The purpose of the present study was to examine the relation between oral hygiene habits, denture plaque, presence of yeasts and stomatitis in institutionalised elderly. A sample of 201 residents, 48-99 yr of age (mean age 82 yr), was selected from four different institutions in Lothian, Scotland. Clinical recordings were carried out under standardised circumstances using well recognised indices. Information about oral hygiene habits was obtained through structured interviews conducted immediately before the clinical examination. A multivariate analysis, principal component, was carried out on the correlated five maxillary denture plaque scores and two components, accounting for 74% and 12% of the variation, were identified. Using these two independent variables, an analysis of variance was carried out testing for significance between the four effects: soaking habits, brushing habits, denture stomatitis and growth of yeasts in the palate together with their interactions. The analysis showed a significant relation between maxillary denture plaque, soaking habits and the presence of denture stomatitis. There was no relation between denture plaque and brushing habits or between denture plaque and growth of yeasts.

A study was carried out of 121 elderly edentulous individuals living in institutionalised homes in the Lothian Region, Scotland to determine the prevalence of yeasts and associated oral disease. Clinical examinations found that 65(54%) of the individuals suffered from denture stomatitis, and yeasts were recovered from 51(78%) of these individuals. The main yeasts isolated were Torulopsis glabrata and Candida albicans. Culture of saliva samples produced a slightly higher recovery rate of yeasts compared with swabbing of the floor of mouth and palate. The number of cigarettes smoked per day had a significant positive effect on the presence of denture stomatitis. No difference in disease state was shown between secretors and non-secretors of blood group antigens in saliva. This study demonstrates a significant level of oral mucosal infection in an institutionalised elderly population.

The objectives of this preliminary study were to determine the prevalence of oral candidal carriage and infection in a group of HIV-positive individuals and compare the humoral immune responses in serum and saliva in this group with a control group of HIV-negative subjects. Patients were examined clinically with particular reference to the presence of candidal lesions and oral swabs taken to identify carriers. Venous blood and whole saliva were obtained for estimation of total and anti-Candida antibody levels. Pseudomembranous candidiasis was the commonest clinical variant in HIV-positive individuals. Candida albicans was the commonest species isolated in both groups. Increased levels of anti-Candida IgG were found in both serum and saliva of HIV-negative individuals who were either carriers of Candida species or had clinical candidiasis. This was associated with a reciprocal fall in anti-Candida IgA. Similar trends were seen in HIV-positive individuals in association with candidal carriage and infection, although the changes were more marked.

SUMMARYNon-diabetic individuals who are non-secretors of blood group antigens are prone to superficial infections by Candida albicans. In this study, 216 patients with diabetes mellitus who were denture wearers were examined for the presence or absence of denture stomatitis. There was an overall trend for non-secretors to be prone to denture stomatitis compared with secretors. Stepwise linear discriminant analysis was used to dissect the contribution of secretor status and other variables to the development of the disease. Secretor status was found to be a contributory factor among patients with non-insulin dependent diabetes but not among those with insulin-dependent diabetes. The possible reasons for this are discussed.

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