Gingivitis and preiodental disease Flashcards

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1
Q

Peridoental disease worsens what?

A

glycemic control

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2
Q

Patients with periodontal disease are twice as likely to develop what?

A

diabetes

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3
Q

treatment of periodontal disease results in 10-20% of what?

A

improvement in glycemic control

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4
Q

poor glycemic control is associated with what?

A

threefold increases risk or periodontal disease

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5
Q

periodontal disease is a more serious condition of what?

A

gingivitis

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6
Q

periodontal disease is when what?

A

the bone holding the teeth in place is destroyed

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7
Q

In periodontal disease the gum may pull away from their original position doing what? which causes what?

A

exposing the roots of the teeth; which allows decay and infection into tooth roots and into bone that supports the teeth

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8
Q

As the bone dissolves the teeth become what?

A

become loose

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9
Q

When the teeth become lose what may happen?

A

it may become so painful that eating becomes difficult and sever infections may develop

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10
Q

Is periodontal disease treatable?

A

May be treatable or may require teeth to be removed.

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11
Q

Preiodontal disease is associated with what in pregnant woman?

A
  • pre-term birth
  • pre-eclampsia
  • gestational diabetes
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12
Q

What patients benefit most from improved oral health?

A
  • pregnant woman
  • children
  • those with diabetes or other chronic conditions
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13
Q

Acute Necrotizing ulcerative gingivitis (ANUG) is also called what?

A

Trench mouth

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14
Q

Early colonizers of the teeth

A
  • Streptococcus gordonii
  • Streptococcus oralis
  • Actinomyces naeslundii
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15
Q

What bacteria colonizes shortly after the early teeth colonizers?

A

Streptococcus mutans

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16
Q

what are shear forces?

A

force acting on a substance in a direction perpendicular to the extension of the substance. Shear forces result in shear strain .

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17
Q

The microbes of teeth have high what?

A

shear forces and have coaggregation

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18
Q

what is coaggregation?

A

when genetically distinct bacteria become attached to one another via specific molecules

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19
Q

What is the physical appearance of plaque

A

long filamentous forms and “corn cobs” that are mixed bacterial aggregates

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20
Q

F. nucleatum wasn’t able to grow as _____ biofilm but was able to grow ______ biofilm

A

F. nucleatum wasn’t able to grow alone or with S.oralis but was able to grow with Actinomycetes

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21
Q

All dental organisms lie in _____

A

mixed microbial environment

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22
Q

S. gordonii and Aa is an example of what?

A

polymicrobial interactions

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23
Q

Aa can grow in ____ environments and survive _____

A

can grow in mixed environments and survive immune system

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24
Q

Lactose is a _____ to do what in Aa?

A

is an inducer to turn genes on an inducer which Aa does not have it instead cross feeds off other bacteria

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25
Q

Lactose breaks down into what in Aa?

A

glucose and galactose which is then used bu Aa

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26
Q

What is Aa stand for?

A

A. actinomycetemcomitans

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27
Q

How does Steptococcus gordonii play an important role in A. actinomycetemcomitans (Aa)?

A

Stretococcus gordonii produces lactate in the oral cavity which Aa cross edds off of which acts as an inducer for the genes of Aa.

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28
Q

Streptococcus mutans is only found when what?

A

teeth present

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29
Q

Dental caries is what?

A

tooth decay

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30
Q

Streptococcus mutans causes what?

A

Dental caries

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31
Q

What bacteria plays a role in Dental caries

A

Streptococcus mutans as well as other streptococci

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32
Q

Streptococcus mutans metabolizes what? fir what?

A

sucrose and starch producing lactic acid and glucans (sugar polymers) used for adhesion

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33
Q

At high cell densities Streptococcus mutans become what?

A

acid resistant and competent (Competence stimulating peptide)

34
Q

what is quorum signaling?

A

the regulation of gene expression in response to fluctuation in cell-population density by releasing chemical signal molecules called autoinducers that increase in concentration as a function of cell density

35
Q

How does Streptococcus mutans become acid resistant and competent?

A

By quorum signaling

36
Q

What are three key factors of Streptococcus mutans?

A

1) Sucrose converted to Dextran, a sticky material which helps adhesion
2) Production of acid de-mineralization of tooth
3) Ability to survive low pH

37
Q

Why is Streptococcus mutans ability to convert sucrose to Dextran important for virulence?

A

a sticky material which helps adhesion

38
Q

What is the process of tooth decay?

A

1) S. mutans produce dextan from sucrose which alows plaque formation in pits and crevices on enamel
2) Lactobacillus and other bacteria produce acids from sugars via fermentation which dissolve the enamel
3) Decay continue into the dentin
4) decay continues into pulp

39
Q

what is the pulp?

A

center of the tooth made up of living connective tissue and cells called odontoblast.

40
Q

Bacteri + refined carbohydrates =

A

acids from sugars via fermentation

41
Q

acid + time =

A

enamel dimineralization

42
Q

untreated decay causes what

A

infection, Abscess, loss if tooth

43
Q

Decay begins with what?

A

acid attacking the tooth enamel (outer prtion of the tooth)

44
Q

How can teeth be kept healthy?

A

-daily oral hygiene
-healthy diet
-using fluoride in watr
toothpaste
-mouth wash
-professionally-applied gel or varnish

45
Q

If decay progresses after attacking the enamel what happens?

A

creates a cavity or hole in that tooth

46
Q

If a cavity is not repaired and doesnt change the condition of the mouth the decay will do what?

A

Destroy the tooth; the tooth may become infected of abcessed

47
Q

Untreated tooth decay or abscess may result in what?

A

tooth needing to be removed but in more serious cases an untreated abscess can lead to serious widespread infection resulting in the swelling of the face and sometimes even swelling of the brain or even death

48
Q

people with weakened immunity may have what?

A

Difficulty recovering from dental abscess

49
Q

A. actinomycetemcomitans (A.a) KatA and apiA are induced on what?

A

H2O2 (hydrogen peroxide) exposure

50
Q

A.a’s coculture with S. gotdonii does what?

A

enhances A.a resistance to killing by human serum

51
Q

in experiments done with A.a coculture it was found what had the highest fold increase in Aa survival?

A

Aa + sg+ catalse (not heat-inactive catalase); had ~ a 7 fold increase

52
Q

H2O2 (hydrogen peroxide) is what?

A

a mediator of A.a’s resistance to innate immunity

53
Q

Enhanced levels of hydrogen peroxide by S. gordonii during plaque growth stimulates _____ leading to what?

A

stimulates inflammation leading to an influx of innate immune modulators including complement and neutrophils.

54
Q

A.a responds to rising hydrogen peroxide by _____ which ______

A

by induction of katA and apiA, which enhances resistance to innate immune effectors.

55
Q

Inflammation caused by hydrogen peroxide releases from S. gordonii innate immune modulators such as neutrophiles. On recruitment to the site of inflammation, neutrophils increase the levels of hydrogen eproxied and further stimulate what?

A

induction of katA and apiA from A.a

56
Q

Lab grown Aa physiology varies with what?

A

culture conditions

57
Q

Whan Aa acts as a coinfected abcess with S. gordonii it is (aerobic/ anaerobic)? WIth what as carbon source?

A

aerobic in mixed culture with lactate as carbon source

58
Q

When Aa is grown as single species abscess it is (aerobic/anerobic)? with reduced availability of what?

A

Fermentative anaerobic reduced availability of lysine and glycine

59
Q

Porphyromonas gingicalis is an example of what?

A

Periodontal disease

60
Q

A.a is _____ associated with

A

oral pathogen associated with heart disease

61
Q

P. gingivalis is a ____ associated with

A

oral pathogen assocaited with heart disease

62
Q

S. mutans is a _____ associated with

A

oral pathogen associated with heart disease

63
Q

Ekenella is a _____ associated with

A

oral pathogen associated with heart disease

64
Q

several species of streptococci can be _____ associated with

A

oral pathogens associated with heart disease

65
Q

IScaling/deep cleaning is used for what?

A

removing plaque and debridement (removing dead tissue)

66
Q

If there is an infection what can be used as treatment?

A

broad spectrum antibiotics

67
Q

Why are bacteria infections of the mouth not cultured?

A

they are polymicrobial biofilms; no dental infection has a single bacteria in the biofilm they are always polymicrobial

68
Q

What is Gestational Diabetes?

A

High blood glucose levels in pregnant woman who have never had diabetes.

69
Q

Pregnant woman with Gestational disease (GD) are at a higher risk for what then pregnant woman who do not?

A

Periodontal disease

70
Q

If preiodontal disease occurs in pregnant woman control Gastrational disease is more difficult and may cause what?

A

pre-term birth and periodontitis

71
Q

preiodontal disease may also be associated with what?

A

pre-eclampsia

72
Q

levels of what are higher in woman with pre-eclampsia?

A

IL-1, and TNF-alpha levels from gingival creviacular fluid is higher

73
Q

Oral pathogens have been found in women with what? which implies _____

A

found in woman with pre-eclampsia which implies possible contribution of periopathogenic bacteria to the pathogenesis of pre-eclampsia.

74
Q

Gingivitis is what?

A

inflammation of gums thus gums are res and swollen and may easily bleed.

75
Q

Can Gingivitis be easily treated?

A

Brushing and flossing can help improve this condition of professional care may be needed

76
Q

If plaque remains of teeth it hardens to form what? which does what?

A

tartar or calculus which irritates the gums?

77
Q

Can plaque be removed by brushing and flossing? what about tartar or calculus?

A

Plaque can but neither tartar or calculus can

78
Q

What eventually happens if the tartar and calculus on the teeth is not removed?

A

gums detach and pull away (recede) along the length of the teeth

79
Q

What may need to be done to tartar before the gingivitis will improve?

A

tartar may need to be removed by having teeth cleaned.

80
Q

The mouth has what environment?

A

many different environments for example:

  • gums are soft tissue
  • salivary glands make a semi-liquid environment