Evaluation of Candida species in oral cavities of patients with oral submucous fibrosis and healthy controls: A comparative study 

Background: Oral submucous fibrosis (OSF) is one of the most abundant premalignant lesions in the oral cavity, in South Asian population (10.54%). Overgrowth of fungi, particularly Candida species, predisposes to the etiopathogenesis of premalignant lesions, developing them to oral malignancies.
Objective: To quantitatively evaluate and determine the prevalence of opportunistic Candida species in OSF patients and healthy controls.
Methods: Healthy controls (n = 28) and OSF patients (n = 28) with histopathologically confirmed diagnosis were recruited from the Oral Medicine Clinic of Dental Teaching Hospital Peradeniya. Samples were collected by oral rinsing technique, and they were inoculated on to Candida HiCrome agar for the isolation of Candida species. Colonies with different colors were counted followed by the germ tube test. The Mann-Whitney U test and Chi square tests were used for the statistical analysis.
Results: OSF patients (78.60%) and only 53.6% of the controls were positive for Candida growth on culture. Candida was found to be present significantly higher (p < 0.05) in OSF group as compared to controls. C. albicans was the most predominant species in the cohort. In both study groups, C. albicans, C. krusei and C. glabarata were isolated.
Conclusion: This study depicted a significantly higher Candida growth in OSF patients than the controls, with C. albicans being the predominant species.  This suggests that, OSF-mediated mucosal changes facilitate Candida colonization in the oral epithelium.