#2 Oral Microbiome and Systemic Disease Flashcards
2 aims of the Human micro biome project
-characterize microbial communities form multiple human body sites-find correlations between micro biome changes and human health
we used to think of microbes as “germs” that are pathogenic invaders but now we are switching our thinking to believe that some are _____
essential
3 ways microbes are beneficial
-resistance against pathogens-metabolic functions-immune activation (if kids are too clean they will have immune problems later in life)
old goal of bacteria vs new goal of bacteria
old: sterile environmentnew: manage and preserve NATIVE microbes
old way of thinking in which it was believed that a disease is caused by a single cause
Koch’s postulate*now we now it is a community disruption and loss of healthy species
what are two example of OLD therapies that focused on broad eradication
-antibiotics-antiseptics
what are three examples of NEW therapies to encourage healthy communities
-probiotics (yogurt)-prebiotics (encourages growth of good bacteria)-targeted antimicrobials
idea that oral “focus of infection” causes systemic disease
theory of focal infection*Hippocrates cured arthritis by pulling a tooth
this was an old way thought to treat mental illness
therapeutic eduntulation (pulling teeth)*ended by 1930
when did evidence for connections between oral infections and systemic diseases start?
25 years ago with cardiovascular disease
oral-systemic connections
-infective endocarditis (infection of heart valves)-pneumonia-cardiovascular disease-type 1 diabetes-cancer-preterm birth-immunosuppression-biofilm infections on implanted devices
what are the two direct mechanisms for oral connections to systemic diseases?
-translocation of bacteria (seeded by oral bacteria)-translocation of toxin (produced by oral bacteria)
what two things constitute good evidence for oral systemic effects?
-epidemiologic studies (no correlation)-evidence of causality —human trials show tx prevents disease—presence of oral bacteria at disease site—effect in animal model
spread of bacteria throughout the blood
bacteremia
60% of the oral bacteria
streptococci (sanguis, mitis, mutans)
in practice does antibiotic prophylaxis prevent bacteremia?
no
what are the two risks to antibiotics?
-allergy-cost
T/F dental procedures associated with infective endocarditis
False
how do you reduce the risk of getting Infective Endocarditis?
-good health and hygiene-optimize regular hygiene measures to keep bacterial load low than give antibiotic prophylaxis
aspiration pneumonia is caused by what two things?
-aspirations of oral secretions-oral bacteria
when is Pneumonia seen?
common when airway protective refexes compromised—physically handicapped or elderly
what prevents lung infection?
oral hygiene measuresreduce nosocomial pneumonia by 40%could prevent 10% of deaths in nursing homes
how is preterm birth carried out?
bacteria in the amniotic fluid, some of them common oral species, associate with it
does periodontal tx reduce the risk of pre-term birth or low birth weight?
no*no strong evidence for cause and effect relationship
