Streptococcus mutans in denture stomatitis patients under antifungal therapy

Streptococcus mutans em pacientes com estomatite protética submetidos à terapia antifúngica

Laurylene César de S. Vasconcelos^I; Fábio Correia Sampaio^I; Maria Carméli Correia Sampaio^II; Maria do Socorro Vieira Pereira^III; Maria Helena Pereira Peixoto^III

^IDepartment of Clinical and Social Dentistry, Federal University of Paraíba, João Pessoa, PB, Brazil
^IIDepartment of Pharmaceutical Sciences, Federal University of Paraíba, João Pessoa, PB, Brazil ]]> ^IIIDepartment of Molecular Biology, Federal University of Paraíba, João Pessoa, PB, Brazil

Correspondence

ABSTRACT

PURPOSE: To assess the number of Streptococcus mutans in saliva of patients with denture stomatitis before and after antifungal therapy.
METHODS: After examining 93 patients, 47 were selected for fungal test. Then, from this sample, thirty patients were selected: 15 with positive and 15 with negative diagnosis for candidiasis that were evaluated for S. mutans counting, salivary flow and buffer capacity evaluation. Oral hygiene and prosthesis hygiene, period using prosthesis, lesion type and salivary data were related with clinical laboratorial characteristics of the patients with Candida.
RESULTS: The most frequent lesions were type I (43.5%) and II (53.5%). The amount of S. mutans was six times higher in patients with candidiasis and it was associated with low salivary flow and poor oral hygiene. After therapy, a reduction of S. mutans was verified particularly in patients with normal salivary flow. The values ranged from 0.01 to 3.88 x 10⁴ cfu/mL.
CONCLUSION: The data suggest that Streptococcus spp collaborates with Candida spp in the etiology and pathogenesis of denture stomatitis. The use of oral antimicrobial agents may provide a beneficial effect for denture stomatitis patients that are under antifungal therapy and that have poor oral hygiene and unfavorable salivary parameters.

Key words: Dental prosthesis; antifungal agents; Candida; Streptococcus mutans

OBJETIVO: Verificar o número de Streptococcus mutans em saliva de pacientes com estomatite protética antes e após a terapia antifúngica.
METODOLOGIA: Após exame clínico de 93 pacientes, 47 foram selecionados para exame micológico e desta amostra foram selecionados trinta pacientes: 15 com diagnóstico positivo e 15 com diagnóstico negativo de candidose foram avaliados para contagem de S. mutans, determinação de fluxo salivar e capacidade tampão. Higiene bucal e da prótese, tempo de confecção, tipo de lesão e dados salivares foram relacionados com características clínicas e laboratoriais de Candida.
RESULTADOS: As lesões frequentes foram dos tipos I (43,5%) e II (53,5%). A quantidade de S. mutans foi seis vezes maior em pacientes com candidose e foi associada com baixo fluxo salivar e higiene oral deficiente. Após a terapia, a redução de S. mutans foi verificada particularmente em pacientes com fluxo salivar normal. Os valores variaram de 0,01 a 3,88 UFC/ml x 10⁴.
CONCLUSÃO: Os dados sugerem que os Streptococcus colaboram com Candida spp na etiopatogenia da estomatite protética. O uso de agentes antimicrobianos orais pode propiciar efeito benéfico para pacientes com estomatite protética submetidos à terapia antifúngica e que apresentam higiene oral deficiente e parâmetros salivares desfavoráveis.

Palavras-chave: Prótese dentária; agentes antifúngicos; Candida; Streptococcus mutans

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Acknowledgments

This study is part of a doctoral thesis and it was supported by Lauro Wanderley University Hospital for its realization.

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Correspondence:
Laurylene César de Souza Vasconcelos
R. Maria Helena da Rocha, 113 - Aeroclube ]]> João Pessoa, PB - Brasil 58036-823
E-mail: laurylene@uol.com.br

Received: May 20, 2009
Accepted: March 31, 2010

Conflict of Interest Statement: The authors state that there are no financial and personal conflicts of interest that could have inappropriately influenced their work.