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Oral Microbiology > Lecture 02: Oral Microbiome and Systemic Disease > Flashcards

Lecture 02: Oral Microbiome and Systemic Disease Flashcards

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Biology 101 flashcards
1
Q

2 aims of the Human micro biome project

A
  • characterize microbial communities form multiple human body sites
  • find correlations between micro biome changes and human health
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2
Q

we used to think of microbes as “germs” that are pathogenic invaders but now we are switching our thinking to believe that some are _____

A

essential

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3
Q

3 ways microbes are beneficial

A
  • resistance against pathogens
  • metabolic functions
  • immune activation (if kids are too clean they will have immune problems later in life)
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4
Q

old goal of bacteria vs new goal of bacteria

A

old: sterile environment
new: manage and preserve NATIVE microbes

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5
Q

old way of thinking in which it was believed that a disease is caused by a single cause

A

Koch’s postulate

*now we now it is a community disruption and loss of healthy species

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6
Q

what are two example of OLD therapies that focused on broad eradication

A
  • antibiotics

- antiseptics

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7
Q

what are three examples of NEW therapies to encourage healthy communities

A
  • probiotics (yogurt)
  • prebiotics (encourages growth of good bacteria)
  • targeted antimicrobials
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8
Q

idea that oral “focus of infection” causes systemic disease

A

theory of focal infection

*Hippocrates cured arthritis by pulling a tooth

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9
Q

this was an old way thought to treat mental illness

A

therapeutic eduntulation (pulling teeth)

*ended by 1930

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10
Q

when did evidence for connections between oral infections and systemic diseases start?

A

25 years ago with cardiovascular disease

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11
Q

oral-systemic connections

A
  • infective endocarditis (infection of heart valves)
  • pneumonia
  • cardiovascular disease
  • type 1 diabetes
  • cancer
  • preterm birth
  • immunosuppression
  • biofilm infections on implanted devices
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12
Q

what are the two direct mechanisms for oral connections to systemic diseases?

A
  • translocation of bacteria (seeded by oral bacteria)

- translocation of toxin (produced by oral bacteria)

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13
Q

what two things constitute good evidence for oral systemic effects?

A
  • epidemiologic studies (no correlation)
  • evidence of causality
  • –human trials show tx prevents disease
  • –presence of oral bacteria at disease site
  • –effect in animal model
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14
Q

spread of bacteria throughout the blood

A

bacteremia

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15
Q

60% of the oral bacteria

A

streptococci (sanguis, mitis, mutans)

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16
Q

in practice does antibiotic prophylaxis prevent bacteremia?

A

no

17
Q

what are the two risks to antibiotics?

A
  • allergy

- cost

18
Q

T/F dental procedures associated with infective endocarditis

A

False

19
Q

how do you reduce the risk of getting Infective Endocarditis?

A
  • good health and hygiene

- optimize regular hygiene measures to keep bacterial load low than give antibiotic prophylaxis

20
Q

aspiration pneumonia is caused by what two things?

A
  • aspirations of oral secretions

- oral bacteria

21
Q

when is Pneumonia seen?

A

common when airway protective refexes compromised

—physically handicapped or elderly

22
Q

what prevents lung infection?

A

oral hygiene measures

  • reduce nosocomial pneumonia by 40%
  • could prevent 10% of deaths in nursing homes
23
Q

how is preterm birth carried out?

A

bacteria in the amniotic fluid, some of them common oral species, associate with it

24
Q

does periodontal tx reduce the risk of pre-term birth or low birth weight?

A

no

*no strong evidence for cause and effect relationship

25
Q

tx of periodontitis improves what?

A

glycemic control

  • shows causality btw periodontitis and diabetes
  • hyperactive innate immune response of both
  • synergistic effect on inflammation
26
Q

what is the effect of treating oral bacteria to help with cardiovascular disease

A

effect is modest

27
Q

inc risk of what type of cancer with periodontitis

A

pancreas

28
Q

cardiovascular implantable electronic device infections are caused by what?

A

bacteria from skin of pts or hands of hospital workers or environment

*recommend NO antibiotic prophylaxis for dental treatment

29
Q

____ rates are high when the infection is around a vascular graft/stent

*90% caused by bacteria native to skin or bowel

A

mortality

*recommend NO antibiotic prophylaxis for dental treatment

30
Q

what percentage of joints become infected

A

1-2%

  • morbidity is high
  • most infections occur in preoperative period from wound contamination
31
Q

evidence for PRIMARY antibiotic prophylaxis relating to joints is when?

A

at the time of device placement

32
Q

is there any dental risks associated with joints?

A

no

33
Q

concerning joints, late infections occur from where?

A

hematogenous seeding

34
Q

is there an indication for antibiotics to prevent oral bacterial source for pts with pins, plates, and screws?

A

no

35
Q

is prophylaxis recommended with cerebrospinal fluid shunts?

A

no

  • no vascular structures so low bacteremia
  • high rate of infection
36
Q

do dental procedures cause infections with CSF shunts?

A

no

37
Q

what conditions involve DIRECT TRANSFER OF ORAL BACTERIA?

A
  • infective endocarditis
  • pneumonia in compromised airway
  • immunosuppression
  • preterm birth
  • primary preventative strategy is to improve oral health and reduce bacterial load
  • antibiotic prophylaxis is indicated in specific HIGH RISK situations
38
Q

what conditions involve TRANSFER OF ORAL BACTERIA OR TOXIN, OR COMMON INFLAMMATORY PATHWAY

A
  • type II diabetes
  • cardiovascular disease
  • pancreatic cancer
  • primary preventative strategy is to treat periodontal disease to improve microbial profile
  • improve overall health by improving risk factors
39
Q

what conditions involve NON ORAL CONDITIONS

A
  • cardiovascular implantable electronic devices
  • vascular grafts/stents
  • intravascular access devices
  • prothetic joints
  • bone pins, plates, screws
  • renal dialysis shunts
  • CSF shunts

*no specific oral precautions

Oral Microbiology (3 decks)

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