Lecture 2: Oral bacteria and systemic disease Flashcards
paradigm shift in microbiology: chronic diseases caused are caused by _______
microbial community disruptions
paradigm shift: therapies to encourage healthy communities focus on?
- probiotics
- prebiotics
- targeting antimicrobial
What defines all microbes, their genomes, and interactions in a defined environment
microbiome
how many species are in oral microbiome?
1000
how many genes are in human dna? base pair sequences?
20,000-25,000, 3 billion base pairs
T/F there are more bacterial cells than human cells
true
T/F bacteria colonize differently at different sites
true
what type of bacteria predominates the oral cavity?
streptococcus
what is the theory that removing the oral focus of infection could cure systemic disease?
theory of focal infection
T/F epidemiologic studies show association and causation
false, cannot show causation
what are the 3 mechanisms for oral bacteria causing systemic diseases?
- distant site infection seeded by oral bacteria
- distant site injury from toxin produced by bacteria in oral cavity
- host genetic hyper-susceptibility to inflammation is common pathway to disease
what are examples of distant site infections seeded by oral bacteria ?
- oral bacteria gaining entry to circulatory system (bacteremia) or airway (aspiration)
T/F infective endocarditis can be caused by oral bacteria traveling through the bloodstream to the heart
true
T/F endotoixns from gram positive bacteria in perio pockets may gain entry to blood and cause cardiovascular disease
false, gram negative
What are some examples of host hyper-susceptibility to inflammation causing disease?
- periodontitis
- cardiovascular disease
- obesity
- diabetes
- insulin resistance
- pancreatic cancer
What is nonbacterial thrombotic endocarditis (NBTE) formed from?
platelets and fibrin adhering to exposed CT
What binds to NBTE?
bacteria from distant sites (oral cavity)
What types of oral bacteria are involved in infective endocarditis?
- streptococci (60%+) (sanguis, mutans, mitis)
- aggregatibacter actinomycetemcomitans
- gemella
what type of skin bacteria are involve in infective endocarditis?
- staphylococci (25%)
T/F dental procedures are associated with infective endocarditis
false, no evidence
antibiotics carry risk of ___ and ____
allergy and resistance
T/F poor oral hygiene and gingival disease are associated with increased risk for bacteremia in IE
true
T/F dental procedures are more likely to causeIE than random bacteremia from daily activities (brushing and chewing food)
false
indications for antibiotic prophylaxis
- invasiveness of procedure
- high risk IE
what is used for antibiotic prophylaxis
single high dose of amoxicillin
what is the most common cause of oral bacteria leading to pneumonia?
- compromised airway protective reflexes in elderly
T/F aspiration of oral secretions can cause pneumonia
true
T/F improving oral hygiene in elderly can reduce pneumonia by 40% and 1/10 deaths
true
_____ in mother is associated with preterm birth
periodontitis
T/F there is a strong relationship between periodontitis and preterm birth
false, causual relationship
During immunosuppression, there is a high risk for ______ or ______ of oral origin
disseminated strep or candida
T/F there is strong evidence for relationship of systemic diseases during immunosuppression caused by dental treatment or efficacy of antibiotics
false
What are cardiovascular implantable electronic device infections (CIED) infections likely caused by?
staph from skin of hospital worker
When implanted CIED, is AP recommended for dental treatment?
no
Most infections (90%) of vascular graft infections are caused by bacteria native to ____ or ____
skin or bowels
Is AP recommended during dental treatment if patient presents with a vascular graft/stent?
- not recommended
- surgeon may ask for AP because there is a high mortality rate with vascular graft infection
T/F patients with intravascular access devices require AP for dental treatment
false, infections caused by staph
what percentage of bacteria in a joint infection is oral bacteria?
5%, mostly caused by skin staph
T/F AP is not needed for dental treatment in patient with prosthetic joint
true, but patient preference should be considered
There is evidence for ______ at the time of joint prostheses placement, but there is lack of evidence for _______ to reduce bacteremia from distant site infections
- primary antibiotic prophylaxis
- secondary prophylaxis
T/F bone pins, plates, and screw infections are caused by staph or skin bacteria and AP is not indicated for dental treatment
true
T/F cerebrospinal fluid shunts have a high rate of infection to oral bacteria
false
- do not involve vascular structure (low bacteremia)
- mostly skin infections (high rate of infection)
T/F there is increased prevalence of periodontitis in diabetics
true
T/F there is a common pathway between periodontitis and diabetes
true, hyperactive innate immune response
Coronary heart disease, stroke, and peripheral vascular disease all associated with ______
periodontitis, no causative relationship though
T/F studies show increased risk of pancreatic cancer in patients with periodontitis
true
T/F systemic lupus is associated with oral bacteria
false
- most patients have mitral valve insufficiency
4 diseases with direct oral connection
1) infective endocarditis
2) pneumona in a compromised airway
3) immunosuppression
4) preterm birth
3 diseases with possible transfer of oral infectious agent, but common pathway most likely
1) type 2 diabetes
2) cardiovascular disease
3) pancreatic cancer
T/F oral bacteria have limited range and limited ability to cause systemic disease
true
