ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title In Patients Requiring Full or Partial Dentures, Susceptibility to Candida Infection Is Increased if the Patient Has Diabetes
Clinical Question In patients requiring full or partial dentures, does the susceptibility of candida infection increase when the patient has diabetes when compared to a non-diabetic patient?
Clinical Bottom Line In patients requiring full or partial dentures, the susceptibility to candida infection is increased if the patient has diabetes. This is supported by a case control study where blood glucose levels and a medical history of type II diabetes were statistically associated with candida colonization. Diabetes and denture usage are two common clinical manifestations, especially in the older population, and extra care should be taken by dentists to advise this patient group of their risk status and proper denture hygiene habits.
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/200946 patients with diabetes and denture use, 46 patients without diabetes and denture useCase Control Study
Key resultsWhen comparing the level of candida colonization collected from the palatal intalglio surface of maxillary dentures, this study found a colony count of 296.6 for the diabetic and 64.7 for the non-diabetic (control) population. These findings were statistically significant (P = 0.001). Additionally, a Spearman correlation test was used to analyze the relationship between the patients' fasting blood sugar (FBS) levels and colonization count. The diabetic patients had a FBS of 289.2, while the control population had a FBS of 94.7. The correlation between FBS and colonization was also found to be statistically significant (P = 0.001). Lastly, while both populations did reveal candida colonization, there were more colonies of non-candida-albicans growth in the diabetic patient when compared to the control.
Evidence Search candida AND dentures AND diabetes
Comments on
The Evidence
Validity: This was a case control study, which does not show a cause-effect relationship between diabetics and candida colonization, but only an associative relationship. Therein, while the relationship between candida and diabetics and candida and dentures has been widely studied, a stronger study is needed specifically within diabetic denture wearers. In this study, the case and control populations were very similar. Patients selected were evenly split between male and female, were all over the age of 50, had been wearing their dentures for at least 5 years, and had not used an antiseptic mouthwash in 6 months. The study used sound statistical analysis to prove their findings significant, as described above. Perspective: While the study did take measures to control the variables responsible for candida colonization between the two populations, one factor I think they missed was controlling for the patient’s hygiene habits and denture care. The only criteria they took to this regard was having worn dentures for 5 years and not used a mouthwash in 6 months. There was no criteria on patient removal of the dentures at night or on regular cleaning of the dentures, which is a major factor for deterring candida growth. Overall, the findings are valid, but again, a stronger study is needed.
Applicability The study represents an average patient population, and interventions such as verbal instruction and oral health education can easily be applied by the dentist to the diabetic edentulous population.
Specialty/Discipline (Public Health) (General Dentistry) (Prosthodontics)
Keywords Candida, Dentures, Diabetes
ID# 3182
Date of submission: 03/28/2017spacer
E-mail vangorp@livemail.uthscsa.edu
Author Chase Van Gorp
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Joseph Connor, DDS, MA
Faculty mentor/Co-author e-mail Connorj@uthscsa.edu
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