Inhibition of microflora associated with oral malignancy

Changes in the microflora on oral carcinoma surfaces may lead to both local and systemic infections, which may complicate the morbidity of the patient suffering from oral malignant neoplasms. Thus, anticancer therapy, irradia tion, chemotherapy or surgery impairs the defence mechanism of the oral muc osa and is accompanied by proliferation of the mucosal biofilm with overgro wth of yeast and bacteria. This study investigates the inhibition of the bi ofilm present on the surface of oral squamous cell carcinomas. Biofilm samp les were obtained from the central surface (1 cm(2)) of each lesion in 10 p atients (eight male, two female; mean age: 47.6 years; SD +/- 7.6) before a ny antibiotherapy or tumour treatment. Patients were randomly divided Into two groups and were rinsed with Meridol mouthrinse (amine fluoride) or plac ebo (saline solution) for 7 days. Samples were repeatedly taken from the sa me sire after rinsing. Samples were transported in pre-reduced brain heart infusion broth and cultured within 1 h of removal, using aerobic and anaero bic complete and selective media. Total aerobic and anaerobic counts were d etermined and isolated bacteria were identified. The median counts of colon y forming units (CFU/ml) after rinsing with Meridol were significantly lowe r for both aerobes and anaerobes than before rinsing with Meridol. (For aer obes before rinsing: 1.35 x 10(6), after rinsing: 7.55 x 10(5); p = 0.025: for anaerobes before rinsing: 1.39 x 10(6), after rinsing: 7.15 x 10(5); p = 0.011. Rinsing with placebo: no significant difference was found. Aerobe median counts before rinsing: 1.17 x 10(6), after rinsing: 1.03 x 105, and for anaerobes: before rinsing 1.75 x 10(6), after rinsing: 1.51 x 10(6); p > 0.05 [Wilcoxon test].) It was concluded that 7-days (three times a day) M eridol rinsing significantly reduced the surface biofilm of oral carcinoma compared to rinsing with placebo. Clinical examination indicated no irritat ion of the mucose. The mouthrinse was well tolerated by the patients, who c ommented on a reduction in burning sensation and bad breath. Besides routin e oral hygiene, rinsing itself could reduce patient morbidity. The findings of the present study indicate that in addition to any other oral focus, th e lesion itself, when ulcerated, should receive direct antimicrobial treatm ent so as to reduce patient morbidity and enhance quality of life. (C) 2000 Elsevier Science Ltd. All rights reserved.