Microbiological testing of oral and tongue swabs includes:
- Microscopic examination after Gram staining
- Cultivation for aerobic microorganisms
- Cultivation for fungi
- Antibiogram or antifungal susceptibility test for the isolated microorganisms that will be considered necessary
Oral and tongue mucosal disorders usually present as acute conditions and may result from a microbiome disorder or a chronic, low-degree infection. Mucosal infections of the oral cavity are often associated with microbial biofilms that can form on surfaces such as teeth and dentures. Gum infections (gingivitis, including acute ulcerative gingivitis) and periodontal tissues (periodontitis) are the most common infections in the oral cavity.
Oral mucositis
Oral mucositis is a painful complication of chemotherapy or head and neck radiotherapy caused by the therapeutic regimens' direct cytotoxicity. Infections, usually with fungi and oral microbiome, can aggravate the problem, and microbiological testing can help guide treatment.
Erythematous and pseudomembranous candidiasis
Erythematous and pseudomembranous candidiasis are the most common clinical manifestations of oral fungal infections. Infections may include the mucosal surfaces of the cheeks, tongue (dorsal and abdominal surface), and the hard and soft palate. The most common cause is Candida albicans, while other Candida species, such as C. glabrata, are rarely isolated, alone or in combination with C. albicans. This is particularly common in immunosuppressed or patients with a history of prolonged antifungal therapy. Atrophic candidiasis (denture stomatitis) can occur in the oral mucosa beneath the surface of the artificial denture, especially when patients sleep with their dentures or have a dry mouth. Isolated Candida species are essential to identify and control their susceptibility, as they may be resistant to first-line antifungal agents and may be responsible for resistant or recurrent infections. Rarely, fungi can colonize and infect the sinuses and cause damage to the palate.
Angular cheilitis and perioral infections
Angular cheilitis and perioral infections commonly affect the corners of the mouth and lips. Microbes of the oral microbiome usually cause them and are more often than those associated with denture stomatitis. The infection may be due to Staphylococcus aureus, Candida species, or group A streptococci.
Staphylococcal mucositis
Patients with serious medical problems reduced salivary flow, and parenteral nutrition may develop staphylococcal mucositis caused by Staphylococcus aureus, although Enterobacteriaceae may play a role in severe cases. The erythematous changes in the oral mucosa cannot be clinically distinguished from candidiasis, making microbiological investigation necessary. The results must be interpreted in relation to the existing clinical picture since there may be an asymptomatic presence of S. aureus or Enterobacteriaceae. Oral hygiene measures are usually sufficient to resolve the clinical problem, and antibiotics are unnecessary.
Mouth ulcer
There are many non-infectious causes of mouth ulcers, such as traumatic ulcers, recurrent aphthous ulcers, inflammatory conditions, and malignant lesions. Infectious causes are usually viral (e.g., herpes simplex). In contrast, uncommon bacterial causes of mouth ulcers are syphilis and tuberculosis, while fungal infections, such as histoplasmosis, are rarer.
Vincent stomatitis
Borrelia vincentii species and certain Fusobacterium species are associated with Vincent stomatitis (or acute necrotizing gingivostomatitis), which is characterized by ulcers of the pharynx or gums and occurs in adults with poor oral hygiene or severe systemic disease.
Important Note
Laboratory test results are the most critical parameter for diagnosing and monitoring all pathological conditions. Between 70 to 80% of diagnostic decisions are based on laboratory tests. Correctly interpreting laboratory results allows a doctor to distinguish "healthy" from "diseased."
Laboratory test results should not be interpreted from the numerical result of a single analysis. Test results should be analyzed based on each case and family history, clinical findings, and the results of other laboratory tests and information. Your physician should explain the importance of your test results.
At Diagnostiki Athinon, we answer any questions you may have about the test you perform in our laboratory and contact your doctor to ensure you receive the best possible medical care.
