Orthodontic Fixed Appliances' Impact on Taste Perception Among Orthodontic Patients: A Prospective Cohort Study

Orthodontic treatment has become the most common therapy among dental treatment seekers, with wide-ranging implications for oral health and overall quality of life. Malocclusion, if left untreated, can lead to various functional and aesthetic issues, including chewing difficulty, speech problems, increased risk of caries, and compromised facial aesthetics, which can significantly impact an individual's quality of life. In addition, the aesthetic impact of malocclusion can affect individuals' self-esteem, social interactions, and psychological well-being. So, malocclusion and correction of the same have become a priority. The prevalence of malocclusion varies among different populations and geographical regions. Factors such as genetics, ethnicity, and environmental influences contribute to these variations. In Saudi Arabia, malocclusion prevalence is significantly high, with crowding of teeth being the most common type, followed by teeth spacing, along with excessive overjet and overbite. Conventional fixed orthodontic treatment, involving brackets and wires, is a widely accepted approach to correct malocclusions. This treatment modality aims to move the teeth into proper alignment, correct bite discrepancies, and achieve optimal occlusion. Moreover, it has long been recognized as a highly effective treatment approach for correcting malocclusion.

In orthodontic therapy, much attention is devoted to the alignment and aesthetics of teeth. However, one aspect that often goes overlooked is the potential alteration of taste perception. According to Bernabé (2008), orthodontically treated patients with fixed appliances reported food intake difficulties. In addition, placing these appliances in the mouth may interfere with or alter the sense of taste. Proper perception of taste, as one of the most important sensual sensations, contributes significantly to human well-being, both in the physical and mental senses, which is a health condition as defined by the WHO. Impaired perception of taste stimuli may occur as a result of a foreign body placement such as placement of the orthodontic material in the oral cavity. Therefore, from a clinical point of view, evaluating the relationship between using fixed orthodontic appliances and its impact on the sense of taste is of greater importance. Taste perception or gustation is a multisensory experience that helps in the sensory recognition of food on the tongue and plays a fundamental role in determining the flavors of foods. In humans, the sensation of taste can be categorized as salty, sour, bitter, sweet, and umami. Alteration or loss of gustation may arise due to a wide range of systemic or acute clinical conditions or medications. Therefore, testing this alteration or loss of taste sensation has become a common mode. One of the simple assessments of taste senses is by using the taste strips as described by Mueller and colleagues. These strips are composed of filter paper and soaked with different taste solutions. A review of the literature to date on taste perception has yielded only a few reports. Further, no reports have been published regarding the altered taste perception and flavor after fixed orthodontic treatment. Thus, this study aims to evaluate changes in taste perception after conventional fixed orthodontic appliance treatment. The outcome of this investigation on the alterations in taste perception and exploring the potential mechanisms will deepen our understanding of the comprehensive effects of orthodontic treatment and enhance patient satisfaction and quality of life.

Most studies in the literature have evaluated the changes in taste sensation using removable orthodontic appliances. Yet, studies on conventional fixed appliances are insufficient. Two studies analyzed taste alterations using removable orthodontic appliances, showing no significant difference in taste perception between patients with and without orthodontic appliances. These findings could be attributed to their short duration of wear, ease of removal, and the fact that appliances could be kept outside the mouth during meals. Wilczyska et al. (2011) conducted the sole study investigating palatal fixed auxiliary appliances' impact on taste perception. They have reported that the identification and perception of different taste sensations and the duration of a taste stimuli reaction were not affected by these appliances. Hence, there was no evidence that the studied orthodontic devices had impaired taste abilities. Another study by Razdan et al. (2017) has shown that there was a transient change in taste perception during the use of removable orthodontic appliances, but this change did not significantly affect taste stimuli.

Nevertheless, there was one study that examined the discomfort experienced by patients with conventional fixed orthodontic appliances, and the results of the study indicated a significant relationship between orthodontic fixed appliances and taste impairment. Overall, it is clear from the review that there is a conflicting report on the effect of orthodontic appliances on the perception of taste. Therefore, the present study is aimed at assessing changes in taste perception after conventional fixed orthodontic appliance treatment.

This proposal aims to shed light on this intriguing phenomenon and its implications for orthodontic care. By investigating the alterations in taste perception and exploring potential mechanisms behind these changes, we can deepen our understanding of the comprehensive effects of orthodontic treatment and enhance patient satisfaction and quality of life.