title: A prospective randomized trial to reduce oral Candida spp. colonization in patients with hyposalivation.
abstract: Low salivary flow rates are associated with higher oral Candida spp. counts, which may predispose to oral candidiasis. The aim of this study was to compare the effect of stimulating salivary flow rates with that of a regimen of chlorhexidine mouth rinse on the intensity of Candida colonization in patients with reduced salivary flow rates. Thirty-one outpatients were randomized to stimulate salivary output (group 1) or to receive chlorhexidine mouth rinses (group 2). Evaluations were performed at baseline (T0), at end of treatment (T1), and 15 days after last day of treatment (T2). Chewing-stimulated whole saliva samples were collected at each visit. Group 1 showed a constant reduction in median cfu counts, although the difference was significant only between T0 and T2 (p = 0.004). Group 2 showed a reduction in median Candida cfu counts between T0 and T1 (p = 0.01), but the counts increased at T2 (p = 0.01), and the difference between T0 and T2 was not significant (p = 0.8). In conclusion, patients who received salivary stimulation showed reductions of Candida cfu counts in saliva and a trend for increasing salivary flow rates between baseline and end of study evaluations. The use of chlorhexidine mouth rinses dramatically reduced Candida cfu counts, but when patients discontinued treatment, intensity of colonization rose again.
authors.affiliation: Department of Oral Pathology and Diagnosis, School of Dentistry, Federal University of Rio de Janeiro. sandratorres@ufrj.br
authors.forename: Sandra Regina
authors.initials: SR
authors.lastname: Torres
authors.forename: Camila Bernardo
authors.initials: CB
authors.lastname: Peixoto
authors.forename: Daniele Manhães
authors.initials: DM
authors.lastname: Caldas
authors.forename: Tiyomi
authors.initials: T
authors.lastname: Akiti
authors.forename: Maria Glória Carvalho
authors.initials: MG
authors.lastname: Barreiros
authors.forename: Milton
authors.initials: M
authors.lastname: de Uzeda
authors.forename: Marcio
authors.initials: M
authors.lastname: Nucci
mesh_terms: D000328:Adult; D000368:Aged; D002176:Candida albicans / Q000187:drug effects / Q000302:isolation & purification*; D002180:Candidiasis, Oral / Q000382:microbiology / Q000517:prevention & control*; D002710:Chlorhexidine / Q000494:pharmacology / Q000627:therapeutic use*; D015169:Colony Count, Microbial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000494:pharmacology / Q000627:therapeutic use*; D011446:Prospective Studies; D012463:Saliva / Q000378:metabolism* / Q000382:microbiology; D012636:Secretory Rate; D018709:Statistics, Nonparametric; D014987:Xerostomia / Q000382:microbiology*
chemical_list: D009067:Mouthwashes; D002710:Chlorhexidine