Oral candida colonization in Thai denture wearing elderly with hyposalivation

Abstract

Objective: To examine relationships between hyposalivation, oral Candida colonization and oral health status in generally healthy elders and evaluate factors that affect salivary flow rates and Candida colonization in a cross-sectional study.

Materials and methods: Fifty-three elderly participants were enrolled and interviewed for medical history, subjective dry mouth symptoms, oral hygiene practice and denture information. Unstimulated and stimulated salivary flow rates, clinical signs of dry mouth, gingival index, tongue coating index and root caries index were recorded. Stimulated saliva samples were cultured on Sabouraud dextrose agar for colony counts and Candida species were identified with chromogenic Candida agar and polymerase chain reaction.

Results: Hyposalivation was associated with higher prevalence of oral Candida colonization (p=0.010; adjusted OR=4.360, 95% confidence interval=1.292-14.717), higher gingival and tongue coating indices (p=0.003 and 0.015, respectively), but not root caries index. These two indices and Candida load were also negatively correlated with unstimulated and stimulated salivary flow rates. Non-albicans Candida species were more frequently isolated in patients who wore dentures (p=0.017).

Conclusion: Hyposalivation is a risk factor for oral Candida colonization and poorer oral health in generally healthy elderly participants. Because hyposalivation could adversely affect oral and systemic health, we suggest that it be carefully monitored in elders.