Candida albicans and Caries in Post-partum Appalachian Women

Objectives: Candida albicans (CA), a common oral commensal, interacts in vitro with other oral species to adhere to tooth surfaces. Studies of children have found an association between CA and caries formation. Here we explore whether there is a similar association among adults.
Methods: Saliva was collected from 101 mothers participating in a mother-infant pair study conducted by the Center for Oral Health Research in North Central Appalachia; at 2, 12, and 24 months post-partum. We used quantitative PCR to test saliva for Streptococcus mitis, Streptococcus sobrinus, Streptococcus mutans, Streptococcus oralis, and Candida albicans. The limit of detection was 100 genomic copies/mL; all samples with abundance values below this threshold were considered negative.
Results: Mothers with active caries had a higher mean abundance of CA (2.44 genomes/mL vs. 1.88 genomes/mL, p<0.01) as compared to mothers without active caries at each time period. Overall, the odds of caries were 2.22 times higher in mothers with CA (95% CI: 1.21-4.08, p<0.01). The association remained significant when S. mutans or S. oralis was present or S. sobrinus was absent. However, the abundance of CA was not correlated with the abundance of any streptococcal species when evaluated by caries status. Mothers with more diverse community types had less CA and fewer caries.
Conclusions: The presence of CA and certain streptococcal species is associated with caries in post-partum Appalachian women. Further analyses to understand how breastfeeding, smoking, alcohol consumption, and gingivitis modifies this relationship is ongoing.