Early Oral Colonization of Candidal Species in Young Children With Cleft Lip and Palate

Cleft lip and palate may promote early oral Candida colonization and caries. This study compared Candida carriage and oral health indices in 0-3-year-old children with trans-foramen cleft lip and palate versus age- and sex-matched controls.

In this observational study, 40 cleft and 40 control children were enrolled. Multi-site oral swabs were cultured with speciation (germ tube test for Candida albicans and CHROMagar for non-albicans Candida); fungal burden was reported as colony-forming units per mL. The def index and caries severity index (CSI) were analyzed using the chi-square test, independent t-tests, and Mann-Whitney U test.

Candida carriage was higher in cleft children than controls (35 (87.5%) vs 8 (20.0%)), and growth categories differed (p<0.001). C albicans and non-albicans Candida were detected in 28 (70.0%) and 7 (17.5%) of cleft children versus 6 (15.0%) and 2 (5.0%) of controls. No clinical oral candidiasis was observed. Growth category was not associated with age band or sex within either cohort (all p>0.05). def was higher in the cleft group (5.62±0.35 vs 4.83±0.45; mean difference 0.79; p<0.001). The CSI was higher (2.79±0.33 vs 1.92±0.28; mean difference 0.87; p<0.001). Ordinal growth ranks favored the cleft cohort (mean rank 53.83 vs 27.18; p<0.001).

Early childhood cleft lip and palate was associated with substantially higher asymptomatic Candida colonization and worse caries-related indices, supporting cleft-adapted hygiene counseling and preventive dental surveillance rather than empiric antifungal therapy in asymptomatic children.