OBJECTIVE: To explore the association between periodontitis and olfactory disorders.
METHODS: Clinical data were collected from 198 individuals between the ages of 18 and 60 years living in Denmark. The exposure was periodontitis, and the outcome was olfactory function (Threshold, Discrimination, Identification - TDI score), both measured clinically. Covariates included sex, age, education level, income, usage of nasal spray, tongue coating, halitosis, xerostomia, smoking, and history of COVID-19. Structural equation modeling was used to estimate the association between periodontitis and olfactory function. Periodontitis was defined using the AAP/EFP classification and dichotomized into \"no\" (healthy subjects) and \"yes\" (Stages I, II, and III). Olfactory function was treated as a one-factor latent variable, including the different olfactory scores. In addition, extra models were performed considering each olfactory component as a separate outcome and the TDI Global Score.
RESULTS: The results showed that periodontitis was associated with a lower olfactory function [standardized coefficient (SC) -0.264, 95% CI -0.401, -0.118]. Additionally, periodontitis was also associated with a lower olfactory Threshold (odorant concentration required for detection) (SC -0.207, 95% CI -0.325, -0.089), Discrimination (ability to discriminate between odorants) (SC -0.149, 95% CI -0.270, -0.027), Identification (ability to identify odorants) scores (SC -0.161, 95% CI -0.277, -0.045), and TDI Global Score (SC -0.234, 95% CI -0.370, -0.099).
CONCLUSIONS: This study suggests that periodontitis is associated with olfactory impairment.

UNASSIGNED: To share a single institutional experience with clinical research on COVID-related olfactory dysfunction (OD).
UNASSIGNED: Narrative review of published original data and ongoing clinical trials on COVID-related OD at Washington University from 2020 to 2023.
UNASSIGNED: There were three new diagnostic-/patient-reported outcome measures developed and tested. We report five clinical trials of interventions for COVID-related olfactory disorders: combined Visual-Olfactory Training (VOLT) with patient-preferred scents versus standard olfactory training (VOLT trial), oral gabapentin versus placebo (Gabapentin for the Relief of Acquired Chemosensory Experience trial), nasal theophylline irrigations versus placebo (Smell Changes and Efficacy of Nasal Theophylline trial), stellate ganglion block (single-arm), and mindfulness-based stress reduction (MBSR) versus lifestyle intervention (MBSR trial).
UNASSIGNED: Initial intervention trials for COVID-related OD have shown potential for improving subjective and objective olfactory outcomes. However, there remains no gold standard treatment that definitively outperforms placebo in controlled trials. Therefore, continued investigation of novel therapeutic strategies for COVID-related OD is necessary to maximize olfactory outcomes for affected patients.

World-wide some 658 million people were infected with coronavirus disease 2019 (COVID-19) and millions suffer from chemosensory impairment associated with long COVID. Current treatments for taste and smell disorders are limited. Involving patients has the potential to catalyze the dynamic exchange and development of new ideas and approaches to facilitate biomedical research and therapeutics. We assessed patients\' perceptions of the efficacy of treatments for chemosensory impairment using an online questionnaire completed by 5,815 people in the US Logistic regression determined variables predictive of reported treatment efficacy for patients aged 18 to 24, 25 to 39, 40 to 60, and 60+ yrs. who were treated with nasal steroids, oral steroids, zinc, nasal rinse, smell training, theophylline, platelet-rich plasma, and Omega 3. The most consistent predictor was age, with the majority of those 40 to 60 and 60+ reporting that nasal steroids, oral steroids, zinc, nasal rinse, and smell training were only slightly effective or not effective at all. Many of these treatment strategies target regeneration and immune response, processes compromised by age. Only those under 40 reported more than slight efficacy of steroids or smell training. Findings emphasize the need to include patients of all ages in clinical trials. Older adults with olfactory impairment are at increased risk for Alzheimer\'s disease (AD). We speculate that olfactory impairment associated with long COVID introduces the potential for a significant rise in AD. Long COVID-associated chemosensory impairment increases the urgency for translational and clinical research on novel treatment strategies. Suggestions for high-priority areas for epidemiological, basic, and clinical research on chemosensory impairment follow.

OBJECTIVE: To explore the association between oral conditions and their interaction with salt taste disability among American adults.
METHODS: Data from the 2013-2014 NHANES cycle were used (n = 2373). The exposures were periodontitis, defined by the 2017 EFP-AAP classification, dental caries, missing teeth, and edentulism, as per the DMF-T index, and xerostomia. The outcome was salt taste disability, objectively assessed. Covariates included sex, age, educational level, poverty index, obesity, diabetes, smoking, alcohol consumption, and medications related to mouth dryness. Weighted multivariable logistic regression modeling was used to evaluate the relationship between oral conditions and their interaction and salt taste disability.
RESULTS: Participants who reported xerostomia were more likely to have salt taste disability (OR 2.42; 95%CI 1.44-4.07), especially those older than 60 years (OR 3.63; 95%CI 1.72-7.63). Among participants aged 40-59, xerostomia increased the chance of salt taste disability; however, the confidence interval included the null value. The interactions between xerostomia and edentulism increased the chance of salt taste disability.
CONCLUSIONS: Oral conditions seem to influence the ability to taste salt. Dental professionals may help identify individuals with taste alterations and raise their awareness of the risk of systemic diseases that require the reduction of salt intake.

Chemosensory disorders (including smell, taste and chemesthesis) are among the established symptoms of COVID-19 infection; however, new data indicate that the changes in chemosensory sensation caused by COVID-19 may differ among populations and COVID-19 variants. To date, few studies have focused on the influence of the SARS-CoV-2 Omicron variant on qualitative changes and quantitative reductions in chemosensory function in China. We conducted a cross-sectional study of patients with COVID-19 caused by the Omicron variant, to investigate the prevalence of chemosensory disorders and chemosensory function before and during infection, using an online questionnaire. A total of 1245 patients with COVID-19 completed the survey. The prevalence rates of smell, taste, and chemesthesis disorders were 69.2%, 67.7%, and 31.4%, respectively. Our data indicate that sex, age, smoking, and COVID-19-related symptoms, such as lack of appetite, dyspnea, and fatigue, may be associated with chemosensory disorders during COVID-19. Self-rating of chemosensory function revealed that patients experienced a general decline in smell, taste, and chemesthesis function. Further longitudinal research studies are needed to generate additional data based on objective assessment and investigate the factors influencing chemosensory function in COVID-19.

To investigate the association between self-reported periodontitis and the senses of taste and smell among employees of one Danish and two American universities.
Data were collected through a digital survey. A total of 1239 individuals from Aarhus University - Denmark, the University of Iowa, and the University of Florida - USA were included. Self-reported periodontitis was the exposure. The perceived senses of taste and smell were the outcomes and were measured through a visual analog scale (VAS). Self-perceived halitosis was the mediator. Confounders were age, sex, income, education, xerostomia, COVID-19, smoking, body mass index, and diabetes. The total effect was decomposed into direct and indirect using a counterfactual approach.
The total effect of periodontitis on an impaired sense of taste was OR 1.56 (95% CI [1.02, 2.09]), of which 23% was mediated by halitosis (OR 1.13; 95% CI [1.03, 1.22]). Additionally, individuals with self-reported periodontitis had a 53% higher chance of having impaired smell (OR 1.53; 95% CI [1.00, 2.04]), with halitosis mediating 21% of the total effect (OR 1.11; 95% CI [1.02, 1.20]).
Our findings suggest that periodontitis is associated with distorted senses of taste and smell. Additionally, this association appears to be mediated by halitosis.

The COVID-19 pandemic caused by SARS-CoV-2 virus quickly spread globally, infecting over half a billion individuals, and killing over 6 million*. One of the more unusual symptoms was patients\' complaints of sudden loss of smell and/or taste, a symptom that has become more apparent as the virus mutated into different variants. Anosmia and ageusia, the loss of smell and taste, respectively, seem to be transient for some individuals, but for others persists even after recovery from the infection. Causes for COVID-19-associated chemosensory loss have undergone several hypotheses. These include non-functional or destroyed olfactory neurons and gustatory receptors or of their supporting cells, disruption of the signaling protein Neuropilin-1, and disruption in the interaction with semaphorins, key molecules in the gustatory and olfactory axon guidance. The current paper will review these hypotheses and chart out potential therapeutic avenues.

BACKGROUND: Chemosensory disorders associated with COVID-19 have been widely discussed during the pandemic. We performed a meta-analysis to assess the risk factors for olfactory and gustatory dysfunction in patients with COVID-19.
METHODS: Three databases (PubMed, Embase, and Cochrane Library) were searched for studies published between December 1, 2019, and August 31, 2021. We selected random-effects model or fixed-effects model to pool data based on heterogeneity. The results were reported as odds ratios (ORs) or standardized mean differences (SMDs) and the corresponding 95% confidence intervals (CIs). Heterogeneity was reported as I2.
RESULTS: Twenty-six studies with a total of 13,813 patients were included. The pooled data indicated that sex (OR 1.47; 95% CI 0.93-2.31), age (SMD -5.80; 95% CI -13.35 to 1.75), smoking (OR 2.04; 95% CI 0.72-5.79), and comorbidity (OR 1.21; 95% CI 0.58-2.53) of patients with COVID-19 had no effect on gustatory dysfunction. Olfactory dysfunction was more likely to occur in older patients with COVID-19 (SMD, -5.22; 95% CI, -8.28 to -2.16). Patients with COVID-19 with nasal congestion (OR 3.41; 95% CI 2.30-5.06) and rhinorrhea (OR 2.35; 95% CI 1.60-3.45) were more prone to olfactory dysfunction.
CONCLUSIONS: These findings emphasize that older patients with COVID-19 are more likely to experience olfactory dysfunction. Symptoms of nasal congestion and rhinorrhea may affect the recognition of olfactory dysfunction.

Chemosensory disorders (CSD) such as disorders of taste and smell are one of the causes of malnutrition in cancer patients. The aim of the research was to evaluate the influence of CSD on taste preferences in cancer patients receiving oral nutritional supplements (ONS). Material and methods. The procedure involves 100 oncological patients (26 men, 74 women; 57.0±1.2 years old). The taste preferences in these patients were assessed using a digital rating scale during ONS. All patients had cancer outside the head and neck area and underwent specific treatment. The functional status on the ECOG scale was 0-II. All patients had indications for DPP (ESMO scale >2 points). Patients were offered a mixture of sweet (banana, coffee, vanilla) and unsweetened (vegetable, chicken soup) tastes in a disposable 30 ml container. The patient was asked to take a sip and evaluate the smell, taste, strength of taste and density (consistency) of the sample on a digital rating scale from 0 to 5 points, where 0 - I do not feel, 5 - I feel excellent. The maximum possible number of points for each sample was 20. Results. Signs of CSD (score <10) were detected in 69% of patients [95% confidence interval (CI) 59.5-77.7]. In this group, the frequency of choosing unsweetened tastes for ONS was 59.4% (95% CI 47.5-70.8), sweet - 40.6% (95% CI 29.2-52.5). In the group of patients without signs of CSD, the frequency of choosing savory tastes was 29.0% (95% CI 14.1-46.7), sweet - 71.0% (95% CI 53.3-85.9) (р=0.0049). Conclusion. The presence of CSD significantly affects the taste preferences of cancer patients and significantly increases the likelihood of choosing products for ONS with unsweetened taste (unsweetened foods).

OBJECTIVE: Neuropathic orofacial pain disorders are frequently managed with topical or systemic medications that carry a risk of dangerous side effects such as drowsiness, disorientation, and/or physical addiction. The aim of this paper is to report the use of neurosensory oral appliances as a safe means of providing symptomatic relief for neuropathic orofacial pain.
METHODS: This is a retrospective chart review of patients with diagnoses of persistent idiopathic facial pain (PIFP), painful post-traumatic trigeminal neuropathy (PTTN), or an oral dysesthesia, who utilized neurosensory appliances with or without the use of topical anesthetic gel.
RESULTS: Eleven patients were identified. Eight patients (62.5%) found benefit with the neurosensory appliance alone, and three patients (37.5%) found relief with the addition of lidocaine 2% gel. All patients reported >50% resolution of their symptoms, with three (37.5%) reporting complete resolution. Seven patients maintained follow-up ≥3 months, with efficacy lasting for a range of at least 3-8 months.
CONCLUSIONS: Oral neurosensory appliances, whether used alone as a physical barrier or as a vehicle to deliver topical anesthetic, represent a safe and effective modality for the management of neuropathic orofacial pain disorders. Additional studies are needed to assess long-term efficacy.