Burning Tongue and Taste Alteration in Xerostomic Undiagnosed Diabetic Patients with Vitamin D Deficiency.

Abstract

Background: Silent diabetes and vitamin D deficiency are difficult to identify because the individual may not even realize they have one. Xerostomia-related burning tongue and taste changes may indicate a systemic condition such as diabetes or vitamin D deficiency.

Purpose: This case report analyzes the association between diabetes, vitamin D deficiencies, and xerostomia.

Case presentation: A 44-year-old female patient complained of having a burning tongue and had lost taste for a week. Routine blood tests and assessments of the Oral Health Impact Profile-14 (OHIP-14) and Depression Anxiety Stress Scale-21 (DASS-21) showed normal results.

Case management: Therapy consists of chlorine dioxide zinc-patented mouthwash, multivitamin, petroleum jelly, and oral hygiene instructions. The symptoms decreased significantly on the second visit, but taste perception did not improve. Another complaint was that the mouth felt dry. The results of the Summated Xerostomia Inventory-Indonesian Version (SXI-ID) and Clinical Oral Dryness Scoring System (CODS) examination showed the patient had mild xerostomia and the unstimulated salivary flow rate was lower than normal. Therapy consists of applying ethyl p-hydroxybenzoate gel, neurotropic vitamins, and blood tests for Hemoglobin A1c (HbA1c) and vitamin D 25 (OH) were advised for further evaluation would be more clear. The third visit showed there were no more complaints of dry mouth, and the taste perception was getting normal. The Unstimulated salivary flow rate and CODS were normal. The patient was diagnosed with diabetes and vitamin D deficiency based on the HbA1c examination results of 11% and vitamin D 25 (OH) of 12.5 ng/mL.

Conclusion: Xerostomia can indicate systemic conditions like diabetes and vitamin D deficiency. A comprehensive examination is carried out so the patient can receive optimal treatment.