Microbiology Flashcards
Window of infectivity for transmission of bacteria
- 19-30 mo
- Has been found in children as young as 10 months
- One study found Streptococcus mutans in 53% of 6-12 months children
- Width of window may vary for individual infants
Adhesin
- A surface structure or macromoleture that binds a bacterium to a specific surface. • Antigen I/II or SpaP. • Attaches to salivary pellicle receptors, salivary agglutinate, and other bacteria. • Also provides mechanism fo binding salivary agglutination glycoprotein to the streptococcal cell surface-generates receptor for other bacteria to adhere. • Enables P. Gingivalis to adhere to streptococci, enabling secondary colonizers to be incorporated into plaque communities.
Glucans
- Tooth adherence
- Promotes aggregation
- Biofilm accumulation
- Retention of bacterial nutrients
Lipoteichoic Acid (LTA)
- Lipoteichoic acid is an amphipathic constitutions of the gram-positive bacteria outer-envelope.
- Can stimulate inflammation - TLR2.
- Analogous to LPS in gram negative bacteria.
- May help in adherence
- Key in virulence
Etiological factors in dental caries
1) Microorganisms - some oral flora are carcinogenic, others protective
2) Host factors (saliva, tooth anatomy, oral hygiene, etc.)
3) Substrate (fermentable carbohydrate)
4) TIME: the more often the above factors are in contact, the more damaging the effect
What are con founders?
An outside factor that correlates (positively or negatively) with the independent variable and the dependent variable.
3 major hypotheses regarding the etiology of caries
1) Specific plaque hypothesis: proposes that only certain species of bacteria are involved in the caries process
2) Nonspecific plaque hypothesis: assumes all plaque/bacteria is pathogenic
3) Ecological plaque hypothesis: suggests that shifts in the pH of the biofilm cause a shift toward carcinogenic bacteria (Streptococci mutants) in the balance of resident oral flora, resulting in disease
Extended caries ecological hypothesis (what we now believe)
- Low pH non-mutans strep include Streptococcus mitis, oralis, and sanguine.
- These bacteria are pioneer bacteria and early colonizers of tooth structure, binding to the pellicle first.
- They have long been thought to be benign and perhaps helpful in preventing caries via competitive inhibition (they compete for nutrients and space in the biofilm, thus leaving little for mutants strep to love on ).
- Given the right environment, even these “good” bacteria can cause demineralization and destruction of tooth structure.
- Our efforts to eradicate caries should not be aimed at a caries vaccine or targeted antimicrobial, but at changing the environment of the biofilm and maintaining a neutral pH.
Paradigm regarding etiology of the carious lesion
- Old paradigm: the carious lesion is an irreversible manifestation of the disease and is the result of progressive demineralization of tooth structure.
- New paradigm: carious lesions represent an imbalance in the ongoing remineralization/demineralization cycle that continuously occurs.
- When demineralization exceeds remineralization, a carious lesion forms.
Composition of enamel
- 95% Hydroxyapatite
- 4.5% water
- 0.5% organic matrix (proteins—amelogenins, enamelins)
Various ions (such as fluoride) can be incorporated into the HA crystals
Chemistry of demineralization/remineratlization
- Neutral conditions: a dynamic equilibrium exists between the mineral content of enamel and the oral fluid.
- When the oral environment is acidic, the H+ ions in the oral fluid react with the phosphate ions and hydroxyl ions in the enamel. The oral fluid is now unsaturated with phosphate ions, so these ions are leached from the enamel in an effort to re-establish equilibrium.
What are the two species of bacteria responsible for initiation of dental caries?
- Streptococcus mutans and Streptococcus sobrinus
- Mutans streptococci have been correlated with caries in numerous cross-sectional epidemiologic studies.
- Presumed to have a major role in the initiation of the lesion, even though they are not the first to colonize the tooth surface. Considered to be essential but not solely sufficient for the production of dental caries.
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Lactobacillus acidophilus and Lactobacillus casei have also been associated with dental caries.
- Minimally involved in lesion initiation, believed to have a role in caries progression.
What bacteria is associated with advanced caries?
- Scardovia wiggsiae
- Slackia exigua
What are the three properties that cariogenic bacteria possess that enable them to function in the disease process?
- Adherent to teeth
- Acidogenic
- Aciduric (can live and function within the acid environment)
A dietary carbohydrate-modified infectious disease in which saliva functions as a critical regulator. In this definition, the term “infection” is used in its most basic sense, meaning colonization of the oral cavity by bacteria.
Dental caries disease process, Venn diagram
- Dental caries is a disease of the dental hard tissues, characterized initially by the decalcification of the inorganic portions of the tooth.
- Loss of the mineral content is then followed by breakdown of the organic matrix.
- This destructive process results from the metabolism of refined carbohydrates by oral microorganisms.
- The process can be visualized by a Venn diagram illustrating the following requirements: (1) A susceptible tooth; (2) Presence of bacteria; (3) Access to refined, fermentable carbohydrate; and (4) Time.
- The Venn diagram illustrates the basis of the acidogenic, or chemicoparasitic, theory of dental caries. Bacteria use refined dietary carbohydrates, principally sucrose, as a substrate for acid production. The resultant acids begin the process of demineralization.
