Yeast Microflora and Halitosis in Oral Squamous Cell Carcinoma- Two Microbiological Aspects of a Disease

Cancers of the oral cavity (ICD C00-C14) belong to the tumors of the highest morbidity and mortality. Their epidemiological characteristics are determined by geographical factors: they are more frequent in the developed countries than in the developing ones. Unfortunately, Hungary appears to be in a leading position regarding both the morbidity and mortality of oral cancer. This is well reflected in the age-standardized incidence rates of GLOBOCAN 2012: the ASR-W of Hungary in 2012 was 9.7 , while of the neighboring countries, Slovakia scored 6.5, Romania 5.4, and Austria only 4.2. In Europe, Greece scored the lowest (1.6). With a score of 9.7, Hungary is the first not only in Central Europe, but in the entire European region. Data of the International Association of Cancer Registries (IACR) and data from the national cancer registry of Hungary (Nemzeti Rákregiszter) show the same. The causes of this unfortunate situation have not been clarified, and it probably cannot be explained by a few simple and well-known factors, such as smoking or excessive alcohol consumption (or the combination of these). These factors play a significant role in the pathogenesis of the oral cancers of the Hungarian population beyond doubt. However, the increasing representation of non-smoking and non-drinking elderly women and young adults among the Hungarian oral cancer patients is definitely against such a simplifying explanation. Certainly, this sadly notable position of Hungary on the international map of oral cancer is an incentive to the Hungarian researcher of oral health to focus on the causes, consequences and potential cures for oral cancer, especially squamous cell carcinoma (OSCC). This, however, is a vast field of study. In the present thesis I narrow my focus down to two oral cancer-related questions, both rooted in the microbiology of the oral cavity. One is considered by many as a cause or promoter of OSCC, the other is obviously a consequence. Yeasts (especially Candida spp.) have long been suspected as causative agents of oral malignant and premalignant states. The thesis discusses the yeast microflora of the oral cavity in OSCC based on our own research, considering also the specific question of the role of lipase/protease activity in epithelial colonization. It is also known that the microbial composition of the oral cavity in OSCC differs from that of the healthy oral cavity both in qualitative and quantitative respects. This also means that the composition of the exhaled air of OSCC patients is different from that of healthy subjects, which can lead to oral malodor (halitosis). This, of course, can lead to serious psychosocial consequences, which makes halitosis in oral cancer (and otherwise) an important problem to be addressed. At the same time, the altered composition of the exhaled air could offer a new diagnostic possibility, even if this topic is scarcely researched in oral cancer. One of the reasons for the relative lack of research in this area is that the available methodologies are not precise and reliable enough. In the present thesis I describe a methodological improvement developed by our team and tested with OSCC patients

Schizophrenia and oral health: a literature review [Skizofrénia és szájhigiénia: irodalmi áttekintés]

Az általános betegségek közvetlenül vagy közvetve befolyásolhatják a fogak egészségét és a páciens szájhigiénéjét.A fogorvosi rendelőben megjelenő betegek körében a pszichiátriai kórképek a leggyakoribb rendellenességek közé tartoznak.A fogászati kezelések során az érintetteknek speciális igényeik vannak. A skizofrénia egy olyan krónikus mentálisbetegség, amely a személyes érzelmek és érzések zavaraival jár, illetve mentális és bizonyos tudati funkciók romlásáhozvezet. A tünetek közé tartoznak a téveszmék, a hallucinációk, a rendezetlen gondolkodás és a következetlenség.Amennyiben hasadásos elmezavarban szenvedő páciens jelentkezik kezelésre a fogorvosi rendelőben, pszichiátriaikonzultációt kell biztosítani. Az elektív fogászati beavatkozásokat el kell halasztani mindaddig, amíg a páciens tüneteikontroll alá kerülnek. A gyógyszerek mellékhatásai súlyosak lehetnek, ezért elengedhetetlen a beteg gondos és folyamatosellenőrzése

Analysis of oral yeast microflora in patients with oral squamous cell carcinoma

Background: Oral squamous cell carcinoma (OSCC) is the most common form of oral cancer, in this study, the association between OSCC and oral yeast carriage was investigated. Findings: 20 patients having OSCC as well as 40 healthy controls were tested for the presence of yeasts in the oral cavity. Fungal burdens were examined by colony forming unit determinations, while the different yeast genera in patient samples were identified by matrix-associated laser desorption/ionization-time of flight-mass spectrometry. We found that the level of oral yeast carriage was significantly higher in patients with OSCC that was accompanied by a higher diversity of yeasts in the oral cavity of these patients. We also examined the extracellular enzyme production of isolated Candida spp.; however, we found that there was no association between the lipase/protease producing capacity of Candida strains and the higher colonisation rate of neoplastic epithelium. Conclusions: In conclusion, our results corroborate the findings of previous studies regarding the association between oral yeast carriage and epithelial carcinoma. © 2016, The Author(s)

Quality of life in head and neck cancer patients after tumor therapy and subsequent rehabilitation: an exploratory study

PURPOSE: The aim of the study was to evaluate patient-reported quality of life effects of post-treatment intraoral and extraoral rehabilitation in head and neck cancer by repeated measures. METHODS: Fifty-nine patients were involved. Basic socio-demographic, oncological and epidemiological data were gathered, and the type of rehabilitation was recorded. For the assessment of quality of life changes, two widely used brief questionnaires, the University of Washington Quality of Life Questionnaire and the Head and Neck module of the European Organization of Research and Treatment for Cancer Quality of Life Questionnaire, were used. The questionnaires were administered to patients two times: the first time after tumor therapy, but before rehabilitation (upon arriving for rehabilitation) and the second time 6 months after the application of any particular method of rehabilitation. Quality of life data were gathered prospectively, while socio-demographic data were gathered from patient files. RESULTS: Quality of life after rehabilitation was significantly enhanced as compared to the post-treatment status, in all domains of both questionnaires (p < 0.05 and p < 0.01, Mann-Whitney U). CONCLUSIONS: The results support the hypothesis that post-treatment maxillofacial rehabilitation in head and neck cancer does not only restore lost physical capabilities, but also brings about profound changes in patients' quality of life in general