infection, sinusitis, allergic rhinitis (runny nose due to allergies) or nasal polyps. Other common causes of taste abnormalities include but aren’t limited to:

Certain medications (anti-thyroid, zinc preparations, antibiotics, neurologic drugs and others)
Chemotherapy or radiation treatment
Aging (decreased ability to taste and smell)
Medical conditions (Bell’s Palsy, Parkinson’s Disease, diabetes, GERD and others)
Injuries to the mouth, nose or head
Poor oral hygiene
Fungal infections on the tongue or in the mouth area
Head and neck cancers

With that being said, I do feel it is important your wife meets with her health-care team (medical and dental) because her metallic or altered sense of taste has lasted several weeks. These professionals would want to make sure there isn’t a more concerning health problem going on.

Questions that need to be answered prior to her visit include:

How long has the taste problem been going on?
What kind of taste change has occurred?
What medications is she currently, or was recently, taking?
Does she smoke, use recreational drugs or drink alcohol?
When was her last dental visit?
How is her appetite?
Are there any foods that taste normal?
Has there been any recent change in smell?
Any recent injury or illness?
Did she recently change her brand of mouthwash or toothpaste?

Fortunately, the most common causes of altered taste are temporary and easy to treat. For example, if she has a fungal overgrowth due to the recent use of antibiotics, eating yogurt with live cultures every day may help restore the normal bacterial balance in the mouth, resulting in better taste. Hopefully, in a little while, your wife will once again get to enjoy the pleasant tastes of her favorite foods.

Read More About Oral Health on MSN Health & Fitness:

Find all articles by Dr. Rob.

Do you have a health question you'd like to ask Dr. Rob? Send e-mail to experts@microsoft.com. Please include Ask Dr. Rob in the subject line.

Each of our experts responds to one question each week and the responses are posted on Mondays on MSN Health. We regret that we cannot provide a personalized response to every submission.

Robert Danoff, D.O., M.S., is a family physician and program director of The Family Practice Residency, as well as the combined Family Practice/Emergency Medicine Residency programs at Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He is the medical correspondent for CN8, The Comcast Network, a regular contributor to Discovery Health Online and a contributing writer to The New York Times Special Features. (Read his full bio.)