Dimorphic Candida exist as commensal yeast carriages or infiltrate hyphae in the oral cavity. Here, we investigated the clinical relevance of Candida hyphae in non-pseudomembranous oral candidiasis (OC) by smears of tongue biofilms. We conducted a retrospective study of 2829 patients who had had tongue smears regardless of OC suspicion. Clinical characteristics were evaluated using a novel method of assessing hyphae. Clinical factors (moderate/severe stimulated pain, pain aggravated by stimulation, tongue dorsum appearance and initial topical antifungal use) were highly significant in the high-grade hyphae group but were statistically similar in the low-grade hyphae and non-observed hyphae group, suggesting low-grade hyphae infection as a subclinical OC state. In addition to erythematous candidiasis (EC), a new subtype named “morphologically normal symptomatic candidiasis” (MNSC) with specific pain patterns and normal tongue morphology was identified. MNSC had a significantly higher proportion of moderate and severe stimulated pain cases than EC. Low unstimulated salivary flow rate (<0.1 mL/min) was found to be a common risk factor in MNSC and EC. In non-pseudomembranous OC, pain patterns were dependent on Candida hyphae degree regardless of tongue dorsum morphology. Morphologic differences seen in high-grade hyphae infection were not associated with systemic diseases or nutritional deficiencies.

Song JH, et al. Yonsei Med J. 2014 Jul;55(4):1123-1129. http://dx.doi.org/10.3349/ymj.2014.55.4.1123

Background: Masticatory muscle training by chewing gum can be performed easily and improve masticatory muscle function and strength. However, increased masticatory muscle activity and function may alter the mandibular shape.Objective: We aimed to investigate the effects of gum chewing training on the occlusal force, masseter muscle thickness (MMT) and mandibular shape in healthy adults.Methods: We conducted a prospective randomised controlled trial from January 2020 to September 2020 at the Yonsei University College of Dentistry. Fifty‐eight participants were randomly assigned to the training and control groups. The training group chewed gum three times a day for 6 months, while the control group received no training. Changes in the maximum occlusal force and MMT were evaluated at baseline and after 1, 3 and 6 months. Changes in the mandibular shape were evaluated at baseline and after 6 months.Results: The mean maximum occlusal force of the training group at 3 months was significantly higher than that at baseline, which was also significantly different from that in the control group (p < .001). As the maximum occlusal force increased, the occlusal contact area also increased (p = .020). There was no statistically significant difference in MMT or mandibular shape compared to the baseline.Conclusion: Mastication training using gum increases maximum occlusal force due to an increase in occlusal contact area but has no effect on MMT or mandibular shape.

Jung HJ, et al. J Korean Acad Oral Health. 2018 Dec;42(4):216-223. https://doi.org/10.11149/jkaoh.2018.42.4.216