Taste and oral conditions in patients submitted to bone marrow transplantation

Author(s)

Camila Cominato Boer

• Document type: Master's Dissertation
• Press: Campinas, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas
• Defense date: 2009-09-10

Examining board members

Carmino Antonio de Souza; Fabio de Abreu Alves; Francisco Jose Penteado Aranha

• Advisor: Carmino Antonio de Souza

Abstract

Patients submitted to allogeneic Hematopoietic stem cell transplantation (HSCT) complain of loss or a change in taste perception and dry mouth. The aim of this study was to evaluate taste perception and salivary flow rate in three different groups of adults patients submitted to HSCT at the BMT Unit/UNICAMP. Patients were classified in three groups considering post-transplant timing. Group I (n= 20), up to 150 days after HSCT, Group II (n= 20), between 151-1094 days, and Group III (n= 21), above 1094 days. Taste acuity was measured with a questionnaire, and also by the taste thresholds for the four basic tastes using 5ml of 4 solutions, in 3 concentrations NaCl, sucrose, citric acid, caffeine. Hyposalivation was clinically evaluated by visual parameters, and, unstimulated saliva was collected. Statistical analysis was performed using parametric and non-parametric tests. From those 61 evaluated patients, 31 presented cGVHD (Graft Versus Host Disease) and oral cGVHD was more presented in Groups II/III. Oral health Results showed a median value of DMFT index was 22±7.94 and the median value of IP and IG indexes were respectively, 1.0±0.63 e 0.75±0.50. From the 61 patients 43 (89.58%), were regularly taking prescribed medications with a recognized influence on taste perception, especially those from grupo I. At the survey, 15 (24.6%) reported a subjective increase of taste perception, whereas 22 patients (36.1%), described a decrease in taste perception after HSCT. Those taste sensitivity's alterations were correlated to the presence of nausea (p= 0.03), changes in olfaction (p= 0.05), abnormal taste in oral cavity (p= 0.03) and to the use of drugs (p= 0.03). Results of taste thresholds showed that the sour and bitter perception was not different between the 3 groups. For the sweet solution, the high and low concentrations were a challenging to be determined for those patients. Perception for a medium concentration of salty solutions was better perceived by groups II and III (p= 0.08). None patients were sensitive for the low concentration of bitter solution (p=0.05), in any period of study. Salivary clinical evaluation showed that, 42 (68.9%) patients presented adherence of a wood spatula to the buccal mucosa, 35 (57.4%) absence of the sublingual lake, 26 (42.6%) mucous saliva and 26 (42.6%) lack of salivation on palpation of the Parotid's ducts. Those conditions were correlated to oral cGVHD and to the patients complain of xerostomia (p= 0.02). The saliva flow rate was diminished in 10/61 patients in all periods (1.36 (0.01-1.35- SD 0.296) and hyposalivation was more intense in the Groups II/III (p= 0.007). The results indicate that, taste alterations were only observed for the sweet and salty tastes even in patients up to 3 years post-HSCT. These results may indicate that taste alterations post-HSCT are not correlated to oral health, cGVHD and to hyposalivation but may be considered as an individual response of the HSCT. (AU)

• FAPESP's process: 08/01847-9 - TASTE DISORDERS AND ORAL CLINIC EVALUATION IN PATIENTS SUBMITTED TO ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION.
• Grantee: Camila Cominato Boer
• Support Opportunities: Scholarships in Brazil - Master