Oral candidosis in long‐term hospital care: comparison of edentulous and dentate subjects

Abstract

OBJECTIVE: To obtain information on the oral health status of the elderly living in a medicalized, geriatric institution. DESIGN: A cross-sectional clinical investigation with complementary microbiological studies. SUBJECTS AND METHODS: A cohort of 233 elderly in one long-term care ward; collection of demographic data; clinical examination to determine dental and prosthetic status and health of the oral mucosae; swabs for detection of mucosal and denture colonization by Candida; paraffin stimulated saliva for detection of colonization by mutans streptococci and lactobacilli. MAIN OUTCOME MEASURES: Oral and denture hygiene; oral mucosal health; degree of colonization by Candida, mutans streptococci and lactobacilli. RESULTS: Mean age of the 233 patients was 85.6 +/- 6.9 years; 61% were totally dependent, 62.7% were wearing one or two complete dentures; 19.7% had natural teeth and no denture and 17.6% neither teeth nor denture. Of those wearing dentures 72% had denture stomatitis. Of those with natural teeth 72% were affected by active caries. Yeast counts were significantly correlated with the intensity of the erythema of the palatal mucosa, plaque score of the natural teeth, denture plaque score, and salivary counts of mutans streptococci and lactobacilli. CONCLUSIONS: High oral yeast counts and frequent prevalence of oral candidosis in elderly subjects living in institutions are associated with poor oral hygiene and neglect of denture care.