Candidal organisms are commonly found in the oral flora of many humans. Oral infection due to candidal overgrowth is often opportunistic in immune suppressed or denture wearing patients. Clinical diagnosis of candidiasis may be accomplished empirically by visual examination or scientifically by laboratory analysis. Objective: To compare two techniques commonly used to diagnose oral candidiasis for the purpose of determining accuracy and consistency. Methods: One hundred and eight patients were tested for oral candidiasis using fungal culturing analysis and exfoliative cytology. Fifty-six patients had clinical signs and symptoms suggestive of candidiasis and 52 patients without signs or symptoms served as the control population. Culturing was accomplished by having the patients rinse with a 5% saline solution for one minute. The expectorate was collected and cultured for growth of various candidal species. Oral lesions suggestive of candidiasis were swabbed, fixed to a glass slide and evaluated microscopically with PAS stain for the presence of candidal hyphae. Results: Positive results were designated to be any culture ³ 100 colony forming units (CFU)/ml or the presence of any candidal hyphae upon microscopic analysis. Comparison of these methods revealed that 76 of 100 patients exhibited comparable culture and exfoliative cytology results with 24 patients exhibiting positive findings and 52 patients exhibiting negative results. Thirty-two comparisons yielded inconsistent findings. Twenty-nine of 32 (90.6%) patients exhibited negative cytology results yet positive culture results. Conclusions: Both methods are valuable diagnostic tools in detecting the presence of Candida in the oral cavity. Exfoliative cytology is of primary value in the presence of clinical lesions suggestive of candidiasis, while culturing is a more reliable diagnostic indicator for the presence of Candida in the oral cavity with or without detectable disease. Supported by: NIH / NIDCR, Grant #: DE07188 and The Baylor Oral Health Foundation.

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