Oral Candida Carriage in Waterpipe and Cigarette Smokers with Various Dietary Habits


  • Najla Dar Odeh Professor, Faculty of dentistry, University of Jordan, Amman, Jordan
  • Osama Abu-Hammad
  • Ahmad Kutkut
  • Maha Samara
  • Zaid Badr
  • Manal Hamdan
  • Alla'a Hasan Haddoush
  • Asem Shehabi




oral Candida carriage, colonization, diet, narghile, waterpipe, cigarettes


Background Tobacco smoking and diet have been both linked to increased oral Candida carriage. The aim of this study is to investigate the distribution of Candida species in the oral cavity of young individuals smoking cigarettes and waterpipe who have various dietary habits. Methods Participants were recruited from university students during December 2013, and were divided into three groups; a control non-smoking, a cigarette smoking, and a waterpipe smoking groups. The study sample completed a pre-structured questionnaire on smoking, and dietary habits. Oral swab samples were collected from all participants to determine oral Candida carriage and the colonizing Candida species.  Data were statistically analyzed to determine the significance of association between Candida carriage on one hand and smoking status, and dietary habits on the other hand. Findings A total of 238 students participated in the study and among those only 30 (12.8%) students had oral Candida carriage. Candida albicans was the most common species to be recovered (56.7%), followed by Candida dubliniensis (23.3%). The association between smoking, and perceived dietary habits on one hand and oral Candida carriage on the other was not statistically significant. Conclusions Smoking, and perceived dietary habits seem to have no association with oral Candida carriage among a young cohort of university smokers. It is recommended that similar studies are conducted on older age groups to investigate if age has any influence.



da Silva-Rocha WP, Lemos VL, Svidizisnki TI, Milan EP, Chaves GM: Candida species distribution, genotyping and virulence factors of Candida albicans isolated from the oral cavity of kidney transplant recipients of two geographic regions of Brazil. BMC oral health 2014, 14:20.

Miceli MH, Diaz JA, Lee SA: Emerging opportunistic yeast infections. The Lancet Infectious diseases 2011, 11(2):142-151.

Alanazi H, Semlali A, Perraud L, Chmielewski W, Zakrzewski A, Rouabhia M: Cigarette smoke-exposed Candida albicans increased chitin production and modulated human fibroblast cell responses. BioMed research international 2014, 2014:963156.

de Azevedo Izidoro AC, Semprebom AM, Baboni FB, Rosa RT, Machado MA, Samaranayake LP, Rosa EA: Low virulent oral Candida albicans strains isolated from smokers. Archives of oral biology 2012, 57(2):148-153.

Daniluk T, Tokajuk G, Stokowska W, Fiedoruk K, Sciepuk M, Zaremba ML, Rozkiewicz D, Cylwik-Rokicka D, Kedra BA, Anielska I et al: Occurrence rate of oral Candida albicans in denture wearer patients. Advances in medical sciences 2006, 51 Suppl 1:77-80.

Soysa NS, Ellepola AN: The impact of cigarette/tobacco smoking on oral candidosis: an overview. Oral diseases 2005, 11(5):268-273.

Baboor AS, Alnazzawi AA, Abu-Hammad OA, Dar-Odeh NS: Unconventional materials and substances used in water pipe (narghile) by smokers in central western region of Saudi Arabia. Saudi medical journal 2014, 35(8):890-893.

Song X, Sun J, Store G, Eribe ER, Hansen BF, Olsen I: Genotypic relatedness of yeasts in thrush and denture stomatitis. Oral microbiology and immunology 2006, 21(5):301-308.

Jaghasi I, Hatahet W, Dashash M: Dietary patterns and oral health in schoolchildren from Damascus, Syrian Arab Republic. Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit 2012, 18(4):358-364.

Al-Hazzaa HM, Al-Sobayel HI, Abahussain NA, Qahwaji DM, Alahmadi MA, Musaiger AO: Association of dietary habits with levels of physical activity and screen time among adolescents living in Saudi Arabia. Journal of human nutrition and dietetics : the official journal of the British Dietetic Association 2014, 27 Suppl 2:204-213.

Lyon JP, da Costa SC, Totti VM, Munhoz MF, de Resende MA: Predisposing conditions for Candida spp. carriage in the oral cavity of denture wearers and individuals with natural teeth. Canadian journal of microbiology 2006, 52(5):462-467.

Zaremba ML, Daniluk T, Rozkiewicz D, Cylwik-Rokicka D, Kierklo A, Tokajuk G, Dabrowska E, Pawinska M, Klimiuk A, Stokowska W et al: Incidence rate of Candida species in the oral cavity of middle-aged and elderly subjects. Advances in medical sciences 2006, 51 Suppl 1:233-236.

Toshiro Majima SI-K, Ryoichi Nagatomi, Kenjirou Nakamura: Study of the oral carriage of Candida sp. in dental students and staff—Identification of Candida sp. and background survey. Oral Science International 2014, 11(1):30-34.

Negroni M, Gonzalez MI, Levin B, Cuesta A, Iovanniti C: [Candida carriage in the oral mucosa of a student population: adhesiveness of the strains and predisposing factors]. Revista Argentina de microbiologia 2002, 34(1):22-28.

Sarkar R, Rathod GP: Clinicopathologic assessment of Candida colonization of oral leukoplakia. Indian journal of dermatology, venereology and leprology 2014, 80(5):413-418.

Willis AM, Coulter WA, Fulton CR, Hayes JR, Bell PM, Lamey PJ: Oral candidal carriage and infection in insulin-treated diabetic patients. Diabetic medicine : a journal of the British Diabetic Association 1999, 16(8):675-679.

Abu-Elteen KH, Abu-Alteen RM: The prevalence of Candida albicans populations in the mouths of complete denture wearers. The new microbiologica 1998, 21(1):41-48.

Soysa NS, Samaranayake LP, Ellepola AN: Antimicrobials as a contributory factor in oral candidosis--a brief overview. Oral diseases 2008, 14(2):138-143.

Shin ES, Chung SC, Kim YK, Lee SW, Kho HS: The relationship between oral Candida carriage and the secretor status of blood group antigens in saliva. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 2003, 96(1):48-53.

Seifi S, Feizi F, Mehdizadeh M, Khafri S, Ahmadi B: Evaluation of cytological alterations of oral mucosa in smokers and waterpipe users. Cell journal 2014, 15(4):302-309.

Al-Amrah HJ, Aboznada OA, Alam MZ, ElAssouli MZ, Mujallid MI, ElAssouli SM: Genotoxicity of waterpipe smoke in buccal cells and peripheral blood leukocytes as determined by comet assay. Inhalation toxicology 2014, 26(14):891-896.

Samaranayake LP, MacFarlane TW: The effect of dietary carbohydrates on the in-vitro adhesion of Candida albicans to epithelial cells. Journal of medical microbiology 1982, 15(4):511-517.

Lll KG, Klimczak A, Rachubinski P, Jaglowska A, Kwapiszewska A: Consumption of sweetened beverages as a risk factor of colonization of oral cavity by fungi - eating habits of university students. Annals of parasitology 2015, 61(3):175-182.







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