Assessment of the fungal flora and the prevalence of fungal infections in the mouth of diabetics

Investigations have revealed that diabetics are more prone to develop infections than are the normal population. Oral candidiasis is one of the most common infections in diabetics and people with impaired immune systems. The purpose of this study was to identify the oral fungal flora and determine the prevalence of fungal infections. 132 type 2 diabetics (109 females and 23 males, aged 25 – 65 years) and 130 (107 females and 23 males) healthy age and sex–matched subjects were studied. Blood and saliva samples were obtained during fasting state. Four samples from different sites of the mouth were collected for culture. Blood groups were also tested. HbA1c was employed to assess the glycemic control of subjects. Candida Albicans was the most frequent species in the mouths of diabetics and controls. The prevalence of oral candida was significantly higher in diabetics than in controls (40.2% VS 16.2%, p<0.001). Blood glucose levels showed a positive and significant correlation with saliva glucose levels (p<0.001) and HbA1c (p<0.02). Saliva glucose demonstrated a positive and significant correlation with HbA1c (p<0.02). Poor glycemic control, denture use, and poor oral hygiene were the most important factors for developing oral candidosis in diabetics. “AB” blood group showed a positive correlation with oral lichen lesions. This study showed that a significant percentage of individuals are carriers of oral candida, without showing any symptoms of infection. In addition, oral candidal carriage and infections in diabetic patients is complex and includes species which have not been previously reported. Better glycemic control, oral hygiene and use of mouthwashes may reduce the chances of oral candidal carriage and infections in subjects.