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CSA Antimicrobials, local ant. in heart folder > CSA microbiology of caries > Flashcards

CSA microbiology of caries Flashcards

1
Q

how is caries multifactorial?

A

key oral microorganisms
susceptible host
enviro. factors

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2
Q

what are enviro. factors?

A

poor diet
poor oral hygiene
low saliva flow rate

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3
Q

what are cofounding factors for caries?

A

o Fluoride availability 
o Diverse natural microbiota
o Non-specific virulence factors

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4
Q

evidence for caries as infectious disease?

A
  • gnotobiotic animal studies

- Human epidemiology studies

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5
Q

What do gnotobiotic studies show?

A

cant get caries in absence of microorganisms

  • showed transmission of caries and
  • showed antimicrobial agents work against caries
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6
Q

what is human epidemiology studies?

A

cross or longitudinal studies

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7
Q

what is cross sec studies?

A

group of people and sample microorganisms on tooth of people with and w/o caries

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8
Q

What is longitudinal studeies?

A
  • Get a cause relationship

- Microorganisms sampled before & after diagnosis of caries

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9
Q

what are the implicated microorganisms with caries?

A

Mutans streptococci
Actinomyces
lactobacalli
Bifidobacteria

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10
Q

what mutans streptococci are there?

A

Strep. Mutans
Strep. sobrinus
Strep. cricetus
Strep. rattus

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11
Q

What actinomyces are there?

A

A. naeslundii
A. odontolyticus
(A. israelii / A. gerencseriae)

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12
Q

What Lactobacilli are there?

A

Lactobacillus spp.

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13
Q

What bifidobacteria are there?

A

Bifidobacterium/ Scardovia spp

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14
Q

what are mutans strepto. ?

A

• Gram positive cocci that are round organisms

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15
Q

what does mutans streptococcie do?

A
  • colonise hard surfaces such as dentures/teeth (non-shedding surfaces)
    • initiate caries if enough of them
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16
Q

what happens if give mutans strep. sucrose?

A

make extracellular sticky polymers

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17
Q

What is lactobacillus?

A

Gram positive rod more associated with advanced lesions

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18
Q

Bifidobacterium?

A

• Gram positive rod that are branched cells

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19
Q

why is it hard to understand aetiology of caries

A
  • Disease occurs at sites with natural diverse microbiota
    • Pathogens can found at healthy sites but in small number
    • difficult to correlate microorganisms to the status of the enamel
    • Lesions can re-mineralise
    • Pathogenic traits are relatively non-specific
    • Caries is multi factorial
20
Q

what is microbiological aetiology of caries?

A
  • MS seen in higher proportion at carious sites

* inverse relationship between MS & S. Sanguinis

21
Q

what does cross sec study of fissure caries show?

A

3/4 of carious fissure had >10% of MS

22
Q

what does longitudinal study of fissure caries show?

A
  • higher proportions of MS at caries sites
  • MS can be after first signs of demineralisation
  • Caries can be apparent in absence of MS
  • Role of other species in caries progression
23
Q

what is role of other bacteria?.

A
  • Acidogenic/Low pH isolated & can survive acidic conditions:
  • Lactate-utilising species
  • Base generating species
24
Q

what is childhood caries?

A

bottle to suck with sugar drink

25
Q

what is root surface caries>

A

older and recession and cementum exposed

26
Q

What does infected dentine culture show?

A
  • Mutans streptococci
  • Lactobacilli
  • Actinomycesspp. (A. israelii; A. gerencseriae)
  • Gram negative anaerobic rods (e.g. Prevotellaspp.)
27
Q

What do bacteria live off in healthy patient?

A
  • glycoproteins -Microorganisms break them down for energy
    • acid production slow & saliva easily buffer it
    • Littledemineralization
28
Q

What do bacteria live off in CARIES patient?

A
  • biofilm exposed to sugars frequently
  • Bacteria like MS rapidly metabolise sugars - produce acid
  • More demineralization than remineralization
29
Q

What are characteristics of cariogenic bacteria?

A
  • rapid sugar transport
  • rapid acid production
  • acidurity
  • extracellular/ intracellular polysaccharide
30
Q

What is the biggest difference between MS and S.sanguinis?

A

have v different acid tolerance

31
Q

what is non specific plaque hypothesis?

A

overall net effect of all these organisms

32
Q

What is ecological plaque hypothesis?

A
  • enviro. plays a role

o Many species contribute if they have right properties

33
Q

How is disease prevented?

A

vaccine

homeostasis

34
Q

Why can caries occur?

A

o Is their OH poor?
o Is their saliva flow compromised?
o Do they have lots of sugary snacks?

35
Q

What does a change in pH lead to?

A

change in microorg. being selected for

36
Q

what bacterial properties are selected for, for caries

A

ACIDOGENIC

ACID TOLERATING

37
Q

What happens when more time under critical pH is spent?

A

oral enviro. more time facilitating growth of caries bacteria

38
Q

Approach to control caries?

A
  • Plaque control
  • Fluoride
  • Sugar substitutes
  • Antimicrobial & anti-plaque therapy
  • Replacement therapy
  • Vaccination
  • Passive immunization
39
Q

What does plaque control ensure?

A

biofilm kept thin and less chance of acidic conditions in mouth

40
Q

What does fluoride produce?

A

fluoroapatite - remineralization

41
Q

what does fluoride do?

A

inhibit bacterial metabolism and inhibit enolase (involved in glycolysis)

42
Q

What are sugar substitutes?

A

xylitol/sorbitol - can’t be metabolized by microorg.

43
Q

what is chlorhexidine active against?

A

MS

44
Q

what is replacement therapy?

A

probiotics in oral cavity, replace orgs. in mouth

45
Q

are streptococci targetable pathogens for vaccines?

A

yes

46
Q

what is passive immunization?

A

coat surfaces with antibodies or synthetic antibody fragments

CSA Antimicrobials, local ant. in heart folder (2 decks)

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