Effects of Nystatin oral rinse on oral Candida species and Streptococcus mutans among healthy adults

Abstract

Objectives To examine the effect of Nystatin oral rinse on oral Candida species and Streptococcus mutans carriage. Materials and methods Twenty healthy adults with oral candidiasis participated in the single-arm clinical trial and received Nystatin oral rinse for 7 days, 4 applications/day, and 600,000 International Units/application. Demographic-socioeconomic-oral-medical conditions were obtained. Salivary and plaque Candida species and Streptococcus mutans were assessed at baseline and 1-week and 3-month follow-ups. Twenty-four salivary cytokines were assessed. Candida albicans isolates underwent Nystatin susceptibility test. Results Half of participants (10/20) were free of salivary C. albicans after using Nystatin rinse. Salivary S. mutans was significantly reduced at 3-month follow-up (p < 0.05). Periodontal status reflected by bleeding-on-probing was significantly improved at 1-week and 3-month follow-ups (p < 0.05). Plaque accumulation was significantly reduced at 1-week follow-up (p < 0.05). Interestingly, the responses to Nystatin oral rinse were not associated with race, gender, age, oral hygiene practice, adherence to Nystatin rinse, or sweet consumption (p > 0.05). No C. albicans isolates were resistant to Nystatin. Furthermore, salivary cytokine eotaxin and fractalkine were significantly reduced at 3-month follow-up among participants who responded to Nystatin rinse (p < 0.05). Conclusions The study results indicate that oral antifungal treatment had an effect on S. mutans salivary carriage. Future clinical trials are warranted to comprehensively assess the impact of antifungal treatment on the oral flora other than S. mutans and Candida. Clinical relevance Due to the potential cariogenic role of oral Candida species, antifungal approaches shed new light on the prevention and management of dental caries from a fungal perspective.

Catalase produced by Candida albicans protects Streptococcus mutans from H 2 O 2 stress—one more piece in the cross-kingdom synergism puzzle

“…The knowledge that C. albicans’ catalase protects S. mutans in close contact with H 2 O 2 stress highlights the importance of developing strategies that target the disassociation of these partners in grime for the successful prevention and treatment of dental caries. Recently, Aljaffari and colleagues showed that the use of nystatin, an antifungal rinse, reduced the burden of S. mutans in saliva and plaque in patients with thrush, suggesting that approaches limiting colonization by C. albicans might help in the prevention and management of caries ( 56 ). Thus, when crafting new strategies to effectively combat caries, a multipronged approach including molecules that disrupt the synergism between caries-associated microorganisms, prebiotics that favor antagonistic properties of health-associated microorganisms, and the introduction of beneficial commensals possessing distinct pathways that inhibit different cariogenic traits of caries-associated microorganisms should be considered.…”

Impact of Nystatin Oral Rinse on Salivary and Supragingival Microbial Community among Adults with Oral Candidiasis

“…The trial procedure has been detailed previously [ 17 ]. Briefly, during the baseline visit, a questionnaire was used to collect data on the participants’ demographic and socioeconomic background, and oral hygiene practice.…”

“…that could not be identified via colony morphology [ 9 ]. Salivary cytokine/chemokine at three time points (baseline, 1 week and 3 months after Nystatin rinse) was assessed in the University of Rochester Human Immunology Center Core Lab facility, detailed previously [ 17 ]. Immune marker data from the trial were used for statistical analysis.…”

“…Our recent in vitro study [ 16 ] showed that Nystatin application led to a reduced formation of C. albicans and S. mutans dual-species biofilms and cariogenic microcolonies. Furthermore, our previous clinical trial [ 17 ] indicated that Nystatin oral rinse reduced S. mutans salivary carriage among adults, despite only 53% of the participants responding to Nystatin rinse (defined as free of oral C. albicans ). The goal of this study was to (a) assess the impact of Nystatin oral rinse on salivary and supragingival microbiota among healthy adults, (b) identify factors (e.g., oral microbiome and immune markers) that could predict a host’s response to Nystatin antifungal treatment.…”

Unveiling the complexity of early childhood caries: Candida albicans and Streptococcus mutans cooperative strategies in carbohydrate metabolism and virulence

“…Notably, nystatin-treated biofilms exhibit distinctive halo-shaped microcolonies, and there is a downregulation in the core EPS coverage and expression of the gtfD and atpD genes of S. mutans [ 45 ]. Furthermore, investigations into the use of nystatin oral rinse have indicated its impact on oral carriage of C. albicans and S. mutans , suggesting that oral antifungal treatments may effectively influence S. mutans salivary carriage [ 73 ]. These findings point to antifungal treatments as a growing potential strategy for managing cariogenic microorganisms in oral environment.…”