Microflora of the Oral Cavity in Patients with Xerostomia

Abstract

Objective. The aim of this study was to evaluate the dependence of the condition of the microflora of the oral cavity on the etiology of xerostomia, patients’ sex, age, degree of hyposalivation, and duration of the sense of dryness. Material and Methods. A total of 64 patients with complaints of oral dryness referred to the Clinic of Oral and Dental Diseases, Hospital of Lithuanian University of Health Sciences, for consultation during the period from 2003 to 2005 were selected for the study. The etiological factors of xerostomia were as follows: radiotherapy (PRT) to the maxillofacial area, Sjögren’s syndrome (SS), and xerogenic medications, tricyclic antidepressants (TCAs). Results. There were 50 women and 14 men. Their mean age was 60.5±1.6 years. All the patients in the PRT group had high counts of Candida spp. as compared with percentages of patients in the TCA and SS groups (100% vs. 66.7% and 56.2%, P<0.05). Patients’ age and sex in different etiology groups had no significant impact on the condition of their oral microflora. There were equal percentages of patients with deficient and normal salivation in the TCA group (44% in both the groups; P<0.01). All the patients in the PRT group had pronounced hyposalivation (P<0.002). A significantly greater percentage of patients with severely reduced salivation had high counts of Lactobacillus spp. (P<0.01). Significantly greater percentages of patients with the clinical duration of xerostomia of up to 6 months had high counts of Lactobacillus spp. and Candida spp. colonies. Conclusions. In patients with xerostomia, the condition of the microflora of the oral cavity and impairment of major salivary gland function varied according to the etiology of the disease. The level of hyposalivation and the duration of xerostomia were found to have a significant impact on the microflora of the oral cavity.

Xerostomia of Various Etiologies: A Review of the Literature

“…They isolated such fungi as Candida albicans and Candida glabata from the tongue and angle of the mouth, respectively, in hyposalivation patients. Guobis [41] postulates an association between mouth dryness and colonization with microorganisms, not only Candida albicans but also Lactobacillus spp.…”

Microbiota and their role in the pathogenesis of oral mucositis

“…Other studies indeed reported an increase in the abundance of Gram‐negative species (Tong et al , ; Panghal et al , ; Sonalika et al , ) together with Candida spp. (Belazi et al , ; Almståhl et al , ; Guobis et al , ; Sonalika et al , ) and Lactobacillus spp. (Tong et al , ; Almståhl et al , ; Guobis et al , ).…”

“…(Belazi et al , ; Almståhl et al , ; Guobis et al , ; Sonalika et al , ) and Lactobacillus spp. (Tong et al , ; Almståhl et al , ; Guobis et al , ). With regard to the fungi, the most frequent etiology of infections found in oral rinse samples during radiotherapy was Candida albicans , followed by Candida glabrata , Candida krusei , Candida tropicalis , and Candida kefyr (Belazi et al , ).…”

“…With regard to the fungi, the most frequent etiology of infections found in oral rinse samples during radiotherapy was Candida albicans , followed by Candida glabrata , Candida krusei , Candida tropicalis , and Candida kefyr (Belazi et al , ). Also swabs of tongue, buccal mucosa, vestibulum, supragingival plaque, and subgingival region and salivary samples showed a significant increase in C. albicans (Almståhl et al , ; Guobis et al , ; Sonalika et al , ). With regard to resident Lactobacillus spp., three studies including >100 subjects in total showed an increased number and proportion of Lactobacillus spp.…”

“…With regard to resident Lactobacillus spp., three studies including >100 subjects in total showed an increased number and proportion of Lactobacillus spp. in swabs of tongue, buccal mucosa, vestibulum, supragingival plaque, and subgingival region and saliva after radiotherapy subjects (Tong et al , ; Almståhl et al , ; Guobis et al , ). Given the conflicting results in the two studies performed and given the small number of subjects tested in both studies, no general conclusions could be made regarding the effect of radiotherapy on Streptococcus spp.…”