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Disorders of smell can be infuriating for the person suffering from them. Phantosmia (detecting a smell which is not present at all) or Parosmia (Alteration in the normal perception of odors) can be unsettling and disorienting as well as dangerous. Imagine a fire breaking out in the house of a person who cannot smell smoke.

The origins of smell disorders can be varied in nature. Some of the things that can potentially be the cause are:

1. Ageing

Normal ageing can play havoc with the normal sensory systems of our body and the sense of smell is no different. Neuron degeneration over a period of time can lead to a reduction in the ability to smell odors or perceive them incorrectly.

2. Head Injury

If the symptoms appear suddenly after a fall or an accident then the possibility of a head injury should be investigated. Our brain is responsible for interpreting the signals received from all over the body and so an injury to the olfactory bulb located near the front of the brain can cause an error in perception of various odors.

Head trauma needs to be dealt with immediately and will require multiple investigations including CT scans and MRI's.

3. Sinus and Upper respiratory tract infections

The presence of inflammation in the respiratory tract or a polyp in the sinuses will affect the ability of the body to detect odors correctly. This can be the reason behind phantosmia or parosmia.

PNS view on radiographs as well as endoscopy will be helpful in the detection of sinus growths. Allergies will also have to investigated as the cause behind inflammation of the upper respiratory tract.

Use of nasal decongestants, removal of the polyps and use of anti histamines should help the normal sense of smell to be regained.

4. Dental Problems

The oral cavity is home to a number of micro-organisms which can turn pathogenic under suitable conditions. Presence of periodntitis in the mouth increases these gram negative organisms which are responsible for producing sulfide like byproducts which cause halitosis, as well as play a role in altering the sensation of smell.

A thorough oral prophylaxis procedure which removes the various niches of gram negative colonies will help resolve the condition.

5. Exposure to chemicals

Exposure to certain elements like Mercury and Lead can have a deleterious effect on the sense of smell. In fact, this may be the first sign of a wider systemic exposure.

The use of these elements is highly restricted especially among products that are ingested or brought in contact with the skin, however extremely high levels are found in areas where vehicular pollutions is uncontrolled.

These elements combine with the cells in the body forming complexes that are difficult to remove. A thin bluish blackish line can appear on the gums and is considered to be a pathognomic sign of poisoning with these elements.

Ingestion of milk which chelates with the elements is advisable. Severe cases may require hospitalization as well.

6. Medications

Some antibiotics and antihistamine medication can cause the antibiotic class which does not have this effect.

The sense of smell will return to normal as the antibiotic concentration is reduced in the body.

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