Self-Administered Taste Testing Without Water: Normative Data for the 53-Item WETT

CLINICAL QUESTION

Can a practical, self-administered taste test provide reliable normative data for assessing gustatory function across age and sex?

BOTTOM LINE

The 53-item Waterless Empirical Taste Test (WETT) provides validated age- and sex-adjusted normative data from more than 1,300 healthy individuals. Scores decline steadily with age beginning in the 30s and are higher in women, especially between ages 40 and 70. This liquid-free test offers clinicians a practical tool for quantitative taste assessment.

BACKGROUND: More than 20 million Americans report chronic taste problems, yet taste testing is rarely performed in practice. Self-reports are unreliable, and “taste” is often conflated with smell. Unlike olfaction, validated self-administered taste tests have been lacking. The WETT was developed to address this need, providing a simple, reliable, waterless test that can be mailed and completed without staff supervision.

STUDY DESIGN: The study included 1,392 healthy participants (493 men, 899 women), ages 10-94 years, who self-administered the 53-item WETT. General linear models were used to evaluate the effects of age, sex, smoking, and COVID-19 history. Normative percentile tables were developed for total and subtest scores.

SETTING: Community-based recruitment from 49 U.S. states plus Puerto Rico and the Virgin Islands. Participants completed the test at home and returned materials by mail.

SYNOPSIS: The participants applied taste strips containing sucrose, citric acid, sodium chloride, caffeine, monosodium glutamate, or blanks to the tongue and recorded responses. Researchers found that WETT scores decreased linearly with age starting in the 30s (p < 0.0001) and were significantly higher in women than men (p < 0.0001), with the largest gap in midlife (ages 40-69). Women outperformed men across all taste qualities except umami. Cigarette smokers had significantly lower salty (NaCl) and bitter (caffeine) scores than nonsmokers, while no significant effect of prior COVID-19 infection was observed. The test demonstrated high reliability (test-retest r = 0.92) without the intervention of a test administrator. Furthermore, age- and sex-adjusted percentile tables allowed clinicians to interpret scores against normative ranges. Limitations of this study included reliance on self-reported health, fewer participants in the oldest groups, lack of genetic or lingual subregion testing, and possible cultural variability in taste responses. Still, this study provided the first robust normative dataset for a reliable, self-administered, waterless taste test, making quantitative taste assessment feasible in both clinical and nontraditional environments.

CITATION: Doty RL, et al. Self-administered taste testing without water: normative data for the 53-item Waterless Empirical Taste Test (WETT). Int Forum Allergy Rhinol. 2025;15:934- 943. doi: 10.1002/alr.23587.

COMMENT: Many of us are familiar with psychophysical testing of olfactory function—for example, the University of Pennsylvania Smell Identification Test; however, systematized assessment of gustatory function is less well established. This study examined the WETT and analyzed the normative data generated by the examination. They found that scores decline starting in the 30s and are lower in men compared with women (a difference also noted with olfaction). This reliable self-administered test could play a helpful role in distinguishing primary smell and taste disorders as well as characterizing their severity.—Ashoke Khanwalkar, MD