Microbiology of dental caries 1 Flashcards
Describe dental biofilm in health
They are diverse and made up of bacteria, fungi an viruses
How many species make up the dental biofilm?
can have as many as 300 different species in a single persons mouth
What is a microbiome ?
A Group of organisms
Where in the body is the most diverse biofilm found?
The gut
What can the dental boflm do in the mouth?
Can desquamate
What does desquamation do?
Reduces microbial load on the mucosal surfaces
What make dental biofilm unique?
It has non shedding surfaces
Give examples on non shedding surfaces in the mouth
- Teeth
- Dentures
- Implants
What do non shedding surfaces permit in the mouth?
They permit heavy biofilm formation if bacteria isn’t controlled
Give examples of some methods we can use to characterise the oral microbiome in health and disease
- Traditional culture
- Microscopy
- Molecular methods
Give some disadvantages of traditional culture tests
- Expensive
- Only 50-70% go he oral microbiota can be cultured
- Need to do multiple tests to identify and name the isolated organisms
- Laborious and time consuming
What di we do in traditional culture tests?
We grow the bacteria in jelly dishes with blood
Give some disadvantages of microscopy
Only cell morphology can be determined nothing else
Give some examples of molecular methods we can use to characterise the oral microbiome in health and disease
- PCR
- DNA-DNA hybridisation
- Humanoral microbiome identification microarray (HOMIM)
- High throughput whole genome sequencing
- DNA sequencing
Describe the process of PCR
Primer that is specific to a organism id added sample and if the organism is present in the sample it will be multipled and a tag is used to assess the presence of varying bacteria
What is the old standard now used to characterise the oral microbiome
Using whole genome sequencing
Give some examples of data bases that can be used in DNA sequencing
- Human microbiome consortium
2. Human oral microbiome database (HOMD)
How are microorganisms in dental biofilm organised?
Structurally and functionally organised
Give some key features of multi species biofilms
- Concerted and collaborative organisms
- Food chains
- Gradients present
- Matrix formation
- Cell-cell signalling
- Complex interactions occur create balance
Give some beneficial qualities of biofilms
- They exclude extrogenous microbes (Provide colonisation residence)
- Down regulation of potentially damaging po inflammatory host repossess
- Stimulates beneficial host responses
- Promotes host microbe balance
- Contributes to the enter salivary nitrate circulatory system
Name some healthy micro organisms
- Strep. Mitis/ oralis
- Actinomyces spp
- Haemophilus spp
- Neisseria spp
- Fusobacterium spp
Name some microorganisms found in caries
- Mutans streptococci
2. Lactobacilli
What do we mean when we say caries is a multifactorial disease
Theres several factor that al have to come into play for you to get caries
Give some factors needed to lead to the formation of caries
- Key oral microorganisms must be present
- Susceptible host present
- Environmental factors
Name some environmental factors that can cause dental caries
- Cariogenic diet
- Poor oral hygiene
- Low salary flow rate
- Fluoride availbilty
5 Non specific virulence traits
What evidence is there or h role of microbes in the aetiology of dental caries?
The Gnotobiotic animal studies
What are the Gnotobiotic animal studies ?
They are tests done on germ free animals
We then introduce micro organisms to the germ free organism to assess the effect of the new microorganism on the animal
What id the Gnotobiotic animal studies show?
- Some bacteria are more cariogenic the others
- Importance of fermentable sugars
- Disease can be transmitted from animal to animal
- Showed effective antimicrobials can prevent caries
WHY can we not do germ free human studies?
For ethical reasons
What type of tests can we carry out on humans?
Human epidemiology studies
Name the 2 types of human epidemiology studies
- Cross sectional
2. Longitudinal
Give some benefits of cross sectional studies
Cheap
Can look at a wide variety of people
Give some disadvantages of cross-sectional studies
Only shows associations
Give some benefits of longitudinal studies
They show a cause and effect relationship
Give some disadvantages of longitudinal studies
They are expensive and take a long time o do as you follow group of people over several years
Name some micro organisms implicated in dental caries
- Strep mutans
- Strep sobrinus
- Strep cricetus
- Strep rattius
- A neslundi
- A odontolyticus
- Lactobacillus spp
- Bifidobacterium
Describe mutans streptococci
- Gram positive cocci/ short rods
- Found on hard non shedding surfaces
- Implicated I the initiation of caries
What ae some f the difficulties when we associate micro organisms with dental caries?
- Disease occurs at sites with natural diverse microbiota
- Pathogens can be found at healthy. sites
- It is difficult to correlate microbiota to enamel status
- lesions can remineralise
- Pathogenic traits are relatively non specific
- Multi factorial nature of caries
Where does disease first occur?
Just below the enamel surface which leads to a white spot lesion
What have cross sectional studies shown us about the aetiology of caries
Mutans streptococci higher at caries sites
Theres an inverse relationship between MS and Step sanguines
Some sites with caries have no MS
What have cross sectional studies shown us about fissure caries
- 71% of caries fissures had more than 10% mutant streptococci
- 70% of caries free fissures had no detectable mutans streptococci
What have longitudinal studies shown us about the aetiology of caries
1 Confirms mutans streptococci present in high numbers at caries sites
- MS can occur after first signs of demineralisation
- Caries can occur in apparent absence of MS
- Other species also playa role incurs progression
Name a lactate utilising micro organism that plays role in dental caries
Veilllonela Spp
Describe veillonella
- Gam negative coccus
- Anaerobic
- Utilises lactic acid in plaque
Name the streptococcus species that produces acid th fastest at ph5.5
S. Sobrinus
Name some base generating species
- Strep Salivarius
- Strep sanguinis
- A. naeslundil
Can mutans streptococci be detected I culture independent studies?
Not. unless they are present in high numbers
Name different types of caries
- Nursing bottle caries
2. Root surface caries
Name some bacteria present in high numbers in nursing bottle caries
Mutans streptococci
Lactobacilli
Name some micro organisms found in infected dentine
- Mutans streptococci
- Lactobacilli
- Actinomycces spp
Give some characteristics of cariogenic bacteria
1. They transport sugar rapidly and produce acid rapidly 2 Aciduricity (acid tolerant) 3. Extracellular polysaccharide 4. Intracellular polysaccharide
Describe the sugar transport system of mutans streptococci
Very rapid
Multiple systems
At what pH do mutans streptococci produce acid?
pH 3.9-4.2
Are mutans streptococci acid tolerant?
Yes they grow at pH 5.5
What type of polysaccharides do mutans streptococci produce?
Soluble and insoluble extracellular polysaccharides
Intra cellular polysaccharides
Describe the sugar transport system of lactobacilli
Rapid but little s known bout their transport system
At what pH do lactobacilli produce acid?
pH 3.8-4.1
Are lactobacilli `acid tolerant?
Ye stheyare very acid tolerant and grow at pH 5
What type of polysaccharides do lactobacilli produce?
Low concentrations of extracellular polysaccharides and Intra cellular polysaccharides
Describe the sugar transport system of actinomyces
Medium speed
Little is known about their transport system
At what pH do actinomyces produce acid?
pH 4.4-.8
Are actinomyces acid tolerant?
Medium tolerant
What type of polysaccharides do actinomyces produce?
Medium concentration of extracellular polysaccharides
Produces intracellular polysaccharides
Describe the sugar transport system of strep sanguinis
Medium speed
At what pH do strep sanguinis produce acid?
pH 4.4-4.8
Are strep sanguinis acid tolerant?
No they have a poor acid tolerance
What type of polysaccharides do strep sanguinis produce?
Soluble and insoluble extracellular polysaccharides
Intra cellular polysaccharides