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Pedo > Lecture 2: Oral bacteria and systemic disease > Flashcards

Lecture 2: Oral bacteria and systemic disease Flashcards

1
Q

paradigm shift in microbiology: chronic diseases caused are caused by _______

A

microbial community disruptions

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2
Q

paradigm shift: therapies to encourage healthy communities focus on?

A
  • probiotics
  • prebiotics
  • targeting antimicrobial
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3
Q

What defines all microbes, their genomes, and interactions in a defined environment

A

microbiome

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4
Q

how many species are in oral microbiome?

A

1000

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5
Q

how many genes are in human dna? base pair sequences?

A

20,000-25,000, 3 billion base pairs

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6
Q

T/F there are more bacterial cells than human cells

A

true

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7
Q

T/F bacteria colonize differently at different sites

A

true

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8
Q

what type of bacteria predominates the oral cavity?

A

streptococcus

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9
Q

what is the theory that removing the oral focus of infection could cure systemic disease?

A

theory of focal infection

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10
Q

T/F epidemiologic studies show association and causation

A

false, cannot show causation

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11
Q

what are the 3 mechanisms for oral bacteria causing systemic diseases?

A
  1. distant site infection seeded by oral bacteria
  2. distant site injury from toxin produced by bacteria in oral cavity
  3. host genetic hyper-susceptibility to inflammation is common pathway to disease
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12
Q

what are examples of distant site infections seeded by oral bacteria ?

A
  • oral bacteria gaining entry to circulatory system (bacteremia) or airway (aspiration)
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13
Q

T/F infective endocarditis can be caused by oral bacteria traveling through the bloodstream to the heart

A

true

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14
Q

T/F endotoixns from gram positive bacteria in perio pockets may gain entry to blood and cause cardiovascular disease

A

false, gram negative

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15
Q

What are some examples of host hyper-susceptibility to inflammation causing disease?

A
  • periodontitis
  • cardiovascular disease
  • obesity
  • diabetes
  • insulin resistance
  • pancreatic cancer
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16
Q

What is nonbacterial thrombotic endocarditis (NBTE) formed from?

A

platelets and fibrin adhering to exposed CT

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17
Q

What binds to NBTE?

A

bacteria from distant sites (oral cavity)

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18
Q

What types of oral bacteria are involved in infective endocarditis?

A
  • streptococci (60%+) (sanguis, mutans, mitis)
  • aggregatibacter actinomycetemcomitans
  • gemella
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19
Q

what type of skin bacteria are involve in infective endocarditis?

A
  • staphylococci (25%)
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20
Q

T/F dental procedures are associated with infective endocarditis

A

false, no evidence

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21
Q

antibiotics carry risk of ___ and ____

A

allergy and resistance

22
Q

T/F poor oral hygiene and gingival disease are associated with increased risk for bacteremia in IE

A

true

23
Q

T/F dental procedures are more likely to causeIE than random bacteremia from daily activities (brushing and chewing food)

A

false

24
Q

indications for antibiotic prophylaxis

A
  • invasiveness of procedure

- high risk IE

25
Q

what is used for antibiotic prophylaxis

A

single high dose of amoxicillin

26
Q

what is the most common cause of oral bacteria leading to pneumonia?

A
  • compromised airway protective reflexes in elderly
27
Q

T/F aspiration of oral secretions can cause pneumonia

A

true

28
Q

T/F improving oral hygiene in elderly can reduce pneumonia by 40% and 1/10 deaths

A

true

29
Q

_____ in mother is associated with preterm birth

A

periodontitis

30
Q

T/F there is a strong relationship between periodontitis and preterm birth

A

false, causual relationship

31
Q

During immunosuppression, there is a high risk for ______ or ______ of oral origin

A

disseminated strep or candida

32
Q

T/F there is strong evidence for relationship of systemic diseases during immunosuppression caused by dental treatment or efficacy of antibiotics

A

false

33
Q

What are cardiovascular implantable electronic device infections (CIED) infections likely caused by?

A

staph from skin of hospital worker

34
Q

When implanted CIED, is AP recommended for dental treatment?

A

no

35
Q

Most infections (90%) of vascular graft infections are caused by bacteria native to ____ or ____

A

skin or bowels

36
Q

Is AP recommended during dental treatment if patient presents with a vascular graft/stent?

A
  • not recommended

- surgeon may ask for AP because there is a high mortality rate with vascular graft infection

37
Q

T/F patients with intravascular access devices require AP for dental treatment

A

false, infections caused by staph

38
Q

what percentage of bacteria in a joint infection is oral bacteria?

A

5%, mostly caused by skin staph

39
Q

T/F AP is not needed for dental treatment in patient with prosthetic joint

A

true, but patient preference should be considered

40
Q

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

A
  • primary antibiotic prophylaxis

- secondary prophylaxis

41
Q

T/F bone pins, plates, and screw infections are caused by staph or skin bacteria and AP is not indicated for dental treatment

A

true

42
Q

T/F cerebrospinal fluid shunts have a high rate of infection to oral bacteria

A

false

  • do not involve vascular structure (low bacteremia)
  • mostly skin infections (high rate of infection)
43
Q

T/F there is increased prevalence of periodontitis in diabetics

A

true

44
Q

T/F there is a common pathway between periodontitis and diabetes

A

true, hyperactive innate immune response

45
Q

Coronary heart disease, stroke, and peripheral vascular disease all associated with ______

A

periodontitis, no causative relationship though

46
Q

T/F studies show increased risk of pancreatic cancer in patients with periodontitis

A

true

47
Q

T/F systemic lupus is associated with oral bacteria

A

false

- most patients have mitral valve insufficiency

48
Q

4 diseases with direct oral connection

A

1) infective endocarditis
2) pneumona in a compromised airway
3) immunosuppression
4) preterm birth

49
Q

3 diseases with possible transfer of oral infectious agent, but common pathway most likely

A

1) type 2 diabetes
2) cardiovascular disease
3) pancreatic cancer

50
Q

T/F oral bacteria have limited range and limited ability to cause systemic disease

A

true

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