Impact of vertical facial patterns and oral habits on microbial colonization in children and adolescents: a cross-sectional study

BACKGROUND: The oral commissures represent a unique anatomical interface where intra- and extra-oral environments converge. This study aimed to investigate the association between vertical facial patterns and microbial colonization at the oral commissures in children and adolescents. METHODS: A total of 150 healthy participants (mean age 13.4 ± 2.7 years; range: 8–18 years) were equally divided into low-, norm-, and high-angle groups according to their cephalometric GoGn/SN values. Swab samples from both oral commissures were cultured for Candida species and Gram-positive bacteria. Commissural wetness, intraoral pH, and oral habits were recorded. Group differences were analysed using chi-square and one-way ANOVA tests (α = 0.05). RESULTS: Vertical facial morphology showed a significant association with bacterial colonization findings (p = 0.001). Gram-positive bacilli were absent in low-angle but frequent in norm- and high-angle individuals. Candida carriage (12.0%) showed no significant association with facial pattern (p = 0.103). Mouth breathing was significantly more prevalent in high-angle participants (p = 0.038), while lip-licking habits showed no intergroup difference. CONCLUSION: Increased vertical facial dimension was associated with bacterial, but not fungal, findings at the oral commissures. Craniofacial morphology may therefore be related to local microbial findings and could be considered a potential modifying factor in paediatric patients presenting with recurrent angular lesions.