Lecture # 19-20 Prevention Flashcards
Dentistry spends too much time _________ instead of ________
- Fixing the problem
- Not preventing
What are some treatments for Dentistry?
1) Caries restoration
2) Periodontal therapies
3) Orthodontics
4) Implants
What are some prevention for dental diseases?
1) Diet
2) Oral hygiene
3) Professional care
4) Fluoride dental products
5) water fluoridation
6) Disease control + management
- sealants
- fluoride products
- anti bacterials
- chlorhexidiuc (CHX)
- tridosan (colgate total; broad spectrum antimicrobial)
- STAMP?
The problem of Caries and Perio disease has gotten __________ since the last 2 decades.
Worse
How does xylitol work?
- Saliva reducing and non fermentable somewhat specific for s. mutans (looks like fructose) they add a phosphate to xylitol and then it accumulates with xylitol-phosphate so then it uses ATP to pump it out by ( adding P+ tp pump it out).
- This is a useless cycle that makes S. mutans “weaken” less energy
What can vaccines do to target dental diseases?
Targets most cariogenic bacteria, S. mutans
-Nasal spray?
What is STAMP?
- In vitro biofilms treated w/ S. mutans (specifically targeted anti-microbial peptides) resisted recolonization w/ S. mutans.
- Once established an ecosystem resists change
- 90% reduction
What are the benefits of Probiotics?
Live microorganisms, which when consumed in adequate amounts, confer a health benefit on the host
What is replacement therapy?
- Gentically modified, “designer” probiotics. GMOs are a hard sell in many communities. GMO germs would probably be even harder!
- Adding ethanol or lactate dehydrogenase to eliminate lactate + DH. End Result to kill otehr species of S. mutans
How affective are sealants for children?
IF properly placed 71% prevented caries
Fluoridated water is how affective in treating caries?
25%
Xylitol vs sorbitol gum benefits is what % ?
Sorbitol = 21% Xylitol = 50%
Why would STAMP be used?
Use to pick only 1 sp. Good guys can fill in specific weed killer
What is Chlorohexadine?
- Kills EVERYTHING (both pathogenic and normal flora bacteria)
- so bacteria will eventually recolonize (maybe worse) if more competition
What are the regions within STAMP?
1) Targeting region (De novo binding peptides)
2) Linker region (Flexible groups)
3) Antimicrobial region(Short antimicrobial peptides)
New trial that effectively removed S. Mutans in mice will have what positive and negative effect ?
Positive effect: Significantly reduced caries (90%) by targeting only S.mutans.
-Has proceeded to phase 3
Downside: Potential for bugs to dodge
- Resistance for the antibiotic
- Not need targeting region
- Use for high risk population
What is the target for vaccine?
Lactate Dehydrogenase
-attack host enzyme inside so antibody cant
GT:
Specific to S. mutans
-Want to induce IgA in saliva via mist (nose spray)- not injection
-prevent gum drop dome
Fimbrae:
Unique attachment structure for S, mutans
-prevent colonization
(Works in mice, no human trials as of yet)
Goal : to have young children vaccinated to make antibodies to prevent the binding and prevent colonization of S. mutans before tooth erupts
What was Metchnikoff theory in the early 1900’s?
Theory: Optimize microbial flora= longer life
Due to the observation that people living in rural parts of Russia seemed to live longer because they ate a lot of dairy products
***He revolutionized the thinking that in fact some Microbes are “good”
What is the rational for probiotics?
To enhance microbial assests and to offset liabilities. In fact most of the microbes that colonize us (normla flora) are “on our side”
In the Late 1990s, what happen to the market?
- Reawakening interest of research into Probiotics.
- Marketing “ahead of the curve”
What are some large scale examples of life forms used to enhance human life?
1) cat vs rat poison
2) Ladybug vs. Bug spray
3) Yougurt vs. Antibiotic
What are the 4 major Probiotic mechanisms?
1) competitive exclusion of pathogens
2) Inhibit growth of pathogens
3) Optimize immune response
4) Restore normal flora after treatment
What is the competitive exclusion principal ?
- Empty seat provides an opening for more pathogenic microbes to sit and colonize
- Once seated more pathogenic microbes are not good neighbors
- A pathogen “gang” becomes established. Often influencing less pathogenic microbes to join. Area becomes trouble
- By filling all the seats less harmful microbes make it harder for pathogens to first colonize area ( competitive exclusion)
How can inhibition of pathogen growth occur?
1) Competing for nutrients
2) Releasing toxic substances (like pathogen bug does not like H2O2, bacteriocins, etc)
