Patients with a long-term history of type 2 diabetes mellitus (T2DM) carried Candida albicans in their dental root canals more frequently when they have a primary endodontic infection, according to data published in the European Journal of Clinical Microbiology & Infectious Diseases. The presence of C albicans also appeared to be related to a higher frequency of apical periodontitis.

Researchers conducted a cross-sectional study in 60 patients with an established diagnosis of T2D and 60 control participants who did not have diabetes received clinical examinations and radiographic analysis to establish a periapical index score (PAI). Root canal samples were also taken and polymerase chain reaction testing was used to identify C albicans.

In the T2D group there was a 2-fold increase in the prevalence of C albicans observed compared with controls (P =.0251). A periapical index score of >3 was more common in patients with T2DM who were positive for C albicans compared with patients without C albicans (65.21% vs 27.02%). Further, researchers also observed a directly proportional correlation between the number of years that patients have lived with T2D and the presence of C albicans in the root canal. There were no significant differences in the clinical characteristics of the teeth between patients with and without C albicans.

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Investigators acknowledged that, “it is a reality that the number of patients included in our study, as well as most other prospective studies, is limited,” which was a result of difficulties in fulfilling the inclusion criteria in the T2DM group. Despite this limitation, researchers noted, there were still clear differences between the study groups. They also noted that disease duration, history of caries/restoration in compromised tooth, and the type and degree of glycemic control may all be associated factors associated with root canal carriage of yeast in patients with T2D and therefore possible study limitations.

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Despite these limitations, the investigators concluded that patients with long-term T2DM carry C albicans more frequently in their root canals when presenting a primary endodontic infection and the presence of this yeast appears to be related to a higher frequency of apical periodontitis.


De la Torre-Luna R, Domínguez-Pérez RA, Guillén-Nepita AL, et al. Prevalence of Candida albicans in primary endodontic infections associated with a higher frequency of apical periodontitis in type two diabetes mellitus patients [published online September 16 2019]. Eur J Clin Microbiol Infect Dis. doi:10.1007/s10096-019-03702-z