Oral candidal colonization in cleft patients as a function of age, gender, surgery, type of cleft, and oral health

Abstract

Purpose: To assess the colonization rate of oral Candida species and the influence of age, gender, oral health status, number of surgeries, and type of cleft.

Patients and methods: A prospective study of 60 patients with cleft and 60 control subjects was carried out at the Cleft Centre at King Abdullah University Hospital and the Maxillofacial Unit at Jordan University of Science and Technology between October 2007 and June 2008. Oral health was assessed using the Gingival, Plaque, and Decayed, Missing, and Filled (DMFT/dmft) indexes using World Health Organization criteria. A culture swab was obtained from the tongue and buccal and palatal mucosae. Candida albicans and other Candida species were identified using the germ tube test and the automated biochemical test panel VITEK.

Results: The colonization rate of Candida in patients with cleft (63.3%) was significantly higher than in healthy control subjects (18.3%). The colonization rate of Candida and the distribution of C albicans varied with age but were not significantly associated with gender in patients with cleft and healthy controls. The candidal colonization rate was highest in patients with cleft who had at least 3 surgeries (78.2%) and in patients with bilateral clefts (77.7%). Patients with cleft had a significantly poorer health status than healthy controls; however, this was not influenced by the type of the cleft or the number of surgeries.

Conclusion: Patients with cleft had a significantly higher rate of oral candidal colonization compared with control subjects, which varied with age, type of cleft, and the number of surgical interventions. Oral health status was significantly poorer in patients with cleft.