Oral Candidal Load and Oral Health Status in Chronic Obstructive Pulmonary Disease (COPD) Patients: A Case-Cohort Study.

Shahnawaz Khijmatgar,Giridhar Belur,Shilpa Shenoy,Veena Shetty,Rajesh Venkataram,Chitta Ranjan Chowdhury,Edward Lynch,Anand Marya,Mohmed Isaqali Karobari,Sunena Shetty,K Chaithra K Chaithra,Martin Gootveld,Avidyuti Chowdhury,Iole Vozza

doi:10.1155/2021/5548746

Abstract

Objective The objective of this study was to determine the candidal load of the patients with Chronic Obstructive Pulmonary Disease (COPD) and evaluate the oral health status of subjects with COPD. Material and Methods. N = 112 COPD subjects and N = 100 control subjects were included in the study. The selection of COPD cases was confirmed based on the set criteria from the American College of Physicians. The oral health status was assessed as per WHO criteria to determine the score of decayed, missing, and filled teeth (DMFT), significant caries index (SiC), community periodontal index and treatment needs (CPITN), and oral hygiene index-simplified (OHI-S). Gram staining was performed to identify Candida using the whole saliva. Quantitative evaluation of the candidal load was carried out using Sabouraud Dextrose Agar (SDA). Chrome agar was used to differentiate between the commensal carriages. A statistical analysis paired t-test and 95% confidence interval (CI) for proportions was carried out using STATA software. Results Candidal growth was found in 21.42% (n = 24) of COPD cases and 1.1% (n = 11) of control cases (p < 0.05) (95% CI 0.45, 0.59). The DMFT score was 8.26 in COPD subjects and 4.6 in controls, the SiC score was 16.42 in COPD subjects and 10.25 in controls, and the CPITN score for both COPD and control cases was score 2. Conclusion In conclusion, there was a higher candidal load among subjects suffering from COPD. Theophylline medication can be a risk factor for increased candidal load in COPD patients.

Highlights

Chronic Obstructive Pulmonary Disease (COPD) is a lung disease characterized by airway obstruction resulting in difficulty in breathing [1]
The rationale of this study is to explore any association between dental caries, periodontal diseases, dry mouth, and gastrooesophageal reflux with Candida among COPD patients of India, which has not been investigated combining oral health status and candidal load level
Candidal growth was found in 21.42% (N = 24) of COPD subjects and 1.1% (N = 11) of control cases, which was statistically significant (p < 0:01) (Figures 1, 2, and 3)

Summary

Introduction

Chronic Obstructive Pulmonary Disease (COPD) is a lung disease characterized by airway obstruction resulting in difficulty in breathing [1]. COPD is caused by long-term exposure to fume/smoke from the environment and impaired function of the lungs and the airways. The global prevalence of physiologically defined COPD in adults aged >40 years is approximately 9-10 percent [2]. In 2012, an Indian study on the epidemiology of asthma, respiratory symptoms, and chronic bronchitis in adults showed that the overall prevalence of chronic bronchitis in adults > 35 years was 3.49 percent [3, 4]. Occupational exposures are believed to be the cause of 10-20% of COPD cases [1, 2, 5]

Methods

Results

Conclusion