Lecture 2- Oral microbiota and systemic connections

Question 1

2 direct mechanisms for oral connections

Answer 1

translocation of bacteria (seeding)

translocation of toxin

Question 2

in infective endocarditis, … and … adhere to exposed connective tissues producing …

Answer 2

platelets and fibrin

nonbacterial thrombotic endocarditis (NBTE)

Question 3

When a patient has NBTE, bacteria from the oral cavity can …

Answer 3

enter bloodstream and adhere to NBTE

Question 4

What can the bacteria do once it adheres to NBTE in heart

Answer 4

multiply, infiltrate heart tissues and cause cardiac and valvular injury

emboli and stroke if dislodged

Question 5

3 types of oral bacteria involved in infective endocarditis

Answer 5

streptococci (sanguis, mitis, mutans)

A.Actinomycetemcomitans

Gemella

Question 6

skin bacteria involved in infective endocarditis

Answer 6

staphylococci

Question 7

T/F there is solid evidence that dental procedures are associated with IE

Answer 7

false

Question 8

Is antibiotic prophylaxis during dental procedures likely to prevent cases of IE?

Answer 8

no

Question 9

whats the best way to reduce the risk of IE

Answer 9

regular good oral hygiene

Question 10

what is the leading cause of death from infection in those over 65

Answer 10

aspiration pneumonua

Question 11

aspiration pneumonia is caused by…

Answer 11

aspiration of oral secretions (oral bacteria)

Question 12

aspiration pneumonia is common in the … and …

Answer 12

physically handicapped

elderly

Question 13

oral hygiene measures can reduce nosocomial pneumonia by … %

Answer 13

40

Question 14

oral hygiene measures could prevent … % of deaths in elderly in nursing homes

Answer 14

10

Question 15

T/F periodontitis is associated with preterm birth, low birthweight and pre-eclampsia

Answer 15

true

Question 16

T/F randomized clinical trials show periodontal treatment reduces risk of PTB or LBW

Answer 16

false

Question 17

T/F treatment of periodontitis improves glycemic control

Answer 17

true

Question 18

… and other perio pathogens found in atherosclerotic lesions

Answer 18

p. gingivalis

Question 19

… exacerbates CVD in animal models

Answer 19

p. gingivalis

Question 20

there is an increased prevalence of … in diabetics

Answer 20

periodontitis

Question 21

coronary heart disease, stroke, PVD are all associated with … but the association is modest and there has not been a causative relationship established

Answer 21

periodontitis

Question 22

studies show increased risk of … cancer in patients with periodontitis

Answer 22

pancreatic

Question 23

cardiovascular implantable electronic device (CIED) infections are caused by bacteria from …

Answer 23

skin of patient or hands of hospital workers

Question 24

T/F the AHA guideline for nonvalvular cardiovascular device-related infections recommend antibiotic prophylaxis for dental treatment

Answer 24

false

Question 25

for vascular grafts/stents, most infections (90%) are caused by bacteria native to ... or ...

Answer 25

skin or bowel

Question 26

T/F CDC guidelines for the prevention of intravascular catheter-related infections recommend prophylaxis antibiotics

Answer 26

false. do NOT give AP for any reason

Question 27

... % of joint prostheses become infected and there is a ... morbidity

Answer 27

1-2% high

Question 28

there is a lack of evidence supporting .... to reduce dental procedure related bacteremia and distant site infection in a joint prostheses

Answer 28

secondary antibiotic prophylaxis

Question 29

there is evidence for .... at the time of placing a joint prostheses unrelated to dental treatment

Answer 29

primary antibiotic prophylaxis

Question 30

late infections in joint prostheses from ... can occur

Answer 30

hematogenous seeding

Question 31

the bacteria responsible for infection of a joint prostheses is most often.... only ...% of the time is it from bacteria found in the oral cavity

Answer 31

staphylococci 5%

Question 32

T/F there is no indication for antibiotics to prevent oral bacterial source for patients with pins, plates and screws

Answer 32

true

Question 33

is there evidence that microorganisms associated with dental procedures cause infection of cerebrospinal fluid shunts?

Answer 33

no

Question 34

conditions associated with direct transfer of oral bacteria

Answer 34

IE pneumonia in immunocompromised immunosuppression preterm birth?

Question 35

primary preventative strategy for reducing risk of transfer of oral bacteria in the following conditions: immunosuppression, IE, PTB, pneumonia

Answer 35

improve oral health and reduce bacterial load antibiotic prophylaxis indicated in specific high risk situations

Question 36

conditions associated with the transfer of oral bacteria or toxin or common inflammatory pathway

Answer 36

type 2 diabetes CV disease pancreatic cancer

Question 37

what are the primary preventative strategies to prevent transfer of oral bacteria toxin

Answer 37

treat periodontal disease to improve microbial profile improve overall health by addressing risk factors

Question 38

7 conditions where there are no special oral precautions since there is not evidence that oral bacteria is the cause

Answer 38

``` CIED vascular grafts/shunts prosthetic joints bone pins, plates, screws renal dialysis shunts CSF shunts ```