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Candida krusei (C. krusei) is associated with oral candidiasis, particularly in immunecompromised patients. The objective of the study was to determine the effect of phenotypic switching to the susceptibility of C. krusei towards amphotericin B, nystatin and aqueous extract of Piper betle (P. betle). To induce phenotypic switching, C. krusei was inoculated in yeast extract peptone dextrose (YEPD) broth supplemented with 5 mg mL-1 phloxine B andincubated for five hours at 25 °C. Later, 100 µL of the suspension was inoculated on YEPD agar supplemented with 5 mg mL-1 phloxine B and incubated for five days at 25 °C. Disc diffusion and minimum inhibitory concentration (MIC) assays were conducted to determine the susceptibility of C. krusei. The results showed that all C. krusei switched generations were susceptible towards amphotericin B and nystatin with the 3rd and 4th generations significantly more susceptible than the un-switched, respectively (P<0.05). All C. krusei switched generations were also observed to be susceptible towards the aqueous extract of P. betle. The MIC of amphotericin B, nystatin and P. betle were determined at 10 µg mL-1, 10 µg mL-1 and 12.5 mg mL-1, respectively for all generations of C. krusei. In conclusion, the susceptibility of C. krusei was phenotypically switched generation dependent towards amphotericin B, nystatin, and Piper betle aqueous extract.

Introduction:  The prevalence of oral cancer has been reported annually along with high mortality rate. Probiotics have been suggested to possess anti-cancer properties, however the role of these microorganisms on oral cancer is  remain unclear. The objective of the present study is to identify the mechanisms exerted by probiotics on oral carcinogenesis by using systematic review and meta analysis with the hypothesis that probiotics inhibit oral carcinogenesis. Materials and method: Comprehensive literature search was conducted on PubMed, Scopus and Web of Science electronic database from January 2019 until April 2019. Main keywords that were used are “probiotic” AND “oral cancer”. Articles that were published in English language were included in this review. Articles were selected independently by three authors and inspected independently by another researcher. The titles and abstracts of the studies were screened to identify studies that meet the inclusion criteria. Full text articles of the remaining studies were assessed to determine the availability to be included in the review. Meta-analysis was conducted by using RevMan 5 software, and the result was graphically plotted on the forest plot. This review was done according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA-P) 2015 guidelines. Results: After thorough screening of the full text articles, seven papers were eligible to be included in the systematic review. The included articles were mainly discussed on the association of probiotics and oral cancer. Two from the seven papers were selected to be analyse for quantitative synthesis (meta-analysis). The present study also showed that,  Lactobacillus salivarius  REN produces protective effect from developing neoplastic tongue lesions with odd ratio < 1. Conclusion:  Probiotics were found to confer positive effect as an inhibitory agent against the oral carcinogenesis thus supported the hypothesis of the present study that probiotics can inhibit oral carcinogenesis.

Candida species including Candida albicans, Candida krusei and Candida glabrata are opportunistic microorganisms that inhabit oral cavity. The objective of this study is to determine the effect of dental caries on Candida spp. biofilm-forming ability on nano- composite with the hypothesis that dental caries enhances the colonization of Candida spp. To assess Candida spp. colonisation in the oral cavity of the paediatric patient, samples were obtained from 30 subjects aged five to six years old from Kuantan, Pahang, Malaysia. The samples were collected from buccal mucosa, palate and tooth surfaces using sterile swabs. 10 mL of patient’s saliva suspension was also collected. Following that, the samples were inoculated on CHROMagar and incubated for 24 h at 37 ºC. Candida biofilm of caries isolate C. albicans (HNFC2), and C. albicans ATCC 32354 were developed on three different types of nano-composites. The study showed that no C. albicans was isolated from the caries-free oral cavity while 76% of children with caries possessed Candida spp. 65% of the yeasts were isolated from the tooth surface. Only 35% of the total isolates were obtained from soft tissues, including palatal and buccal mucosa. C. albicans is the most isolated Candida spp. with 82% and 67% of the yeast were obtained from the tooth surface and buccal mucosa, respectively. Besides, HNFC2 significantly colonised the nano- composites more than the ATCC (P < 0.05). In the comparison of the three types of nano- composites, nano-hybrid-based containing pre-polymerised filler (cB) exhibited the least C. albicans HNFC2 cells colonisation with 7.7 x 10³ cells mL-1. In contrast, the nano-composite that contained bulk-filled nanohybrid (cC) was the most colonised with 14.3 x 10³ cells mL-1. In conclusion, dental caries enhances the colonization of Candida spp. in children's oral cavity, and that caries isolate form more biofilm on nano-composites compared to the lab strain C. albicans.