Micro Final Flashcards
About ___ kinds of MO’s exist in the human mouth
700 kinds
For MO’s to become established memebers of oral microbiota, they must
Attach to oral surfaces and be able to multiply
What is dental plaque
Microbial mass that accumulates on the teeth
Dental plaque accumulates due to
The absence of oral hygiene
Impacting of bacteria/food in the non self cleansing areas of the dentition
Plaque is ____ composed of bacterial cells embedded in an _____
Biofilm
Intercellular matrix
When does dental plaque begin to reform after teeth are cleaned
Within seconds
What is pelicle
Think proteinacious layer that coats all tooth surfaces exposed to saliva
Bacteria attaches to the pelicle forming
The initial layer to which other bacterial cells attach
Plaque can mineralize (accumulate calcium) forming a hardened material known as
Calculus or tartar
Dental caries is an infectious disease caused by
Demineralization of tooth structures by acids
4 types of caries
Occlusal caries
Smooth surface caries
Interproximal caries
Root caries
4 factors necessary for caries to occur
Susceptible host
Microorganisms
Substrate
Time
Microorganisms are also called
Agent factors
____ is a substrate that is metabolized by oral bacteria through catabolic fermentation to produce ____
Diet
Acids
What is the most caries conductive component of our diet
Sucrose
What are caries conductive bacteria found in the mouth
Mutans streptococci
thought to be the most important bacteria in initiating caries
3 pathogenic properties of mutans streptococci for caries formation
Producing acids from carbohydrates (being Acidogenic)
Surviving at low ph (Aciduric)
Accumulating on teeth
Mutans streptococci aka
Plaque formers
What is responsible for the initial attack on the tooth
Mutans streptococci
What is responsible for progression of carious lesions
Lactobacillus
Lactobacillus thrive best within?
Highly acidic carious lesions
What is attributed to root caries formation
Actinomyces Naeslundii
What is critical level of ph that if at or below it is perfect environment for caries to form
5.2
Dental caries occur when what occurs more slowly
Remineralization occurs more slowly than demineralization
Bacteria found in periodontal disease are?
Gram negative
3 types of periodontal diseases
Gingivitis
Chronic periodontitis
Necrotizing ulcerative gingivitis
Gingivitis is what when plaque is removed
Reversible
What type of periodontitis is characterized by slow progression of destruction and usually occurring in people 35 years and older
Chronic periodontitis
Necrotizing ulcerative gingivitis is often referred to as
Trench mouth
Mechanisms of fluoride (3)
Inhibit bacterial metabolism after diffusing into the bacteria as hydrogen fluoride
Inhibiting demineralization
Enhance remineralization
Pulpitis
Inflammation of the tooth pulp
Periapical infection
Infection of the tooth apex
Cellulitis
Infection of the facial tissues
What is transient bacteremia
Members of the normal oral microbiota enter the bloodstream as a result of bleeding (cheek biting, traumatic tooth brushing, dental procedures)
What is subacute bacterial endocarditis
Certain oral bacteria in the blood may induce damage to heart valves in someone who has previous damage to heart valves
People who have had prior damage to heart valves (rheumatic heart disease) should do what before oral treatment
Pre med with antibiotics
What does going green mean
Using products and procedures that have lower adverse impacts on health and the environment
4 stages in the development of an infection prevention program with reduced environmental impact
Inventory of infection control procedures
Develop a plan
Implement the plan
Review and monitoring
Carbon footprint is defined as
The amount of greenhouse gases directly or indirectly emitted
The greenhouse effect is a natural occurrence that
Helps regulate the temperature of our planet
Ozone depleting substances (ODSs) destroy the “good” atmospheric ozone. What are some examples of these
Some solvents, aerosol propellants and coolants
Biodegradation is the breakdown of materials by
Microbes in the environment
Do not compromise what so you can go green
Infection control
Can an infection control procedure improve the environment
Typically no, most have a negative effect because of increased waste and harmful chemicals
Aseptic techniques do what
Prevent or reduce the spread of MOs from one site to another
When are aerosols generated
During use of high and low speed handpieces, ultrasonic scalers and air water syringe
Spatter consists of particles larger than ? And can settle where?
Larger than 50um that can settle anywhere
Minimizing dental aerosols and spatter (3)
High volume evacuation
Rubber dam
Proper positioning of clients head
The HVE system should be cleaned at the end of the day by evacuating what through the system?
What should you not use?
Evacuate detergent or water based detergent disinfectant.
DONNOT USE BLEACH
What is the best approach in minimizing dental aerosols and spatter
HVE + rubber dam
Studies have shown that a mouth rinse with a long lasting antimicrobial agent can reduce the level of oral MOs for up to
5 hours
Examples of antimicrobial agents in pre procedural rinses
Chlorhexidine. Iodophors. Essential oils
Safe injection practices help prevent the transmission of disease agents during
Preparation and administration of parental medications
Aseptic retrival refers to
Retrieving a single item from a container without contaminating other items in the container
After barrier removal, sensors (digital X-rays) should be cleaned of ? And disinfected with?
Cleaned of gross debris and saliva
Disinfected with a low level disinfectant or as per manufactures instruction
Clean disinfect and rinse all dental prosthesis and prosthodontic materials (impressions, bite reg) using at least?
An intermediate level disinfectant
What should you use for heavy soiled prosthesis
Ultrasonic cleaner
(Plastic bag w zipper or beaker)
2 types of dental environmental surfaces related to disease spread
Clinical contact surfaces and housekeeping surfaces
Contamination of environmental surfaces can be (3)
Droplet. Direct. Indirect
Clinical contact surfaces are
Touched frequently with gloves during patient care that may be contaminated with blood or saliva
2 general approaches to surface asepsis
Surface barrier
Preclean and disinfect
Surface covers should be ____ to fluids to keep MOs in saliva; blood or other liquids from soaking through to contact the surface
Impervious
Precleaning reduces then number of
Contaminating MOs and the presence of bio burden
Using a disinfectant for the Precleaning step starts
The killing process early and reduces the chances of spreading contamination to adjacent surfaces
Antibiotics kill MOs
In or on the body
Antiseptics kill MOs
On the skin and other body surfaces
Disinfectants kill MOs
On environmental/inanimate sirfaces
Skull and crossbones pictogram is used for
Hazardous products that can cause death or acute toxicity if inhaled, swallowed or through skin contact even in small amounts
The symbol of the flame indicates potential
Fire hazard
The flame over circle pictogram is used to indicate
Oxidizing; fire and or explosion in the presence of flammable or combustible material
The gas cylinder symbol indicates?
What do these include ?
Gasses under pressure that may explode if punctured heated or dropped.
May include dissolved gas, liquified gas, compressed gas and refrigerated liquefied gas
The health hazard symbol is used on product labels and SDSs that cause
Or are suspected of causing allergic reaction, respiratory sensitization, specific target organ toxicity, reproductive toxicity, carcinogenicity, aspiration hazard or germ cell mutagenicity
The corrosion symbol is used on products that can cause
Severe skin burns and eye damage. As well as products that are corrosive to metals
The exploding bomb pictogram is used for products
At risk of explosion due to fire, shock, friction, heat or puncture
The exploding bomb pictogram is placed on labels of
Mixtures of self reactive substances and organic peroxides
The exclamation mark pictogram is used for products that may
Cause less serious health effects
Ex. Product may be harmful to skin, cause eye irritation, respiratory damage and/or fatal in large doses
The biohazardous pictogram is used only in
Canada
Biohazardous pictogram indicates products may have
Organisms or toxins that can cause diseases in humans and animals
What are examples of products that are exempt from WHMIS
cleaning products like toilet bowl cleaner/ windex
Pesticides/herbicides
Cosmetics
Tobacco
Drugs/ pharmaceuticals
Explosives
What does WHMIS stand for
Workplace hazardous materials information system
There are 3 times more deaths every year from _____ than traumatic injuries
Exposure to chemicals
Exposure to hazardous materials can cause or contribute to
Irritation
Burns
Sensitization
Heat ailments
Kidney/lung damage
Cancer
Death
What are the goals of WHMIS
-provide employers and employees information about hazardous materials in the workplace
-prevent accidents or injury occurring in the course of employment
Routes of entry include
Inhalation
Ingestion
Absorption
Injection
WHMIS principles of prevention
*hint ARACE
Avoid hazards
Recognize hazards
Assess hazards that cannot be avoided
Control hazards
Evaluate controls
3 key elements of WHMIS
Labels on hazardous products
Safety data sheets (SDS)
Training
For WHMIS what terms are interchangeable
Controlled products and hazardous materials
2 types of labels
Workplace labeling and supplier label
Who are suppliers
Manufacturers
Processors
Packaged
Importer
Seller
Suppliers must (3)
Classify materials into one or more of the hazardous classifications
Supply labels for controlled products
Prepare and provide sds
If there is no label it is the _____ duty to request from supplier
Employers
Innate defences
Always active; 1st and 2nd line of defense
Acquired (adaptive) defense
Must be stimulated to become active; 3rd line of defense
Innate host defense barriers include
Physical
Mechanical
Cellular
Antimicrobial
Chemicals
Examples of physical barriers
Unbroken skin
Mucous membranes (eyes, nose, mouth)
Mechanical barriers examples
Movement of cilia
Sticky nature of mucous
Hair in the nose
Coughing
Sneezing
Examples of antimicrobial chemicals
HCL in stomach
Organic acids on skin
Interferon
Cellular barrier examples
Phagocytes (neutrophils or macrophages)
Is acquired immunity present at birth
No
Antigens are foreign to the ____ and activate the ____
Body; immune response
Lysosome (chemical barrier) is an enzyme produced in
Sweat
Tears
Saliva
(Kills bacteria)
Gastric juices ( chemical barrier) is
Stomach acids that kills bacteria and toxins
Saliva (chemical barrier) dilutes
MO’s and washed oral cavity
Phagocytosis
Phagocytes destroy microbes in body tissue
Localized response to damage is called
Inflammation
T-lymphocytes (acquired immunity) is a ___ mediated response
Cell mediated response
B-lymphocytes (acquired immunity) is a _____ mediated response
Antibody mediated response
Plasma produces
Antibodies
What are the 5 main types of white blood cells (WBC)
Lymphocytes
Monocytes
Neutrophils
Eosinophils
Basophils
WBC (aka leukocytes) protect against
Infectious disease and foreign invaders
B cells attack ____ and where?
Attack invaders OUTSIDE the cells
T cells attack
Infected cells
B cells divide to produce
Plasma and memory cells
Produces antibodies which bind to bind to antigens and eliminate them
Plasma
Effectively respond to a second encounter with a pathogen
Memory cells
Killer/ cytotoxic cells
Track down cells infected with virus
Largest WBC
Monocytes
Monocytes turn into what when they leave the blood stream
Macrophages
Most abundant WBC
Neutrophils
Found mostly in mucous membranes and deal with parasites
Eosinophils
Rarest of the WBC
Basophils
Basophils are responsible for what response and release what
Allergic reactions. Antigen response
Release histamine
Artificial immunity involves being
Immunized or vaccinated against a specific disease
Cell mediated allergic reaction
Contact dermatitis
The initial immune response = increased number of
Lymphocytes
Once we had infectious disease we frequently
Will not get that disease again
The lysosomal enzymes in the vacuole digest the
Bacterial cell
To the site of inflammation the earliest cells to arrive are? Followed by?
Earliest = neutrophils
Followed by monocytes/macrophages and lymphocytes
In acquired immunity the immune system learns how to attack
Antigens and develop memory
Response to infection that inhibits bacterial growth and increases rate of repair
Fever
These are more common in lymph than in blood, they have the longest life span (memory cells) and include B cells and T cells
Lymphocytes
Activate more WBC’s and are driving force in maintaining defense system
Helper T cells
Neutrophils (aka PMNs) are the first responders to what kind of infections?
They make what?
Bacterial and fungal infections
They make pus
Activation of the immune system by certain antigens can cause damage to the body; what is an example of this
Pollens-antibody-mediated allergic reaction to the nose and eyes
Hay fever
Asthma
Allergy to a substance distributed throughout the body may result to a widespread reaction affecting the blood stream, lungs and heart
Anaphylactic shock
In phagocytosis the cell membrane will surround a bacteria to produce a pocket that will eventually close tightly around the bacteria; this pocket is a
Vacuole called the phagosome
