Prevalence of Candida and Salivary Flow Rates in Oral Submucosal Fibrosis Patients

Abstract

BACKGROUND Candida species belong to the normal microbiota of an individual's mucosal oral cavity, gastrointestinal tract and vagina. The alteration in the homeostasis between Candida, host immune system and normal oral bacterial flora causes damage to tissue by resisting host defense and production of hydrolytic enzymes. Salivary gland hypofunction may alter the oral microbiota and increase the risk of oral candidiasis. Oral submucosal fibrosis patients are prone to the above pathologies. The objective of this study is to study the prevalence of candida species and to determine the salivary flow rates of patients with oral submucosal fibrosis. MATERIALS AND METHODS 42 patients presenting to ENT OPD of VIMSAR, Burla, with clinically diagnosed oral submucosal fibrosis (OSMF) between September 2015 and August 2017 were chosen for the study. The patients were compared with age and gender matched controls (n= 42). Samples for candida colony count were collected by oral rinse technique and salivary flow rates in mL per minute were calculated by saliva collection techniques. Patients were staged from stage 1 to 4 OSMF clinically. Candida was quantified as colony forming units (CFU) and species identification was done by standardised methods. Data was tabulated in Excel Sheets and statistical analysis was done by Mann-Whitney U Test in SPSS software version 16.0. Statistical significance was set at p < 0.05. RESULTS There was significant difference between cases and controls with regards to prevalence of candida and salivary flow rates (p<0.000). Candida albicans was the most common species identified in both cases and controls. Salivary flow rates progressively decreased from stage 1 to 4, while CFUs were highest in stage 3 and lowest in stage 1 OSMF. CONCLUSION The mucosal changes in OSMF render the patients to increased susceptibility to Candida infection. With clinical progression of OSMF, salivary flow rates decrease. This study may be helpful for deciding prophylactic management of fungal infection as well as xerostomia in OSMF patients.