Impact of Oral Environment Alterations on Salivary Candida Load: An Exploratory Clinical Study.

Abstract

Objective: Candida species are common oral commensals that can become opportunistic pathogens under specific conditions. Most research centers on medically compromised individuals, leaving a gap in understanding oral colonization patterns in healthy populations. This study aimed to investigate the impact of oral conditions and dental restorations on salivary candidal load in healthy individuals.

Materials and methods: Ninety-seven participants were divided into five groups based on the oral environment as follows: Group 1: participants with healthy mucosa and restoration-free teeth; Group 2: participants with dental fillings, conventional crowns, and fixed partial dentures; Group 3: removable dentures and appliances-positive control; Group 4: participants with tongue-coating abnormalities. Group 5: participants with partially erupted third molars. Saliva samples were collected and analyzed for Candida species using culture methods and colony-forming units per milliliter (CFUs/mL).

Results: Candida albicans (C. albicans) was present in 49.5% of samples, predominantly in Group 2 (73.7%). Non-albicans Candida (NAC) was detected in 67% of samples, exhibiting minimal intergroup variation. Age, gender, ethnicity, plaque, and calculus scores significantly influenced the growth of C. albicans and NAC, with older males and Asians exhibiting higher fungal loads. Group 2 demonstrated a significant increase in C. albicans CFUs (10 × ) compared with the negative control. NAC load (CFUs/mL) was notably higher in participants with impacted molars. Age, oral health, and sociodemographic factors were key predictors of salivary C. albicans and NAC loads, with worse oral hygiene correlating to increased NAC growth.

Conclusion: This study highlights the impact of the oral environment on the salivary Candidal load in disease-free populations, in particular. The presence of complex fillings, crowns, or fixed partial dentures has the most significant impact on C. albicans loads. However, the impacted molar has the most significant effect on NAC. The growth of both C. albicans and NAC was affected by the age, socioeconomic status, and oral hygiene status of the patient. Recognizing the colonization patterns in these individuals can aid in selecting restorative materials and preventive measures to reduce colonization and excessive salivary carriage. Further research is needed to explore the long-term implications of these findings on oral and systemic health.