Oral health status in geriatric rehabilitation patients

Objective: To study the microflora on the tongue and tooth surfaces in subjects with hyposalivation because of radiation therapy in the head and neck region (RT). Material and methods: The RT subjects (≥16 teeth, an unstimulated secretion rate of ≤0.1 ml min⁻¹, 6 months after completed radiation therapy) were matched with controls with normal salivary secretion rates according to age, sex and number of teeth. A clinical examination was performed, and samples for microbial analysis were taken. Results: The RT group (n  =  16) had a mean age of 53 ± 8 years and 28 ± 2 teeth. The unstimulated secretion rate was 0.02 ± 0.04 ml min⁻¹ and the stimulated 0.4 ± 0.2 ml min⁻¹. On the tongue, Fusobacterium nucleatum and Prevotella intermedia , associated with gingivitis, were found in low numbers in almost all RT subjects. Candida albicans and enterococci, associated with mucosal infections, were frequently found in high numbers. On the tooth surfaces, the number of C. albicans was increased. Lactobacillus species, indicating an acidic environment, were generally found in very high numbers in the RT subjects. Mutans streptococci, strongly associated with the development of caries, showed a different pattern. In 44% of the RT subjects, mutans streptococci could not be detected; 38% of the subjects showed very high numbers. Conclusions: Although high numbers of microorganisms associated with the development of mucosal infections and caries were frequently found in RT subjects, there were differences between subjects, especially for mutans streptococci. Microbial analysis might therefore be a helpful tool to identify RT subjects with an increased risk of oral disorders.