Objectives: The purpose of this retrospective study was to examine the relationship between quantitative salivary flow rate and the presence of candidiasis in patients with xerostomia
Methods: Unstimulated whole (UWS) saliva collected (n= 158) by drooling method and paraffin stimulated whole saliva (SWS) was collected from patients of the Oral Medicine Clinic of Tufts University School of Dental Medicine for xerostomia. To assess the presence of oral candidiasis, a swab was used to collect samples directly from the tongue, buccal mucosa, vestibule, floor of mouth, hard palate etc. and was cultured and processed in Dentocult TM. Colony forming units were assessed according to manufacturer’s instructions to determine the level of candidiasis. Nonparametric Mann Whitney U Tests and Spearman Correlation coefficients were determined for saliva and candidiasis tests.
Results: The mean UWS was 0.107 ml/min (0 – 0.921) and the mean SWS was 1.08ml/min (0.0- 5.22) respectively and 45% had SWS below 0.7 ml/min. 54.4 % were determined as positive for candidiasis. Those that were positive for candidiasis had significantly less saliva, both UWS (0.068+/-0.129 vs.0.152=/- 0.181, MW p< 0.0001), and SWS (.862+/- 1.0 vs. 1.34+/- 1.05 MW, p<0.003). A significant negative correlation was found between the level of candidiasis colony forming units and both UWS and SWS (p< .0001) in a xerostomic population.
Conclusion: Quantitative loss of salivary flow, leads to increased levels of candidiasis due to C. albicans in the oral cavity.