title: Comparison of oral Candida species prevalence and carriage among gutka-chewers and betel-quid chewers.
abstract: OBJECTIVE
  To compare prevalence and carriage of Candida species among gutka-chewers and betel-quid-chewers.
  
  
  METHODS
  The cross-sectional case-control study was conducted between January and December, 2015 at the Oral Surgery department of Abbasi Shaheed Hospital and the Dental department of Jinnah Postgraduate Medical Centre, Karachi, and comprised oral yeast samples of gutka-chewers, betel-quid-chewers, and non-chewers. A standardised questionnaire was used to gather demographic data and oral hygiene maintenance information. Oral Candida strains were collected, cultured and identified using standard techniques and yeast identification system. In all groups, unstimulated whole salivary flow rate was determined. Lesions on the tongue and oral mucosa were clinically investigated and numbers of missing teeth were recorded. SPSS 20 was used for data analysis.
  
  
  RESULTS
  Of the total 185 samples, 50(27%) were from gutka-chewers, 50(27%)betel-quid-chewers, and 85(46%) non-chewers. Oral Candida carriage was comparable among betel-quid-chewers (18 [36%])and gutka-chewers (20 [40%]), but it was significantly higher than the non-chewers (11 [12.9%]) (p<0.05).Candida species were isolated from 45 (90%) of gutka-chewers and 45 (90%) of BQ-chewers. Among the groups, Candida albicans was the most commonly isolated yeast species (38% in gutka-chewers and 12.9% non-chewers). Mean numbers of missing teeth were significantly higher among BQ-chewers (6.8±0.4 teeth [range: 5-10]) (p<0.01) and gutka-chewers 6.8±0.6 teeth (range: 5-10) (p<0.01) than non-chewers (2.2±0.3 teeth [range: 0-3 teeth]). There was no significant difference in unstimulated whole salivary flow rate and the number of missing teeth among gutka-chewers and betel-quid-chewers (p>0.05).
  
  
  CONCLUSIONS
  Prevalence and carriage of Candida species were comparable between betel-quid-chewers and gutka-chewers compared to non-chewers.
authors.affiliation: Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Tariq
authors.initials: T
authors.lastname: Abduljabbar
authors.affiliation: Oral Surgery, Karachi Medical and Dental College, Karachi, Pakistan.
authors.forename: Mudassir
authors.initials: M
authors.lastname: Hussain
authors.affiliation: Community Medicine, Karachi Medical and Dental College, Karachi, Pakistan.
authors.forename: Tariq
authors.initials: T
authors.lastname: Adnan
authors.affiliation: Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Fahim
authors.initials: F
authors.lastname: Vohra
authors.affiliation: Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, NY, USA.
authors.forename: Fawad
authors.initials: F
authors.lastname: Javed
mesh_terms: D000328:Adult; D001114:Areca; D002175:Candida / Q000145:classification / Q000302:isolation & purification; D002180:Candidiasis, Oral / Q000453:epidemiology / Q000382:microbiology; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008409:Mastication; D008875:Middle Aged; D009061:Mouth Mucosa / Q000382:microbiology*; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D014030:Tobacco, Smokeless
keywords: Lime-piper betel-quid, Candida, Prevalence, Tobacco, Smokeless.