Prevalence and intraoral distribution of Candida albicans in Sjogren's syndrome

SUMMARY An imprint culture technique has been employed to study the prevalence and intraoral distribution of Candida albicans in 16 patients with Sjogren's syndrome and in 16 healthy controls matched for age, sex, and dental status. The prevalence and intraoral density of C. albicans was found to be significantly higher at almost all sites in the Sjogren's patients than in the controls. The distribution of candida was also altered, being significantly higher in the floor of the mouth and anterior labial sulcus in the Sjogren's group. There was an approximate inverse relationship between candida populations and rate of salivary flow. Mean candida densities were found to be significantly higher in those Sjogren's patients with detectable serum rheumatoid factor in the serum. However, patients with primary Sjogren's syndrome had significantly higher mean candida densities compared with patients with secondary Sjogren's syndrome. Sjogren's (1933) syndrome is characterised by xerophthalmia, xerostomia, and, in most cases, an associated connective tissue disorder (Bloch et al., 1965). Chisholm and Mason (1973) state, without supporting data, that oral candida infections are common in Sjbgren's syndrome. Using an imprint culture technique, a normal range for the oral density and distribution of Candida albicans has recently been established for healthy subjects (Arendorf and Walker, 1979a). In healthy carriers, there was an upper limit to the density of C. albicans found at any site, which was, however, regularly exceeded in candida infections. In the present investigation, quantitative imprint cultures have been used to assess whether the prevalence or intraoral dens ty and distribution of C. albicans is significantly altered in Sj6gren's syndrome compared with that of normal subjects. The serum candida fluorescent antibody titres were also determined since Lehner (1966) suggested that this test could also discriminate between the healthy carrier state and oral candidosis