Sjögren's syndrome sufferers have increased oral yeast levels despite regular dental care

Aim:  To investigate the prevalence and quantity of oral yeasts and their association with oral candidiasis in Sjögren's syndrome (SS) patients receiving regular dental care.
Materials and methods:  Yeasts in oral rinse and full-mouth supra-gingival plaque samples from 25 primary SS, 27 secondary SS and 29 control subjects were selectively cultured. All yeasts except single-species isolates were genotyped using pulsed field gel electrophoresis (PFGE).
Results:  Ten (19%) SS sufferers had symptomless candidiasis. SS subjects had a higher prevalence (73% vs 7%) and quantity of yeasts than controls in both oral rinse and plaque samples ( P  < 0.05). The prevalence of yeasts in plaque was associated with candidiasis regardless of denture wearing ( P  ≤ 0.04). Candida albicans was the predominant yeast isolated. PFGE showed 20 (66% of total) C. albicans isolate pairs, i.e. C. albicans species isolated from plaque and oral rinse samples of the same individual, were of closely related genetic clonal types ( P  < 0.01).
Conclusions:  Despite effective oral hygiene, more SS subjects than controls had detectable levels of oral yeasts and their presence in supra-gingival plaque was associated with candidiasis. Candida albicans colonized supra-gingival biofilm even in well-maintained SS individuals, posing a challenge to the control of oral candidiasis.