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Frequently Asked Questions
1. What is our sense of smell?
Our sense of smell is the ability to detect odors in our
environment, like the fragrance of flowers or the smell of
baking bread. Smell is also the ability to detect food odors
released in our mouths when we eat, which then flow from the
throat to the nose. Smell is part of our chemical sensing
system, or the "chemo senses."
2. Why is smell important?
Smell is important because it lets us fully enjoy scents and
fragrances, and contributes greatly to our enjoyment of food
and beverages. But, even more important, smell can be a
warning sign that something is wrong in our environment. Smell
helps us to know when food is spoiled or if there is a gas
leak.
3. Do people confuse smell problems with taste problems?
Yes. Many people mistakenly think they have a problem with
taste, when what they are really experiencing is a problem
with smell. It is common for people who lose their sense of
smell to think that food has lost its taste. This is usually
not the case. The food has lost its aroma, but tastes, such as
sweet, salty, sour, and bitter, remain.
4. How common are problems with our sense of smell?
Roughly 200,000 people each year visit a doctor for either a
smell or taste problem. Thirty percent of older Americans
between the ages of 70 and 80 have a problem with their sense
of smell. Two out of three people over the age of 80 have a
problem with their sense of smell, with men affected more
often than women.
Some studies estimate that more than two million people in the
United States have problems with smell and taste. The number
may be much higher, because many cases are not reported.
5. What impact can loss of smell have on an older person's
life?
Older people who have lost their sense of smell may eat too
much or eat too little. In severe cases, loss of smell can
lead to depression. Although problems with smell are rarely
life-threatening, loss of smell can be dangerous. Identifying
smells is your brain's way of providing you with information
about your environment and keeping you safe.
6. How does normal smell occur?
Normal smell occurs when the odors around us release
microscopic molecules into the environment that stimulate
small nerve cells, called olfactory cells, and located high up
in the nose. Once the cells detect the molecules, they send
messages to our brains, where we identify the smell.
7. How do I know if I have a problem with my sense of smell?
There are several types of smell disorders depending on how
the sense of smell is affected. If you have a smell disorder,
you may experience a decrease in your ability to smell or
changes in the way you perceive odors. Or you may not be able
to detect any odor at all.
Sometimes, familiar odors may become distorted, or an odor
that usually smells pleasant instead smells foul. Some people
with smell disorders perceive a phantom smell or a smell that
isn't there at all.
8. What are some of the common causes of smell disorders?
Most people who have a problem with smell have recently had an
illness or injury. The most common causes are upper
respiratory infections, such as the common cold, and chronic
sinus or nasal disease. Other common causes are head injuries
and exposure to toxic chemicals.
Nasal polyps can block the ability of aromas to reach nerve
cells. People with head and neck cancers who receive radiation
treatment to the nasal area can also experience problems with
smell.
9. Can I do anything to prevent a smell disorder from
occurring?
Problems with smell that occur with aging are not preventable.
Loss of smell caused by respiratory infections and colds can
be prevented by washing your hands frequently, especially
during the winter months.
If your smell disorder is caused by allergies, you should
avoid allergens, like ragweed, grasses, and pet dander.
Quitting smoking also may improve smell and prevent loss of
smell.
10. Can certain medicines cause a problem with smell?
In rare cases, certain medicines may cause a change in your
ability to smell. Antibiotics and blood pressure pills are
among the most common medications that cause a problem with
smell. If you are taking these medications and notice a change
in your sense of smell, talk to your doctor. You may be able
to adjust or change your medicine to one that will not cause a
problem with smell.
Sometimes it is difficult to determine if the problem with
smell is caused by medication or the underlying condition.
11. Are there certain medical conditions and/or diseases that
are associated with smell disorders?
Sometimes a problem with smell can be a sign of a more serious
health problem, such as a disease of the nervous system, like
Parkinson's disease, Alzheimer's disease, or multiple
sclerosis. In rare cases, it can be a sign of a brain tumor.
Malnutrition and diabetes also can be accompanied or signaled
by chemosensory problems, like smell disorders.
12. Can a person completely lose their sense of smell?
In rare instances, a person can be born without the ability to
smell. In other cases, total loss of smell is usually caused
by nasal and sinus disease or head injury. If the nerves
involved in the sense of smell are severed, either by trauma
or surgery, complete loss of smell will occur.
13. Can losing your sense of smell be serious?
Losing smell can be more than a quality-of-life issue. Loss of
smell deprives us of an early warning system that most of us
take for granted. Smell helps us detect spoiled food and
beverages. It also alerts us to the smoke of a fire, the odor
of dangerous fumes, or a gas leak.
Loss of smell can also be a first sign of a more serious
condition or disease. In some cases, especially in older
people, loss of smell can interfere with normal eating
patterns, causing us to eat too much or too little, and may
even lead to depression.
14. How is smell disorders diagnosed?
Scientists have developed tests to determine the nature and
extent of a person's smell disorder. Tests measure the
smallest amount of odor patients can detect as well as their
accuracy in identifying different smells.
An easily administered "scratch and sniff" test allows a
person to scratch pieces of paper treated to release different
odors, sniff them, and try to identify each odor from a list
of possibilities. In this way, doctors can easily determine
whether a person has hyposmia, a decreased ability to smell,
anosmia, the inability to detect any odors, or another kind of
smell disorder.
15. Can smell disorders be treated?
Depending on the cause of your smell disorder, your doctor may
be able to treat your problem or suggest ways to cope with it.
If a certain medication is the cause of the disorder, stopping
or changing the medicine may eliminate the problem.
Some patients with respiratory infections or allergies regain
their sense of smell when the illness or condition is over.
Often, correcting a general medical problem also can restore
the sense of smell.
For patients with nasal obstructions, such as polyps, or other
inflammatory conditions of the nose or sinuses, medical
treatments or surgery can restore the sense of smell.
Occasionally, the sense of smell returns to normal on its own,
without any treatment.
16. What can I do if my medication is causing me to have a
problem with my sense of smell?
See your doctor and ask if your medicine could be causing your
problem with smell. Some medicines, like antibiotics and high
blood pressure pills, are more likely to cause problems. Your
doctor may be able to adjust your medicine or change your
medicine. If not, he or she may suggest ways to manage your
problem.
Do not stop taking your medicine unless directed by your
doctor. To reduce unwanted side effects, your doctor may try
to find a new medicine for you or reduce the dose of your
medicine.
17. What should I do if I think I have a problem with my sense
of smell?
The best thing you can do is see your doctor. Proper diagnosis
by a trained professional, such as an otolaryngologist, is
important. These physicians specialize in disorders of the
head and neck, especially those related to the ear, nose, and
throat. Diagnosis may lead to an effective treatment of the
underlying cause of your smell disorder.
Many types of smell disorders are curable, and for those that
are not, counseling is available to help you cope.
18. How can I best talk to my doctor about my problem with
smell?
You can help your doctor make a diagnosis by writing down
important information about your problem beforehand and giving
the information to your doctor during your visit.
Write down answers to the following questions:
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When did
I first become aware of the problem?
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Did I
have the cold or the flu?
Write down answers to these questions:
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Did I
have a head injury?
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Was I
exposed to air pollutants, pollens, danders, or dust to
which I might be allergic?
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Is this
a recurring problem?
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Does it
come at any special time, like during the hay fever season?
19. What research is being done on smell disorders?
The National Institute on Deafness and Other Communication
Disorders supports basic and clinical studies of smell
disorders. Scientists are working to understand more about the
sense of smell so that new treatments can be developed to help
restore the sense of smell to those who have lost it.
Scientists are finding out more about how our sense of smell
works and how we detect and smell the many different compounds
that form odors. These findings are helping scientists study
the sense of smell as a model for other sensory systems in the
body.
Scientists have also found that the loss of smell affects the
choices an older person makes about eating certain foods. They
are looking at how and why this takes place in order to
develop more effective ways to help older people -- especially
those with chronic illnesses -- cope better with problems with
smell.
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