Factors affecting the prevalence of yeasts in the oral cavity of patients with diabetes mellitus

Abstract

Objective To investigate fungal flora of the oral cavity as well as the influence of denture, smoking, antibiotic and corticosteroid therapies on oral yeasts of patients with diabetes mellitus. Patients and methods Oral samples, which were obtained from 132 diabetic patients and 130 healthy controls, were cultured on selective media, in order to isolate, count and identify the yeasts. Results All the diabetic patients carried significant amounts of yeast cells, especially Candida albicans, in the oral cavities compared to healthy subjects ( P < 0.05). A total of four major yeast genera including six Candida species were isolated from the patients including C. albicans (22.4%), C. glabrata (10%), C. tropicalis (5.4%), C. dubliniensis (4.4%), C. krusei (2%), C. pseudotropicalis (1.6%), Saccharomyces spp. (0.6%), Rhodotorula spp. (0.4%) and Trichosporon spp. (0.2%). These organisms were recovered at higher densities in diabetics wearing dentures and receiving antibiotics compared to those suffering other predisposing factors ( P < 0.05). Saliva and tongue were the commonest sites of yeast colonization into the oral cavity in all population. The relationship between the yeast colony count mean and blood sugar was significant ( P < 0.05), whereas there was no significant relationship between oral yeast density and salivary sugar. Conclusion Regarding the high frequency of oral candidal carriage in diabetic patients, hygienic condition in the oral cavity of the patients and using local antiseptic and antifungal agents are necessary.