Oral Candida colonisation and cariogenic bacteria in children and adolescents with cleft lip and/or palate: A systematic review and meta-analysis.
6 affiliations
- 1Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia.
- 2Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Muhammadiyah University of Palangka Raya, Palangka Raya, Indonesia.
- 3Department of Orthodontics and Dentocraniofacial Orthopedics, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia.
- 4Department of Orthodontics and Dentocraniofacial Orthopedics, Faculty of Dentistry, Muhammadiyah University of Palangka Raya, Palangka Raya, Indonesia.
- 5Hasanuddin University Dental Hospital, Makassar, Indonesia.
- 6Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Lambung Mangkurat University, Banjarmasin, Indonesia.
Abstract
Purpose
Children with cleft lip and/or palate (CL/P) face a disproportionate cariogenic burden, yet the role of oral Candida and its partnership with cariogenic bacteria remains poorly quantified. This systematic review and meta-analysis synthesised observational evidence on oral Candida colonisation, cariogenic bacterial carriage, and clinical caries outcomes in non-syndromic CL/P, with GRADE-rated certainty.Methods
Following PRISMA 2020 and the Cochrane Handbook (PROSPERO CRD420261402624), six databases were searched from inception to 27 May 2026. Eligible studies were observational designs enrolling children aged 0-18 years with non-syndromic CL/P versus non-cleft controls. Risk of bias used ROBINS-E. Random-effects meta-analyses (DerSimonian-Laird) pooled risk ratios (RR) for dichotomous outcomes and standardised mean differences (SMD) for continuous caries indices, with GRADE certainty.Results
Ten studies (2011-2026; 421 CL/P vs 567 controls) were included. Oral Candida carriage was nearly threefold higher in CL/P (RR 2.94, 95% CI 2.04-4.22; I ² = 23.4%; k = 4), with C. albicans predominant. High salivary Streptococcus mutans counts were similarly elevated (RR 2.74, 95% CI 1.42-5.27; I ² = 0%), whereas Lactobacillus carriage showed no significant difference (RR 1.33, 95% CI 0.71-2.47). Caries indices were directionally higher in three of four datasets but highly heterogeneous (SMD 0.74; I ² = 92.3%). GRADE certainty was Low to Very Low.Conclusion
CL/P children carry elevated oral Candida and S. mutans burdens, supporting an early fungal-bacterial cariogenic shift. Candida assessment should be integrated into caries-risk evaluation from the deciduous-dentition stage within the multidisciplinary cleft pathway.
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BibTeX
@article{hendrawan2026oral,
title = {{Oral Candida colonisation and cariogenic bacteria in children and adolescents with cleft lip and/or palate: A systematic review and meta-analysis.}},
author = {Muhammad Irpan Hendrawan and Elsa Ayu Amanda and Ita Purnama Alwi and Husni Mubarak and Irham Taufiqurrahman and Andi Tajrin},
journal = {Journal of oral biology and craniofacial research},
year = {2026},
month = oct,
doi = {10.1016/j.jobcr.2026.101555},
url = {https://europepmc.org/article/MED/42894730},
note = {CC BY},
}
RIS
TY - JOUR
TI - Oral Candida colonisation and cariogenic bacteria in children and adolescents with cleft lip and/or palate: A systematic review and meta-analysis.
AU - Muhammad Irpan Hendrawan
AU - Elsa Ayu Amanda
AU - Ita Purnama Alwi
AU - Husni Mubarak
AU - Irham Taufiqurrahman
AU - Andi Tajrin
PY - 2026
DA - 2026/10/09
JO - Journal of oral biology and craniofacial research
DO - 10.1016/j.jobcr.2026.101555
UR - https://europepmc.org/article/MED/42894730
AB - Purpose Children with cleft lip and/or palate (CL/P) face a disproportionate cariogenic burden, yet the role of oral Candida and its partnership with cariogenic bacteria remains poorly quantified. This systematic review and meta-analysis synthesised observational evidence on oral Candida colonisation, cariogenic bacterial carriage, and clinical caries outcomes in non-syndromic CL/P, with GRADE-rated certainty.Methods Following PRISMA 2020 and the Cochrane Handbook (PROSPERO CRD420261402624), six databases were searched from inception to 27 May 2026. Eligible studies were observational designs enrolling children aged 0-18 years with non-syndromic CL/P versus non-cleft controls. Risk of bias used ROBINS-E. Random-effects meta-analyses (DerSimonian-Laird) pooled risk ratios (RR) for dichotomous outcomes and standardised mean differences (SMD) for continuous caries indices, with GRADE certainty.Results Ten studies (2011-2026; 421 CL/P vs 567 controls) were included. Oral Candida carriage was nearly threefold higher in CL/P (RR 2.94, 95% CI 2.04-4.22; I ² = 23.4%; k = 4), with C. albicans predominant. High salivary Streptococcus mutans counts were similarly elevated (RR 2.74, 95% CI 1.42-5.27; I ² = 0%), whereas Lactobacillus carriage showed no significant difference (RR 1.33, 95% CI 0.71-2.47). Caries indices were directionally higher in three of four datasets but highly heterogeneous (SMD 0.74; I ² = 92.3%). GRADE certainty was Low to Very Low.Conclusion CL/P children carry elevated oral Candida and S. mutans burdens, supporting an early fungal-bacterial cariogenic shift. Candida assessment should be integrated into caries-risk evaluation from the deciduous-dentition stage within the multidisciplinary cleft pathway.
SN - 2212-4268
SN - 2212-4276
ER -