Study on clinical symptoms of oral fungal disease in people who are head and neck cancer and complete dentition

Abstract

Background: Fungal disease (candidosis) is an opportunistic infection that spreads to the skin, mucous membranes, and internal organs, caused by a conditionally pathogenic fungus of the Candida type. During clinical examinations, there are several areas of the mouth covered with white spots like edema. These areas are on the mucous membrane of the mouth, tongue, palate, lips, and hard and soft palate. These patients mostly have pain and dryness discomfort complaints. The mechanism of oral fungal disease is not perfectly formulated yet, but there are several factors that inhibit the disease as an adhesion mechanism of the fungi, the host’s immune system, epithelial defense mechanism, immunoglobulin A, and salivary factors. Risk factors include tooth decay, reduced salivation, oral mucosal disorders, corticosteroid treatment, diabetes, joint disease, HIV infection, AIDS, cancer, immunosuppressive drugs, and head and neck radiation therapy. Oral fungal infection is increasing year by year, but the symptoms are subtle. Therefore, the identification of the causative agent at the species level through laboratory analysis and the determination of clinical symptoms are the reason for conducting this study. Aim: To study the clinical features of oral fungal disease in people who are head and neck cancer and complete dentition Materials and Methods: We conducted a case-control study. The study inclusion criteria were patients with a high risk of candidiasis. A total of 80 people were included of the study participants who were admitted to the radiation therapy department of National Cancer Center and Central Dental Hospital of Mongolian National University of Medical Sciences. A questionnaire with 3 main parts and 12 questions was collected and the oral examination was performed by a single dentist, and the information was recorded on the patient card. A swab was taken from the oral mucosa of the participants and the pathogen was identified by laboratory analysis. Participants who were found to be infected with fungi were included in the case group, and participants who were not found were included in the control group. Ethical approval was obtained from the Research Ethics Committee of MNUMS. The results of the study were processed using statistical software Stata-25 and Microsoft Excel, and detailed statistical analysis was performed. Results: When studying the clinical symptoms of the oral mucosal fungal disease by questionnaire method, 59.57% of dry mouth and 42.55% of soreness the case group had symptoms of in the mouth, while in the oral examination, 42.55% of the case group had a dry tongue, 42.55% of pale mucus, and 42.55% of the underlying mucosa. Redness was found in 36.17% and dry mucus in 38.03%. There was a statistically significant difference between the control and case groups in the clinical features (p=0.022). Conclusion: In the clinical examination of oral mucosal candidiasis, the symptoms of tongue slippage, paleness of the mucous membrane, reddening of the underlying mucosa, and dryness of the mucous membrane were relatively high. We concluded that even though the causative agents of fungal diseases have been identified, cases with mild clinical symptoms predominate.