Prevalence, density, and manifestations of oral Candida albicans in patients with Sjogren's syndrome

Objective: Various investigators have reported a high prevalence of oral Candida species in patients with salivary gland dysfunction (SGD). The purpose of this study was to assess the prevalence of oral Candida albicans, its oral manifestations, and to compare the number of colony-forming units of Candida albicans in patients with primary Sjogren's syndrome and secondary Sjogren's syndrome with the whole unstimulated salivary flow rate in each group. Method: An age-sex-matched group of control subjects was selected for comparison. Oropharyngeal collection of samples and culturing was performed on each subject. Quantitative cultures specific for Candida albicans were performed. Results: The frequency distribution indicated that > 80% of all SS subjects were positive for Candida albicans vs. none of the controls. The most common lesion was angular cheilitis followed by chronic atrophic candidiasis. The subjects with Sjogren's syndrome also demonstrated significantly high numbers of Candida albicans colony-forming units. Conclusions: This study indicates significantly higher Candida albicans colonization in patients with primary or secondary Sjogren's syndrome as compared to a control population. Candida albicans colonization was higher in patients with secondary Sjogren's syndrome than in patients with primary Sjogren's syndrome; however, the amount of Candida albicans was not universally relative to salivary flow.