Oral Candida species and betel quid-associated oral lesions in Padaung women of Northern Thailand P. A. Reichart, 1 P. Khongkhunthian, 2 L. P. Samaranayake, 3 J. Yau, 3 V. Patanaporn 2 and C. Scheifele 1 1 Department of Oral Surgery and Dental Radiology, Charite ´, Universita¨tsmedizin Berlin, Berlin, Germany, 2 Faculty of Dentistry, Chiangmai Universitiy, Chiangmai, Thailand and 3 Faculty of Dentistry, The University of Hong Kong, Hong Kong Summary Purpose of the present investigation was to study the association between the betel quid chewing (BQC) habits, the oral yeast flora and oral lesions in female Padaung of northern Thailand. Oral swabs were taken from the tongue and palate of 50 Padaung women with and 50 control individuals without BQC habit. The spectrum of oral Candida species in both groups was determined microbiologically. In addition, oral mucosal lesions were registered in both groups. Mean age of BQ chewers was 35.4 years, of non-chewers was 19.2 years. Candida parapsilosis was the most common Candida spp. isolated both in BQ chewers (46%) and non-chewers (44%). Candida albicans was revealed in 24% of BQ chewers and 18% of non-chewers. There was no significant difference in carriage of Candida spp. isolated between both groups. Forty- four per cent of BQ chewers revealed betel chewers mucosa, 10% showed leukoedema. Isolated populations such as the Padaung may reveal different patterns of candidal flora, in this case a predominance of Candida parapsilosis. Key words: Candida, oral colonization, betel, epidemiology, Thailand. Introduction Betel quid chewing (BQC) is a widely practiced habit in South and Southeast Asia. While in some countries such as India, Bangladesh, Myanmar, Pakistan, Sri Lanka and Taiwan the habit is still highly prevalent, a decline has been noted in Thailand in recent years. 1,2 BQC has a strong association with oral cancer and oral precancerous lesions such as oral leukoplakia and submucous fibrosis. 3,4 In addition, betel chewers mu- cosa (BCM) is associated with BQC. 5,6 While the bionegative influence of the betel quid (BQ) on the oral mucosa has been recognised for a long time a putative antimicrobial activity of its constituents has also been suggested. Len Meng 7 first described some therapeutic effects of the BQ in oriental medicine and its role in prevention of some oral and dental diseases. Mo ¨ller et al. 8 first discussed a possible cariostatic effect of the BQ. Reichart et al. 6 studied BQ-associated oral Candida spp. and oral lesions in a female Cambodian cohort. A total of 70.8% of the cases were carriers of Candida spp. Candida albicans was isolated in 27.1%. Microbiological findings indicated that BQC had no significant effect on oral colonisation by Candida spp. The purpose of the present study was to examine BQ-chewing women of the Padaung tribe for the oral yeast flora and oral mucosal lesions. Patients and methods A total of 100 voluntary women from three different villages (Huay Puh Gaeng, 1 Nai Soi, 2 and Huay Suea Tao 3 ) Amphoe Muang, Changwat Mae Hong Sorn, northern Thailand were available for the study. These villages have recently been established housing mem- bers of three different tribes. The majority of individuals examined were women of the Padaung tribe (ÔLong neckÕ Karen, n ¼ 75), the so-called ÔLong-EarÕ Karen (n ¼ 12) and Red Karen (n ¼ 13). The Padaung are Correspondence: Prof. Dr. Peter A. Reichart, Zentrum fu ¨ r Zahnmedizin, Abteilung fu ¨ r Oralchirurgie und zahna ¨ rztliche Ro ¨ ntgenologie, Charite ´ , Uni- versita ¨ tsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany. Tel.: +49 30 450562602. Fax: +49 30 450562901. E-mail: peter-a.reichart@charite.de Accepted for publication 11 February 2004 Original article 132 Ó 2005 Blackwell Publishing Ltd • Mycoses, 48, 132–136