Clinical and gustatory features in taste disorder patients based on oral Candida culture status

To investigate the clinical, gustatory, salivary, psychological, and laboratory features of patients with taste disturbances, stratified by burning mouth syndrome (BMS) and Candida status, and to determine the contribution of oral Candida status independent of BMS subtype. This retrospective study analyzed 141 patients with taste disturbances, classified into six groups based on burning mouth symptoms and oral Candida culture status: primary BMS, secondary BMS, and non-BMS patients, each subdivided by Candida status. To evaluate the independent role of Candida, positive Candida culture was not considered a local factor in defining secondary BMS. Clinical characteristics, taste test results, whole salivary flow rates, psychological profiles, and blood laboratory parameters were compared across groups, with age-matching applied when groups differed in age. In the primary BMS, Candida-positive patients showed no normogeusia and had significantly lower objective taste scores after age-matching. Stimulated whole salivary flow rates were significantly reduced in Candida-positive patients with primary BMS and in those without burning mouth symptoms. Psychological distress was more pronounced in the Candida-positive subgroups within the primary BMS and in overall BMS groups. A positive oral Candida culture is not universally associated with impaired taste but is associated with gustatory deficits, hyposalivation, and psychological stress in specific subgroups, particularly primary BMS. A positive oral Candida culture may aggravate oral symptoms and psychological distress in patients with BMS, particularly those with primary BMS. Recognizing Candida as an independent variable could improve etiology-based diagnosis and tailored management of taste-related complaints.