Oral prevalence of Candida and its association with dental caries in children

Abstract

Oral commensal Candida has been suggested to contribute to the pathogenesis of dental caries. However, studies on Candida in oral cavity and caries lesions of patients with dental caries are lacking. This study investigated the presence of Candida in oral cavities and dental caries lesions in patients with dental caries. A group of 60 children (6 – 12 years) seeking treatment for dental caries from the Dental Teaching Hospital Peradeniya, Sri Lanka were included. None had received dental treatment or antimicrobial therapy within the preceding three months. Candida from oral rise and the caries biofilm samples were isolated on Sabouraud dextrose agar and identified using Gram stain, germ tube test, CHROMagar, and Polymerase Chain Reaction (PCR). Hemolysin and phospholipase activities of 12 selected C. albicans isolates each from oral and caries lesions were assessed using in vitro plate assays. Site distribution of Candida was analysed using Chi square test, while mean hemolysin and phospholipase activities were compared with paired t test. The sample comprised 31 males (50.8%) and 29 females (47.15%). Candida prevalence was higher in the oral cavity (76.6%,46/60) than in caries lesions (58.3%, 33/60). C. albicans predominated in the oral cavity (84.8%,41/46), whereas Non-albicans Candida (NAC) species were common in caries lesions (51.4%, 18/33). There was a significant difference in Candida distribution between these two sites (χ² = 5.33, p = 0.021). Hemolysin activity of C. albicans from caries lesions was significantly higher than that of oral isolates (p = 0.02), while phospholipase activity showed no significant difference (p = 0.65). These findings demonstrate that C. albicans predominates in the oral cavity, whereas NAC species are more frequent in caries lesions. The elevated hemolysin activity of C. albicans from caries lesions suggests a potential role in caries pathogenesis, while NAC species may also contribute to lesion development.