In vitro Impact of Limited Exposure to Subtherapeutic Concentrations of Chlorhexidine Gluconate on the Adhesion-Associated Attributes of Oral Candida Species

Abstract

Objective:Candida albicans and its non-albicans counterparts, such as C. tropicalis, C. krusei, C. glabrata and C. dubliniensis, are the major etiological agents of oral candidosis. Their adherence to buccal epithelial cells (BEC), denture acrylic surfaces (DAS) and cell surface hydrophobicity (CSH) are attributes associated with yeast colonization and infection. Chlorhexidine gluconate (CG) is a widely used antiseptic in dentistry. When administered, the diluent effect of saliva and the cleansing effect of the oral musculature reduce its bioavailability, compromising its efficacy. Hence, intraorally, Candida undergoes a transient exposure to high CG concentrations, and thereafter it is likely to be subtherapeutic. Therefore, the impact of CG on adhesion to BEC, DAS and CSH of different oral Candida species was investigated following brief exposure to three subtherapeutic concentrations of CG. Materials and Methods: Ten oral isolates of each of the above five Candida species obtained in Kuwait from oral rinse samples were exposed to 0.00125, 0.0025 and 0.005% CG for 30 min. Subsequently, the yeast adhesion to BEC, DAS and CSH was determined. The data were analyzed using ANOVA Dunnett's t tests. Results: Exposure to the lowest dilution (0.00125%) of CG did not elicit a noteworthy collective suppression on all three adhesion traits evaluated. Exposure to 0.0025% CG curtailed the adhesion to BEC, DAS and CSH of Candida species by 50.89, 40.79 and 24.58%, respectively (p < 0.001). Exposure to the highest concentration (0.005%) of CG reduced the adhesion to BEC, DAS and CSH of Candida species by 64.68, 54.59 and 50%, respectively (p < 0.001). Conclusions: Brief exposure to subtherapeutic concentrations of CG suppressed the adhesion to BEC, DAS and CSH of oral Candida species, indicating probable pharmacodynamics that may potentiate its antiseptic properties.