Oral Candida colonization in patients with fixed orthodontic appliances: The importance of some nutritional and salivary factors

We investigated the relationship between fixed orthodontic appliances and oral Candida colonization. The influence of some important nutritional and salivary factors was also investigated. These factors included: hemoglobin, vitamin B12, ferritin and folate levels, salivary flow rate, salivary pH, tobacco smoking and dietary habits. Patients enrolled in this study were adolescent patients aged 12-18 years who attended the Orthodontics Department/University of Jordan Hospital for the provision of fixed metallic orthodontic appliances. Salivary samples were collected on the first visit prior to bonding, one month and four months later. All patients were investigated for serum vitamin B12, serum ferritin, red-cell folate, complete blood count, salivary pH, and salivary flow rate. Data were obtained from the patients regarding tobacco smoking and dietary habits. We found that Candida colonization did not increase after bonding of fixed orthodontic appliances. None of the local oral factors investigated was correlated with Candida colonization. Only two systemic factors (serum vitamin B12 and red-cell folate) were significantly (P < 0.05) associated with Candida colonization during the study period. It was obvious that metallic fixed orthodontic appliances did not encourage oral Candida colonization during the four months study period. On the other hand, it seems that nutritional factors like serum vitamin B12 and red-cell folate can influence oral Candida colonization more than tobacco smoking, dietary and salivary factors.