What causes a salty mouth taste?

This question was submitted by a general dentist: In the last month, I have had 3 patients complain of a salty taste in their mouths, what could be the cause? 

Dr. Gary Klasser in collaboration with Dr. Suham Alexander, Oasis Discussions Editor, provided this quick initial response

When introduced in the oral cavity, food interacts chemically with salivary components which, in turn, stimulate taste receptors. These receptors are most commonly found on the superior surface of the tongue as well as the palate and epiglottis, but also occur in tissues like chemosensory cells of the alimentary tract, brain, pancreas and airway epithelium.

Normally, saliva has a high sodium and chloride composition; however, because the amount of salt in saliva remains consistent and taste buds adapt to this, our saliva does not taste salty.

Causes

Taste alterations may be due to CNS pathology, head and/or surgical trauma, middle ear infection. Additionally, an excessively salty taste in the mouth can be attributed to an increase in the saliva salt concentration or to an increased sensitivity of taste buds to salt which in turn may be due to the following reasons:

• Medications side-effects:~400 medications may cause alterations in taste sensation
• Dehydration
• Excessive tears: tears drain through tear ducts inside the nose and can drain into the back of the throat leading to increased salt sensations in the mouth.
• Sinus infection and post-nasal drip: mucus may have a high salt concentration and typically drips into the back of the throat.
• Acid reflux: while acid reflux is mostly responsible for producing a sour or bitter taste in the mouth, it can also be the cause of a salty sensation.
• Diseases of the Salivary Glands: autoimmune diseases, such as Sjogren’s Syndrome
• Periodontal disease: seepage of crevicular fluid into the saliva which has a higher salt concentration than saliva
• Denture adhesives: adhesives flavouring may contribute to an increased salt sensation.

Management

Patients should consult their physicians for advice and to explore whether any prescription medication or over-the-counter medications/herb/ supplements might be responsible for this sensation.

References

1. LeWine H. Causes of Salty Taste in Mouth. Harvard Health Publications; 2009.
2. Sumanth Kumbargere N, Naresh YS, Srinivas K, Renjith George P, Shrestha A, Levenson D, Ferraiolo DM. Interventions for the management of taste disturbances. Cochrane Database Sys Rev. 2013;4 :CD010470 doi: 10.1002/14651858.CD010470. Available: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010470/abstract
3. Lorber M. Salty taste in the mouth. JAMA. 1985;253(6):778

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