Microbes in Dental Disease Flashcards

1
Q

What bacteria is indicated in caries?

A

Streptococcus Mutans

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2
Q

What virulence factor does Strep mutans have?

A

Glycolytic systems

EPS/sucrose metabolism

Very acidic

Attachment mechanisms- GTF, Ag

Ecological competitiveness at low pH

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3
Q

Describe caries progression in terms of biofilm formation.

A

Adhesion of bacteria
Survival and growth
Biofilm formation
Complex plaque
Acid
Caries

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4
Q

What clinical specimen would you take if there was caries?

A

Specimen from occlusal surface swab.

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5
Q

What methods could be used to detect the organism present?

A

PCR
Cell culture
DNA probes
NGS

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6
Q

What bacteria is present in Periodontitis?

A

Porphyromonas Gingivalis- strict anaerobe
Prevotella Intermedia
Tannerrella Forsythia
Treponema Denticola

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7
Q

What bacteria is present in Gingivalis?

A

Prevotella Intermedia
Fusobacterium Nucleatum
Actinomyces

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8
Q

Describe the development of a plaque biofilm.

A

Adhesion
Colonisation
Accumulation
Complex community- nutrients can be shared, difficult to remove now
Dispersal

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9
Q

What are the virulence factors of P.Gingivalis?

A

Fimbriae- help invade membrane vesicles of host cells by binding to cellular integrals

Endotoxin- LPS

Proteases

Capsular polysaccharide and outer membrane vesicles

Gingipains

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10
Q

If you wanted to try determine the bacteria present in perio disease of a patient, what would you do?

A

Take a sample of plaque from the gingival margin and subgingivally of the worst site- use a paper point.

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11
Q

What are the 4 types of oral candidiasis?

A

Pseudomembranous- thrush
- can be rubbed off.

Erythematous- atrophic, denture related

Hyperplastic- candidal leukoplakia
- looks like lichen planus.
- The hyphae invade the tissues and grow inside- cannot be wiped off.

Angular Cheilitis- hyphae interact with gram positive bacteria.

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12
Q

What treatment would be used for Angular Cheilitis?

A

Topical miconazole cream- 2% 20g tube- apply to angles of the mouth twice a day.

If someone cannot use miconazole
- Prescribe sodium Fusidate ointment 2%, 15g tube, apply to angles of the mouth 4 times a day.

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13
Q

Why might someone get a candida infection?

A

Immunocompromised- chemotherapy, radiotherapy, HIV, diabetes

Steroid inhaler

Poor denture hygiene

Patients with nutritional deficiency

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14
Q

What treatment is advised for pseudomembranous candidiasis?

A

Local measures first- OHI, if taking corticosteroid inhaler then rinse mouth out after using it, Chlorhexidine mouthwash 0.2%.

Fluconazole capsules 50mg- 1 capsule per day for 7 days.

or

Nystatin- oral suspension 100,000 units/ml.

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15
Q

Describe Newton’s classification of denture stomatitis.

A

Type 1- localised inflammation

Type 2- Diffuse inflammation

Type 3- Granular inflammation

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16
Q

What fungal species are responsible for candida infections?

A

Candida albicans- sensitive to fluconazole and miconazole

Candida Glabrata- not sensitive to azaleas.
- Must use Nystatin instead.

17
Q

Describe the pathogenesis of Candida.

A

Adhesion
Colonisation
Hyphal penetration and invasion
Vascular dissemination
Endothelial colonisation and penetration

18
Q

How do Azoles work?

A

Inhibit the synthesis pathway so ergosterol isn’t synthesised.

19
Q

How do polyenes work?

A

Bind directly to ergosterol and make pores in it so that the cell contents leak out and cause the fungus to die.

20
Q

What types of bacteria are present in primary and secondary endodontic lesions?

A

Primary infection- gram negative bacilli

Secondary infection- E.Faecalis