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Background  Despite the well-documented associations between poor maternal oral health and increased risk for adverse birth outcomes and dental caries in children after birth, prenatal oral health care is under-utilized, especially among the underserved population. In addition, oral  Candida  has recently been suggested as a potential culprit for children’s dental caries, with evident maternal contributions. Therefore, this study aimed to obtain epidemiological data on the oral health and oral  Candida  carriage in a cohort of underserved US pregnant women, and reveal factors associated with their oral  Candida  carriage.    Methods  Demographic-medical-oral hygiene practice data were collected. Comprehensive oral examination was conducted. Caries status and plaque index were recorded. Oral samples (saliva, plaque and swab) were processed to identify  Candida  species and  Streptococcus mutans  by culturing-dependent and -independent methods. Multiple logistic regression analyses were used to identify factors associated with oral  Candida  carriage and caries severity.    Results  Eighty-two socioeconomically disadvantaged women (48 pregnant and 34 non-pregnant) were enrolled. More pregnant women (79.1%) had > = 1 untreated decayed tooth when compared to their non-pregnant counterparts (47.1%) ( p  = 0.01). The average number of decayed teeth in pregnant and non-pregnant women was 3.9 and 3.1 ( p  > 0.05). Caries severity was positively associated with race (African American vs. white), plaque index and salivary  Candida albicans  level.  C. albicans  was the most predominant/abundant  Candida  strain, with cheek and tonsil as the most common colonized sites. The detection of  C. albicans  was 56%/56% in saliva and 40%/47% in plaque of the pregnant and non-pregnant groups, respectively. Study women’s oral  Candida  carriage is positively associated with hypertension [ p  = 0.03, odds ratio = 14.47(1.28, 163.51)], decayed teeth number [ p  = 0.04, odds ratio = 1.31 (1.01,1.69)] and salivary  S. mutans  level [ p  = 0.03, odds ratio = 4.80 (1.18–19.43)].    Conclusions  Socioeconomically disadvantaged US women are in need of improved prenatal oral health, a large proportion of them have untreated decayed teeth and high carriage of oral  Candida . Due to the observed significant association between the decayed teeth number and oral  Candida  carriage, providing oral health care during pregnancy (including limiting decayed teeth) will not only improve women’s oral health, but also present as a promising approach to reduce oral  Candida  carriage in women.

Oral health and Candida carriage in socioeconomically disadvantaged US pregnant women