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

## TL;DR

Children with cleft lip and palate have higher Candida colonization and worse dental health compared to controls, suggesting a need for tailored dental care.

## Contribution

This study identifies higher asymptomatic Candida carriage and dental issues in young children with cleft lip and palate.

## Key findings

- Candida carriage was significantly higher in cleft children (87.5%) compared to controls (20%).
- Cleft children had higher def and caries severity index scores than controls.
- Asymptomatic Candida colonization was associated with cleft lip and palate but not with age or sex.

## Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusions: 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.