Microflora in oral ecosystems in primary Sjogren's syndrome

Objective. Knowledge of the effect of primary Sjogren's syndrome (pSS) on t he microbial flora in the different predilection sites for oral disorders i s needed for planning preventive treatment. We carried out microbial analys is of samples from the dorsum of the tongue, smooth mucose, supragingival t ooth surfaces, and the gingival crevice region of 20 patients with pSS. Methods. A clinical oral examination was performed and whole unstimulated a nd stimulated secretion rates were measured. Results. Compared with healthy controls, subjects with pSS harbored higher numbers and frequencies of Streptococcus mutans, Lactobacillus spp., and Ca ndida albicans in the supragingival plaque. On the smooth mucosa and tongue , the pSS subjects displayed an increased frequency of C. albicans, Staphyl ococcus aureus, enterics, and enterococci. C. albicans was detected about t wice as frequently in the supragingival plaque as it was on the tongue. In the gingival crevice region, the pSS group harbored slightly lower proporti ons of Fusobacterium nucleatum and Prevotella intermedial Prevotella nigres cens than controls, The clinical and microbial differences were mainly due to the pSS subjects with a stimulated secretion rate of <0.5 ml/min. Porphy romonas gingivalis and Actinobacillus actinomycetemcomitans were not detect ed in any subject with pSS. Conclusion. The microbial flora in the different ecosystems reflected the s tatus of oral disorders in the subjects with pSS. Specific site sampling an d analysis in subjects with pSS revealed further differences compared with controls, and is therefore preferable to saliva sampling for oral treatment planning and for the evaluation of the effect of oral treatment and of pre ventive measures implemented in individuals with pSS.