Quantification and Categorization of Oral Candida among Denture Wearers with Type II Diabetes Mellitus Associated Co-morbid Conditions

Abstract

Background: Candida species are opportunistic pathogens that frequently colonize the oral cavity. Denture wearing and diabetes mellitus significantly enhance Candida growth and pathogenicity, potentially leading to severe infections. The interaction between these factors, especially in patients with comorbidities, requires further investigation. Objectives: To evaluate Candida colonization quantitatively and categorize Candida species among type II diabetic complete denture wearers with co-morbid conditions. Methodology: This cross-sectional observational study included 150 type II diabetic denture wearers with comorbidities. Saliva samples were collected, cultured on Sabouraud Dextrose Agar and CHROMagar, and incubated at 37°C for 24-48 hours. Colony-forming units (CFU) were counted, and species were identified based on colony morphology. Data were analyzed using chi square test, ANOVA and post-hoc Tukey tests, p-value<0.05 considered statistically significant. Results: The study population was predominantly male (63.3%) and over 50 years of age (80%). Significant differences in Candida colonization were observed across comorbidity groups (p=0.036). Endocrine conditions demonstrated the highest mean Candida colonization (921.7±98.6 CFU), followed by cardiovascular (856.4±124.8 CFU) and gastrointestinal conditions (825.6±132.4 CFU). Post hoc analysis revealed significant differences between endocrine conditions and nephrological (p=0.031), and neurological conditions (p=0.004). Candida albicans was the predominant species (57.3%), with highest counts in endocrine conditions (608.3±65.1 CFU). Candida parapsilosis (18.8%), Candida tropicalis (11.9%), Candida glabrata (9.2%), and Candida krusei (2.0%) were also identified, with significant distinct distribution patterns across comorbidities. Conclusion: Type II diabetic denture wearers with endocrine and cardiovascular comorbidities exhibit significantly higher Candida colonization, particularly C. albicans. These findings highlight the need for targeted oral health interventions and regular monitoring in this high-risk population to prevent oral fungal infections and potential systemic complications.