Salivary carriage of Candida species in relation to dental caries in a population of Saudi Arabian primary school children

Aim: Salivary Candida carriage patterns seem to significantly vary by geographical location. The aim of this study was to assess carriage of Candida species in saliva of primary school children in a Saudi population, and correlate it to their dental caries activity. Materials and methods: A total of 270 children of both genders were recruited from six primary schools. Oral hygiene and dental caries were assessed using the simplified oral hygiene and dft/DMFT indices, respectively. Chromagar Candida medium was used to identify and quantify Candida species in unstimulated saliva samples. Results: Seven percent of the subjects were caries free while 74% had high caries activity. Candida was detected in 63.3% of the children with a mean count of 1076 ± 1888 CFU/ml. Significantly higher carriage was observed in males (70% vs. 56%; P = 0.02). Candida albicans accounted for 69% of the isolates, while Candida tropicalis, Candida glabrata, Candida krusei and unidentified species represented 11.8%, 5.5%, 2.3% and 11.4%, respectively. Twenty-five percent of the carriers harbored 2 or more species. Four carrier clusters were identified as described previously. Carriage status showed the strongest association with both d and D scores (P < 0.01), caries status (OR = 5.9; P = 0.003) and caries extent (OR = 5.5; P = 0.001). Carriage at >1000 CFU was only seen in caries active subjects. Conclusions: Asymptomatic oral carriage of Candida at high counts seems to be common among children from Arabia. Further evidence is provided here for the potential use of Candida counts for prediction of caries risk.