Gustatory Changes Following Mandibular Third Molar Surgery: A Systematic Review of the Literature

Research Article

J Dent & Oral Disord. 2019; 5(2): 1114.

Gustatory Changes Following Mandibular Third Molar Surgery: A Systematic Review of the Literature

Al-Samman AA*, Al-Nuaime OS and Yaseen YA

Department of Oral Surgery, The Left Specialized Dental Centre, Ninavah Health Directorate, Ministry of Health, Iraq

*Corresponding author: Abdurrahman A. Al- Samman, Department of Oral Surgery, The Left Specialized Dental Centre, Ninavah Health Directorate, Ministry of Health, Iraq

Received: June 12, 2019; Accepted: July 19, 2019; Published: July 26, 2019


The purpose of this study was to systematically review studies to measure the incidence of gustatory changes because of LN damage following Mandibular Third Molar (M3M) removal. A computerized search of the several databases and references cited in the various studies was performed to identify eligible articles. The primary predictor variable was taste changes after M3M surgery. Five published studies acceptable for detailed analysis according to predetermined inclusion and exclusion criteria. In the 5 selected articles, incidence of gustatory changes were 0-38.3%, and 2.9% of the pooled studies. Taste disturbance as a result LN deficit in M3m surgery in not uncommon complication especially in patients with high difficulty index score.

Keywords: Wisdom tooth surgery; Taste disturbance; Gustatory deficit; Neuro-sensory deficit


The removal of mandibular third molars (M3M) is the most common surgical procedure associated with Lingual Nerve (LN) damage [1,2].

LN is anatomically related to third molar area; within the periosteum in the lingual or distal side of third molar; that makes it at risk when lingual flap is reflected [3], lingual flap retractor is used [4], and/or when tooth extracted using lingual split technique [5]. Moreover, the anatomic variation on LN and the fact that panoramic radiography cannot preoperatively predicts of LN injury [6], the surgeon is often not able to avoid this complication.

LN injury may result in a variety of neurosensory deficits like anesthesia, paresthesia, dysesthesia, hypoesthesia and/or a change in taste perception of food and drink (hypogeusia or ageusia [7,8]. It is very disabling complication causing many problems for patients like tongue biting, drooling, burns from hot food and drinks, and a burning sensation of the tongue [7].

This systematic review aimed to identify all available relevant studies in the literature related to gustatory changes because of LN damage in M3M surgery, and to determine the incidence and time course of these changes.

Materials and Methods

Electronic search, including PubMed, Scopus, and the Cochrane Library were performed. In addition; the online databases of the Journal of Oral and Maxillofacial Surgery; International Journal of Oral and Maxillofacial Surgery; British Journal of Oral and Maxillofacial Surgery; Oral Surgery; Oral Medicine; Oral Pathology; Oral Radiology as well. Search performed for all years available up until 10/July/2018. Only articles published in English were included. The following key words/terms were used in search: third molar or wisdom tooth combined with paresthesia, dysesthesia, taste, gustatory function, neurosensory deficit, neurosensory disturbance and sensory nerve impairment.

pThe authors carried out the search individually. The abstract of each article was viewed and the full text was downloaded if it was considered relevant to the inclusion criteria of the study:

1. Articles relevant to lingual nerve deficit caused by M3M surgery;

2. Articles list the gustatory deficit that the subjects experienced based on clinical objective taste testing.

3. Articles must be randomized clinical trials, controlled clinical trials, or prospective clinical studies.

4. Studies were also selected if contain data of interest among other findings.

A second-round search was carried out using the references of all included articles that met the inclusion criteria. Any disagreement between authors solved by consensus.

Due to a limited number of studies, and the considerable differences in study design, it was not possible to determine the risk of bias of included studies.

Then, the variable of interest in the results of all selected studies were analyzed as ‘‘mixed group’’ of studies to assess taste deficits among patients undergoing M3M extraction.


A computer searches resulted in 191 potentially relevant articles. A review of the reference lists in these articles yielded another 23 articles, giving a total of 214 articles.

In the first round of evaluation, 206 article were excluded from the study: eighty-two articles only assessed paresthesia and/or dysesthesia of LN. Twenty-five articles were review, case reports, case-series, and technical notes. Twenty-five articles related to mental/inferior alveolar nerve deficit. Twenty-three duplicated articles. Twenty-one articles not related to wisdom tooth surgery. Eleven articles published in non-English language. Seven articles assessed taste function of LN after repair surgery or maxillofacial trauma. Abstract not available in six articles. Five articles were letter to editor, and one animal study.

Only eight articles considered eligible and passed through the second round of evaluation. In this round, three articles were excluded; two retrospective studies [9,10] evaluated taste function in subjective way, and correlate patients with taste deficits with neurosensory dysfunction. Another article11 assessed taste function subjectively 3-12 months after surgery.

Five studied were suitable for final review [12-16]. One of the selected studies were randomized clinical trials and 4 were prospective clinical studies (Figure 1, Table 1).

Citation:Al-Samman AA, Al-Nuaime OS and Yaseen YA. Gustatory Changes Following Mandibular Third Molar Surgery: A Systematic Review of the Literature. J Dent & Oral Disord. 2019; 5(2): 1114.