The effects of orthodontic appliances on Candida in the human mouth

Background.  Candida is an opportunistic pathogen present in about 50–60% of the healthy human population, and becomes pathogenic when the host immune defence is undermined such as in HIV infection. Adhesion and colonization of the oral cavity by Candida albicans is an initial step in candidosis, and the presence of orthodontic and other oral appliances seems to alter the oral ecological environment, hence may tip the balance to favour the candidal presence.
Objective.  The purpose of this paper was to review the literature with specific attention to prevalence; intra-oral density of the candidal organisms; and Candida carriage status in orthodontic patients before, during, and after treatment.
Conclusions.  The limited amount of literature demonstrated that the density of Candida increases; the most common Candida species isolated in the orthodontic patients was C. albicans ; and that there seems to be a direct relationship between the presence of a removable appliance, Candida , and low salivary pH levels. No healthy patients developed Candida infection from the orthodontic appliances. However, there seems to be a trend that some non- Candida carriers converted to Candida carriers following the insertion of the appliances by unknown mechanism. This may indicate a more cautious approach when providing orthodontic treatments to immunocompromised children concerning the possible increased risk of candidal infection.     

Nickel in dental plaque and saliva in patients with and without orthodontic appliances

The aim of this study was to compare the content of nickel in the saliva and dental biofilm in young patients with and without orthodontic appliances. The possible influence of a dietary intake of nickel on recorded nickel levels was examined. Nickel content in unstimulated whole saliva and in dental plaque of 24 boys and girls (mean age 14.8 years) with intraoral fixed orthodontic appliances was compared with 24 adolescents without such an appliance. Sample collection was set up to exclude nickel contamination. Diet intake was recorded for the preceding 48 hours to account for the influence of recent nickel content in food. Saliva and plaque were analysed for nickel content using an electrothermal atomic absorption spectrometric (ETAAS) method. The acidified saliva samples were analysed as Millipore-filtered saliva with filter-retained fractions and plaque following dissolution in acids. No significant difference in nickel content of filtered saliva was found between the test and the control samples (P = 0.607); the median values of nickel content were 0.005 and 0.004 mug/g saliva, respectively. On the other hand, a significant difference was found for the filter-retained fraction (P = 0.008); median values for nickel were 25.3 and 14.9 mug/g, respectively. A significant difference in nickel content between test and control samples was also found in plaque collected at various tooth sites (P = 0.001; median values 1.03 and 0.45 mug/g, respectively). A stronger difference was found when comparing plaque collected from metal-covered tooth surfaces than from enamel surfaces of orthodontic patients. No association could be found between calculated dietary intake of nickel and recorded nickel in the test and control samples. It is concluded that nickel release occurs into the dental plaque and components of saliva of orthodontic patients, a situation that may reflect time dependence of its release from orthodontic appliances into the oral cavity and an aggregation of nickel at plaque sites.     

Prevalence of yeasts in the oral cavity of children treated with inhaled corticosteroids

The aim of this study was to observe the prevalence of Candida spp. in the oral cavity of children undergoing treatment with inhaled corticosteroids. Thirty children treated with inhaled corticosteroids and thirty control children were studied. Saliva samples were collected through oral rinses with phosphate buffered saline (PBS). The samples were plated on Sabouraud's dextrose agar and incubated at 37 degrees C for 48 h. After this period, the number of colony-forming units per ml (cfu/ml) of saliva was calculated. The isolates were identified by phenotypic characterization. Candida spp. was isolated from 43.33% of the samples of children treated with corticosteroids, with a mean of 780 cfu/ml of saliva, and from 30% of the samples of the control group, with a mean of 560 cfu/ml of saliva. No significant statistical difference was observed between the groups. C. albicans was the prevalent species in both groups, followed by C. guilliermondii, C. parapsilosis and C. stellatoidea. Furthermore, Rhodotorula rubra and C. lusitaniae were also isolated from the treated group. We concluded that there was no significant increase in the prevalence and number of Candida spp. in the oral cavity of children treated with inhaled corticosteroids.     

Leaching of additives and degradation products from cold-cured orthodontic resins

Unstimulated saliva was collected from orthodontic patients and subjected to combined gas-chromatography and gas-chromatography/mass-spectrometry analyses. Saliva was collected before insertion of removable orthodontic appliances made of cold-cured resins. Saliva was then collected 1-2 months after insertion of the appliances and 1 week after they had been removed. Phenyl benzoate (PB) and phenyl salicylate (PS) were identified in pooled saliva samples from patients wearing the appliances. Biphenyl and 2-methoxy-4-hydroxy-beilzo-phenone in addition to PB and PS were identified in a study with in vitro specimens made of orthodontic resin. The leaching of compounds from these test specimens processed by a powdering technique and a pre-mix technique was compared.     

Efficacy of ultrasonic, electric and manual toothbrushes in patients with fixed orthodontic appliances

OBJECTIVE: This crossover study compared the efficacy of an ultrasonic toothbrush for the reduction of plaque, gingival inflammation, and levels of Streptococcus mutans, in relation to an electric and a manual toothbrush. MATERIALS AND METHODS: Twenty-one patients with orthodontic appliances were divided into three groups. All patients were evaluated by a periodontist and samples of saliva were collected for quantification of S mutans. The patients received their first brushes with appropriate instructions. For each crossover leg, patients used each toothbrush for a period of 30 days. At the end of each washout period, participants received a periodontal evaluation and new samples of saliva were collected. After 15 days of using their own toothbrushes, patients received the next toothbrushes in the experimental sequence. RESULTS: The ultrasonic brush group presented significant improvement in the reduction of visible plaque on the buccal surfaces (-6.36%, P = .007). The counts of S mutans decreased in the electric (2.04 x 10(5) to 1.36 x 10(5) colony-forming units [CFU]/mL) and ultrasonic (2.98 x 10(5) to 1.84 x 10(5) CFU/mL) groups. There were no statistical differences among the three brushes for the clinical and microbiological parameters evaluated. CONCLUSIONS: This study did not demonstrate that the ultrasonic toothbrush was better in reducing gingival inflammation in adolescent orthodontic patients, but plaque scores were lowered on buccal surfaces of teeth with orthodontic brackets. In addition, S mutans counts were markedly decreased in the electric and ultrasonic groups, which should be related to a reduced risk of oral disease.     

Salivary nickel and chromium in patients with fixed orthodontic appliances

The purpose of this study was to determine the alterations in the chromium and nickel concentrations in the saliva of orthodontic patients treated with fixed orthodontic appliances. Forty-five orthodontic patients were included in this study. The first group consisted of 15 patients (7 female, 8 male) with fixed appliances placed in their upper and lower arches. The second group consisted of 15 patients (8 female, 7 male) with a fixed appliance placed only in the upper arch. The control group consisted of 15 patients (7 female, 8 male) who were not undergoing orthodontic treatment. Four samples of stimulated saliva were collected from each patient before insertion of the fixed appliance, 1 week after insertion of the appliance, 1 month after insertion of the appliance, and 2 months after insertion of the appliance. The same 4 samples of saliva were collected from each control patient at the same time intervals as for the fixed-appliance groups. The chemical analyses were done with an electrothermal atomic absorption spectrophotometer (Perkin Elmer 2380, Perkin Elmer Corp, Baden Seewerk, Germany). The Wilcoxon matched-pairs signed ranks test was used to test differences between samples before and after insertion of orthodontic appliances. A Kruskal Wallis 1-way analysis of variance was used to test differences in nickel and chromium concentration among the 3 test groups. It was observed that there was a large variation in the concentrations of both nickel and chromium in saliva. No significant differences were found between the no-appliance group and the samples obtained after insertion of the appliances. The results of the study suggest that fixed orthodontic appliances do not significantly affect nickel and chromium concentrations of saliva during the first 2 months of treatment.     

Salivary nickel and chromium in subjects with different types of fixed orthodontic appliances

The aim was to investigate nickel and chromium concentrations in saliva of patients with different types of fixed appliances. Saliva samples were collected from 47 orthodontic patients, ages 8 to 30 years. Four samples from each subject were collected: (1) before insertion of the appliance, (2) 1 to 2 days after, (3) 1 week after, and (4) 1 month after insertion of the appliance. A considerable variation in the concentrations of both nickel and chromium was observed. No significant differences were found between the no-appliance samples and the samples obtained after insertion of the appliances. The results suggest that nickel and chromium concentrations of saliva are not significantly affected by fixed orthodontic appliances during the first month of treatment. (Am J Orthod Dentofac Orthop 1997;111:595-8.)     

健康老年人口腔念珠菌与义齿修复的相关研究

目的 研究健康老年人群中口腔念珠菌的定植状况,分析义齿修复对老年人口腔念珠菌定植的影响。方法 212例健康老年人分为4组：A1组（男性,有义齿）,B1组（男性,无义齿）,A2组（女性,有义齿）和B2组（女性,无义齿）。标准含潄法取样,样本接种于沙堡琼脂培养基培养念珠菌,CHROMagar CandidaTM鉴定培养基鉴定白色念珠菌,碳水化合物同化反应鉴定体系鉴定念珠菌菌种。培养基中念珠菌菌落计数为每个样本的念珠菌检出强度。比较4组健康老年人念珠菌检出率和检出强度有无统计学差异。结果 212例老年人中116例检出念珠菌,检出率为54.72％。检出念珠菌包括白色念珠菌、近平滑念珠菌、克柔念珠菌、热带念珠菌等10个菌种。A1、B1、A2和B2组念珠菌检出率分别为66.67%,36.07%,64.15%和56.00%;白色念珠菌检出率分别为56.25%,21.31%,56.60%和38.00%。A1组念珠菌、白色念珠菌检出率高于B1组（P<0.05）。高念珠菌强度者在A1、A2组所占比例分别较B1、
B2组高（P<0.05）。结论 健康老年人口腔总念珠菌及白色念珠菌检出率和检出强度增高与义齿修复相关。老年人
口腔念珠菌检出率和检出强度的差异主要是白色念珠菌检出率和检出强度的差异所造成。     

Antimicrobial activity of Croton cajucara Benth linalool-rich essential oil on artificial biofilms and planktonic microorganisms

We have previously demonstrated that a linalool-rich essential oil from Croton cajucara Benth presents leishmanicidal activity. In the present study, we demonstrate that this essential oil inhibits the growth of reference samples of Candida albicans, Lactobacillus casei, Staphylococcus aureus, Streptococcus sobrinus, Porphyromonas gingivalis and Streptococcus mutans cell suspensions, all of them associated with oral cavity disease. The purified linalool fraction was only inhibitory for C. albicans. Microbes of saliva specimens from human individuals with fixed orthodontic appliances, as well as the reference strains, were used to construct an artificial biofilm which was exposed to linalool or to the essential oil. As in microbial suspensions, the essential oil was toxic for all the microorganisms, while the purified linalool fraction mainly inhibited the growth of C. albicans. The compounds of the essential oil were separated by thin layer chromatography and exposed to the above-cited microorganisms. In this analysis, the proliferation of the bacterial cells was inhibited by still uncharacterized molecules, and linalool was confirmed as the antifungal component of the essential oil. The effects of linalool on the cell biology of C. albicans were evaluated by electron microscopy, which showed that linalool induced a reduction in cell size and abnormal germination. Neither the crude essential oil nor the purified linalool fraction is toxic to mammalian cells, which suggests that the essential oil or its purified components may be useful to control the microbial population in patients with fixed orthodontic appliances.     

The most frequently isolated gram-negative anaerobes in saliva and subgingival samples taken from young women

Stimulated saliva and a pooled subgingival sample from the first molars were collected from 30 Caucasian women (mean age 30 years) for the presence of gram-negative anaerobic bacteria. The samples were inoculated on nonselective and selective media. The gram-negative anaerobic species occurring in the oral cavity of more than 50% of the subjects were selected for further analysis. Fusobacterium nucleatum and Prevotella melaninogenica were not recovered from subgingival sites without a simultaneous recovery in saliva. When positive subgingivally, Leplotrichia spp., nonpigmented Prevotella spp., Prevotella intermedia, Capnocytopha-ga spp., Bacteroides gracilis and Prevotella loescheii were simultaneously detected from saliva in 76%, 72%), 64%>, 64%, 61% and 55% of the subjects, respectively. Intraindividually, the proportions of F. nucleatum, nonpigmented Prevotella spp., Leptotrichia spp., B. gracilis and P. loescheii of the anaerobic flora were quite similar in the salivary and subgingival samples. Capnocytophaga spp. and P. intermedia were present in higher proportions in subgingival samples than in saliva, whereas P. melaninogenica was present in higher proportions in saliva. Our data indicate that many oral gram-negative anaerobes are frequently recovered from stimulated saliva. Furthermore, when subgingivally positive, most subjects harbored these anaerobes simultaneously in saliva.     

In vivo study of metal content of oral mucosa cells in patients with and without fixed orthodontic appliances

OBJECTIVE: To compare the concentration of nickel, chromium and cobalt in oral mucosa cells of patients with and without fixed orthodontic appliances. MATERIALS AND METHODS: A total of 60 patients were included in this study. The control group consisted of 30 patients without any type of fixed orthodontic appliances or metal restoration in the mouth (20 females and 10 males from 16 to 20 years with a mean age of 18 years). The test group consisted of 30 patients who had fixed orthodontic appliance in their upper and lower arches (20 females and 10 male from 16 to 20 years with a mean age of 18.2 years). The metal content determinations were carried out using atomic absorption spectrophotometry with a graphite furnace. RESULTS: According to spectrophotometric analysis, no significant differences in chromium (p = 0.09) and cobalt (p = 0.10) content of oral mucosa cells were found between the test and control samples. The nickel content in mucosa samples was significantly higher (p = 0.003) in orthodontic patients compared with the controls. The mean levels of nickel in control and orthodontic patient group were 12.26 and 21.74 ng / ml, respectively. CONCLUSION: Our findings indicate that there was no difference in the concentration of chromium and cobalt in oral mucosa cells of patients with or without fixed appliances. However, a significantly higher concentration of nickel can be found in oral mucosa cells of patients wearing fixed orthodontic appliances. Continued follow-up is needed to determine the long-term significance of nickel release.     

Nickel and chromium levels in the saliva and serum of patients with fixed orthodontic appliances

The aim of this study was to evaluate the concentrations of nickel and chromium ions in salivary and serum samples from patients treated with fixed orthodontic appliances. A second aim of this study was to determine any significant changes in these concentrations during any period of the treatment time. Saliva and blood samples were collected from 100 patients ranging in age from 12 to 33 years. Twenty samples from each group were obtained. The groups were as follows: In the first group, saliva and blood samples were collected before insertion of the fixed appliances. In the second, third, fourth, and fifth groups, samples were collected at 1 week, 1 month, 1 year, and 2 years after appliance insertion. The serum was prepared by centrifuging the blood samples at 3000 rpm for 10 minutes. The fixed appliances consisted of an average of 4 bands and 20 bonded brackets. No palatal or lingual appliances welded to bands or extraoral auxiliary appliances were used. The spectrophotometric determinations were carried out using electrothermal atomic absorption spectrophotometry. The results indicated certain differences in the amounts of nickel and chromium released from fixed orthodontic appliances during different periods of treatment. The Mann-Whitney U-test from the SPSS statistics program was used to analyze the significance of the differences between no-appliance samples and those obtained with the appliances present. In the serum, there were statistically significant increases in ion concentration in the second-year groups. In saliva samples, nickel and chromium reached their highest levels in the first month and decreased to their initial level in the rest of the groups. It can be concluded that fixed orthodontic appliances release measurable amount of nickel and chromium when placed in the mouth, but this increase doesn't reach toxic levels for nickel and chromium in the saliva and serum.     

The effect of orthodontic appliances on the distribution of Candida and plaque in adolescents

The site prevalence and intra-oral density of Candidal organisms may be increased by local factors including prostheses. However, whether significant changes in Candidal carriage occurs with denture wearing is not clearly established. This study employed the imprint culture technique to assess the effects of fixed and removable orthodontic appliances on oral carriage, site prevalence and intra-oral density of Candida in adolescents. Moreover, alterations in plaque distribution were measured. Groups of 12-16 year olds without or wearing fixed and removable appliances were studied. Imprint cultures were taken from six intra-oral sites and colony counts recorded after 48 hours incubation on selective media. Plaque scores were recorded from non-appliance and removable appliance wearers. The prevalence of Candidal carriage in the groups was not significantly different being 46 per cent of non-appliance, 51 per cent of fixed appliance and 52 per cent of removable appliance wearers. However, the prevalence of Candidal recovery at some sites and Candidal densities at all sites were significantly increased in both fixed and removable appliance wearers. Thus orthodontic appliances may predispose to Candidal proliferation in oral carriers. However, the results do not permit the conclusion that appliances may change non-carriers of Candida to carriers. Plaque distribution was significantly altered in removable appliance wearers when compared with non-appliance wearers as a result of increases in palatal plaque scores. These findings again emphasize the particular need for oral hygiene instruction in patients wearing appliances or partial prostheses.     

Streptococcus mutans counts in plaque adjacent to orthodontic brackets bonded with resin-modified glass ionomer cement or resin-based composite

This study investigated the number of Streptococcus mutans CFU (colony forming units) in the saliva and plaque adjacent to orthodontic brackets bonded with a glass ionomer cement--GIC (Fuji Ortho) or a resin-based composite--RC (Concise). Twenty male and female patients, aged 12 to 20 years, participated in the study. Saliva was collected before and after placement of appliances. Plaque was collected from areas adjacent to brackets and saliva was again collected on the 15th, 30th, and 45th day after placement. On the 30th day, 0.4% stannous fluoride gel was applied for 4 minutes. No significant modification in the number of Streptococcus mutans CFU in saliva was observed after placement of the fixed orthodontic appliances. On the 15th day, the percentage of Streptococcus mutans CFU in plaque was statistically lower in sites adjacent to GIC-bonded brackets (mean = 0.365) than in those adjacent to RC-bonded brackets (mean = 0.935). No evidence was found of a contribution of GIC to the reduction of CFU in plaque after the 15th day. Topical application of stannous fluoride gel on the 30th day reduced the number of CFU in saliva, but not in plaque. This study suggests that the antimicrobial activity of GIC occurs only in the initial phase and is not responsible for a long-term anticariogenic property.     

正畸患者牙龈炎的口腔综合保健

目的 观察口腔综合保健对正畸患者牙龈炎的作用。方法 本文以４０名１１￣１８岁正畸患者为检测对象,观察带固定矫治器后的第二月,第四月及第六月时牙龈指数（ＧＩ）、龈沟出血指数（ＳＢＩ）、龈袋深度（ＧＤ）和菌斑指数（ＰＬＩ）的改变。实验组采用口腔综合保健措施。结果 实验组带固定矫治器后各观察时间ＧＩ、ＳＢＩ值均非常显著低于对照组;ＧＤ值在第四月、第六月时,实验组非常显著低于对照组。结论 口腔综合保健是一     

Relationship between oral gram-negative anaerobic bacteria in saliva of the mother and the colonization of her edentulous infant

Various gram-negative anaerobic bacterial species can be detected in the oral flora of edentulous infants. However, knowledge of the initial infection source is still scarce. Thirty Caucasian mothers (mean age 30 years) and their edentulous infants (mean age 3 months) were examined for the possible similarity of the oral gram-negative anaerobic flora. Paraffin-stimulated saliva was collected from the mothers. A pooled swab sample from mucosal surfaces and unstimulated saliva were collected from the infants. The samples were inoculated on nonselective and selective media and cultured aerobically and anaerobically. All of the 30 mothers harbored Fusobacterium nucleatum and 29 mothers Prevotella melaninogenica in their saliva. The salivary levels of P. melaninogenica, F. nucleatum, nonpigmented Prevotella spp., Prevotella intermedia and Prevotella loescheii exceeded 10(4) CFU/ml in about half of the 30 mothers. At this maternal salivary level, the infants' colonization frequency of P. melaninogenica and F. nucleatum was doubled. A positive correlation between maternal salivary concentration and infant's colonization was found for P. melaninogenica. No positive association was found with nonpigmented Prevotella spp., P. intermedia and P. loescheii. It can be speculated that maternal saliva may act as a source of some gram-negative anaerobes in the oral microflora of edentulous infants as early as before tooth eruption.     

Antimicrobial activity of Croton cajucara Benth linalool‐rich essential oil on artificial biofilms and planktonic microorganisms

We have previously demonstrated that a linalool‐rich essential oil from Croton cajucara Benth presents leishmanicidal activity. In the present study, we demonstrate that this essential oil inhibits the growth of reference samples of Candida albicans, Lactobacillus casei, Staphylococcus aureus, Streptococcus sobrinus, Porphyromonas gingivalis and Streptococcus mutans cell suspensions, all of them associated with oral cavity disease. The purified linalool fraction was only inhibitory for C. albicans. Microbes of saliva specimens from human individuals with fixed orthodontic appliances, as well as the reference strains, were used to construct an artificial biofilm which was exposed to linalool or to the essential oil. As in microbial suspensions, the essential oil was toxic for all the microorganisms, while the purified linalool fraction mainly inhibited the growth of C. albicans. The compounds of the essential oil were separated by thin layer chromatography and exposed to the above‐cited microorganisms. In this analysis, the proliferation of the bacterial cells was inhibited by still uncharacterized molecules, and linalool was confirmed as the antifungal component of the essential oil. The effects of linalool on the cell biology of C. albicans were evaluated by electron microscopy, which showed that linalool induced a reduction in cell size and abnormal germination. Neither the crude essential oil nor the purified linalool fraction is toxic to mammalian cells, which suggests that the essential oil or its purified components may be useful to control the microbial population in patients with fixed orthodontic appliances.     

Improved oral hygiene and Candida species colonization level in geriatric patients

OBJECTIVES: This work consists in improving oral hygiene (OH) for elderly dependent people in long-term hospital care, in order to decrease the degree of colonization and the associated risk of developing oral candidiasis. As this population frequently suffers from such colonization and because it is difficult to install and practice OH care, a study protocol was designed at the request of geriatricians. The objective of the present study was to set up a programme of OH, applied by the care staff, and to monitor oral colonization of by Candida spp. BASIC RESEARCH DESIGN: We compared the levels of hygiene and Candida spp. colonization for a group of 110 long-term patients in geriatric departments at T1, when clinical data were collected and oral mycological samples taken before the OH protocol was applied, and at T2, during the postprotocol phase after 3 months of application, when the clinical data and sample collection were repeated. RESULTS: During these 3 months 11 patients died. These patients were excluded from the results, which are presented for matched series of the 99 patients still present at T2. Statistical analysis comparing the clinical and biological parameters at T1 and T2 established that there had been an improvement in OH: the 'adequate' level was reached for 72.4% of patients at T2 compared with 41.8% at T1 (P < 0.001) and the 'very inadequate' level was observed for 9.2% at T2 compared with 27.9% at T1 (P < 0.01). A reduction was observed in the number of patients showing the highest degree of C. albicans and C. glabrata colonization (> 50 colony forming units) from 41.9% at T1 to 24.9% at T2 (P < 0.05) and from 56.4% at T1 to 13.0% at T2 (P < 0.05) respectively. The number of patients with candidiasis fell significantly from 43.2% at T1 to 10.2% at T2. CONCLUSIONS: The OH protocol led to an overall decrease in Candida spp. colonization, a significant reduction in the number of candidiasis and an improvement in the level of oral and denture hygiene but vigilance is still necessary concerning OH care and the initial training of staff in specific care of the mouth.     

Association of asymptomatic oral candidal carriage, oral candidiasis and CD4 lymphocyte count in HIV-positive patients in China

OBJECTIVES: To compare the prevalence of asymptomatic oral candidal carriage in healthy volunteers with human immunodeficiency virus (HIV)-positive patients in China, as well as to investigate the relationship between CD4+ lymphocyte count and oral candidal colonization or oral candidiasis. METHODS: Oral candidal carriage and oral candidiasis were investigated in 101 patients with HIV-infection seen at Youan Hospital, Beijing, China. Two hundred and seventeen healthy volunteers were involved as a control. Culture from saliva was used to test for the presence of oral Candida. CD4+ lymphocyte count was measured by flow cytometry. All data were analyzed statistically by SAS. RESULTS: Asymptomatic oral candidal carriage rate (28.6%) in HIV-positive group was similar to that in the healthy group (18.0%; P = 0.07). No significant difference in CD4+ lymphocyte count was found between oral Candida carriers and non-carriers among HIV-positive subjects (P = 0.89). However, the frequency of oral candidiasis increased with the decrease in CD4+ lymphocyte count (P < 0.0001), and pseudomembranous candidiasis was predominant in HIV-positive patients with CD4+ <200 cells microl(-1) (66.7%). CONCLUSIONS: In HIV-positive subjects, asymptomatic oral candidal colonization is not related to CD4+ lymphocyte count of blood, and the carriage rate is similar to that in the healthy population. Oral candidiasis is more likely to be observed in HIV-positive patients who have a low CD4+ lymphocyte count.     

The role of salivary factors in persistent oral carriage of Candida in humans

Background

Candida albicans is a commensal oral yeast in approximately one-third to one-half of the healthy population. To date, there are no studies investigating the multiple anti-candidal salivary constituents of healthy individuals with either nil or, consistent oral yeast carriage.

Objective

To compare the composition and anti-candidal activity in stimulated whole saliva of healthy ‘consistent’ oral Candida carriers with Candida-free individuals.

Methods

A sub-sample of 22 consistent, Candida-free individuals and 10 consistent Candida carriers were recruited from a 12 months screening study investigating oral Candida carriage in 97 healthy patients treated by fixed orthodontic appliances. Unstimulated and stimulated saliva samples were collected. The following salivary attributes were measured using standard methodology: the flow rate, pH, lysozyme, lactoferrin and IgA concentration and, the degree of inhibition of blastoconidial growth and blastospore germination.

Results

Saliva from the Candida-free individuals showed 20.2% higher inhibition of blastoconidial growth (p < 0.05) of a reference strain of Candida albicans. No significant differences between the other salivary attributes of the two groups were found.

Conclusion

The fact that saliva of Candida-free individuals significantly inhibited the blastoconidial growth more than Candida-carriers (p < 0.05) suggests that saliva may play a role in modulating oral candidal populations in health. Further studies, with a larger cohort are needed to confirm these findings and determine the factors that confer enhanced salivary anti-candidal activity.