Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), Francisco José Longo , Brazil
Oral Colonization by Candida Species in Patients with Multiple Sclerosis
Introduction: Multiple sclerosis (MS) is a chronic inflammatory demyelinating autoimmune disease that affects the central nervous system. Since immune system plays a key role in this disease, patients with MS can present higher risk of infections.
Purpose: This study aimed to investigate the prevalence of Candida spp. in the oral cavity of MS patients in relation to a control group METHODS: In total, 100 individuals were selected: 55 diagnosed with MS and 45 healthy individuals (control group). Saliva samples were collected and seeded in culture media selecting for Candida. Following an incubation period of 48 h, colony-forming units (CFU mL-1) were counted and colonies were isolated for Candida species identification by multiplex PCR. The results were analysed by chi-squared and Mann-Whitney U statistical tests considering a significance level of 5%.
Results: Candida spp. were confirmed in the oral cavity of 50.09% patients in the MS group and 35.55% individuals in the control group. In individuals positive for the growth of Candida spp., the median values of Candida colonies were 220 CFU mL-1 for the MS group and 120 CFU mL-1 for the control group. However, no statistically significant differences were observed between groups for both prevalence and CFU mL-1 count. Of the Candida species identified, 73.91% were C. albicans, 21.73% C. glabrata, 2.17% C. tropicalis, and 2.17% C. krusei.
Conclusions: The colonization of Candida spp. in the oral cavity of individuals with multiple sclerosis was higher than in the control group; however these findings were not proven to be statistically significant.
Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Saudi Arabia
Is there an association between multiple sclerosis and oral health?
Data sources: PubMed, Scopus, Web of Science, MEDLINE and CINAHL.
Study selection: Randomised controlled trials, cross-sectional studies and cohort studies.
Data extraction and synthesis: Two reviewers independently extracted data using piloted forms and contacted authors if relevant data were missing. Assessment of quality was done using the Newcastle-Ottawa scale (NOS) for both cohort and cross-sectional studies. The score of NOS ranged from 1-9, where 6-7 is considered moderate quality while 8-9 is high quality.
Results: Seventeen studies were included in the review (13 cross-sectional and four cohort). Seven out of 13 cross-sectional studies scored ≤5 which indicates poor quality. The four case-control studies were of moderate quality. Overall, there is limited evidence that patients with multiple sclerosis (MS) have more dental caries or gingival disease. However, evidence suggests that patients with MS have more risk of periodontal disease and poor oral hygiene. The evidence also suggests a moderate association between MS and temporomandibular disorders (TMD).
Conclusions: With the exception of TMD, current evidence does not establish an association between MS and most oral health conditions. More high-quality evidence is needed to further explore and establish an association.