Abstract
Hyposalivation is an important problem in elders and could interfere with several oral functions and microbial ecology. While the number of independent elders who retain more natural teeth increases worldwide, few studies examined hyposalivation in this population. Thus, this study aims to examine relationships between hyposalivation, oral health conditions and oral Candida colonization in independent dentate elders and evaluate factors associated with salivary flow and Candida carriage. We conducted a cross-sectional study in fifty-three dentate elders (≥65 years old with at least 4 pairs of posterior occlusal contacts) with no, or well-controlled, systemic conditions. Participants were interviewed for medical history, subjective dry mouth symptoms, oral hygiene practices and denture information. Unstimulated and stimulated salivary flow rates, objective dry mouth signs, gingival, tongue-coating, and root-caries indices were recorded. Stimulated saliva was cultured on Sabouraud-dextrose agar for Candida counts. Candida species were identified using chromogenic Candida agar and polymerase chain reaction. Statistical significance level was set at p<0.05. The results showed that hyposalivation was associated with higher gingival and tongue-coating indices (p = 0.003 and 0.015, respectively), but not root-caries index. Hyposalivation was also associated with higher prevalence of oral Candida colonization (p = 0.010; adjusted OR = 4.36, 95% confidence interval = 1.29-14.72). These two indices and Candida load were negatively correlated with unstimulated and stimulated salivary flow rates. Interestingly, non-albicans Candida species were more prevalent in denture wearers (p = 0.017). Hence, hyposalivation is a risk factor for poorer oral health and oral Candida colonization in independent dentate elders. Because of its potential adverse effects on oral and systemic health, hyposalivation should be carefully monitored in elders.
Highlights
As global life expectancy increases, the ageing population is continually growing worldwide [1]
We previously found that denture use was associated with higher colonization of non-albicans Candida species (NACS) in xerostomic post-radiation therapy patients [17]
We examined the relationship of hyposalivation to oral health indices and oral Candida carriage in a population of dentate Thai elders with no or well-controlled systemic conditions
Summary
As global life expectancy increases, the ageing population is continually growing worldwide [1]. Other local factors that predispose to oral candidiasis are poor oral hygiene, ill-fitting dentures, poor denture hygiene, or prolonged denture usage [16] These conditions are prevalent in the elders and may contribute to risk of Candida infection. Because the commensal oral Candida may be a source of infection when the host becomes immunocompromised [22], information regarding oral carriage of Candida and factors that affect colonization is important to evaluate risk of infection in the elderly population This cross-sectional study aimed to examine the association of oral health status, as measured by gingival, tongue-coating, and root caries indices, and oral Candida species colonization, with hyposalivation in independent dentate elders with no, or well-controlled, systemic conditions. We evaluated the factors that associate with salivary flow rates, Candida colonization, and oral health indices
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