ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Blood Glucose Levels Have a Greater Effect on Oral Candidiasis Colonization in Denture-Wearing Diabetics than in Denture-Wearing Non-Diabetics
Clinical Question In denture patients, do blood glucose levels have a greater impact on oral candidiasis colonization in diabetics vs. non-diabetics?
Clinical Bottom Line Blood glucose levels have a greater effect on oral candidiasis colonization in denture-wearing diabetics than in denture-wearing non-diabetics. In a case control study involving 92 edentulous participants (46 diabetic and 46 non-diabetic denture wearers), results showed that there was an increase in candidiasis colonization in denture-wearing diabetics compared to denture-wearing non-diabetics. A significant correlation was seen between blood glucose levels and the duration of denture usage with the colonization of Candida in denture-wearing diabetics. Controlling blood glucose levels should improve the oral health status of the denture-wearing diabetic and lead to a decrease in oral candidiasis colonization.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 21528026Lotfi-Kamran/ 200992 Edentulous denture-wearing diabetics (n=46) and non-diabetics (n=46)Case Control Study
Key resultsA higher density of isolated colonies was seen in the diabetic group compared to the control group (P = 0.0001). There was a statistically significant correlation between the blood glucose level (P = 0.0001) and the duration of denture usage (P = 0.022) with the colonization of Candida on dentures of diabetic patients.
#2) 23878569 Ganapathy/201315 complete denture wearers with Type II diabetes mellitusCohort study
Key resultsThere was a positive correlation between the blood glucose levels and candidal colonization (colony forming units [CFU]) (P < 0.05). There was significant reduction in the mean values of blood glucose levels (P < 0.001) and the mean values of the CFU (P < 0.001) following oral hypoglycemic drug therapy.
Evidence Search ("dentures"[MeSH Terms] OR "dentures"[All Fields] OR "denture"[All Fields]) AND ("candida"[MeSH Terms] OR "candida"[All Fields]) AND ("blood glucose"[MeSH Terms] OR ("blood"[All Fields] AND "glucose"[All Fields]) OR "blood glucose"[All Fields])
Comments on
The Evidence
Validity: Both studies had populations of denture-wearing diabetics (one study had a comparison group of denture-wearing non-diabetics), so a specific issue was clearly focused on. Using the case control method in the first study allowed oral candida colonization comparisons to be made between the diabetic and non-diabetic denture wearers. Samples were taken from the palatal impression surface of maxillary dentures and were cultured directly on sabouraud agar medium and isolated colonies were counted and identified based on specific tests; results were objective with minimal bias. Results showed a positive correlation between blood glucose levels and candida colonization, aiding in validity for both studies. Perspective: Candida colonization thrives and feeds off of glucose, so it’s no surprise that when blood glucose levels are up, bacterial growth increases as well. Both studies listed above support this statement.
Applicability This will be applicable to many of my future patients who will be diabetic and denture wearers. Keeping their blood glucose under control will lead to controlling the density of oral candida colonization and improving oral health status. However, if an oral candida infection is seen in diabetics, it will be best to refer them to a physician to make sure their blood glucose levels are under control.
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (General Dentistry) (Prosthodontics)
Keywords Candida albicans, Colonization, Denture, Diabetics, Non-diabetics
ID# 3175
Date of submission: 04/19/2017spacer
E-mail ahmedmn@livemail.uthscsa.edu
Author Maliha Ahmed
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Suman Challa, DDS
Faculty mentor/Co-author e-mail challas@uthscsa.edu
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