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5th yr- Finals- CSA revision > Microbiology of dental caries > Flashcards

Microbiology of dental caries Flashcards

1
Q

Describe dental biofilms

A
  • A natural and beneficial part of the oral mucosa
  • Diverse composition of bacteria, fungi and viruses
  • Relatively stable composition
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2
Q

How do we characterise the oral microbiome in health and disease

A

Pathogenic vs beneficial micro organisms

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3
Q

How many species make up the dental bio film

A

can have as many as 300 in a single person

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4
Q

What is a microbiome

A

A group of organisms

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5
Q

What is desquamation

A

Shedding

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6
Q

What does desquamation allow for

A

reduction in microbial load on the mucosal surfaces

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7
Q

What makes dental biofilm unique

A

It has non shedding surfaces

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8
Q

Give examples of non shedding dental surfaces

A
  1. Teeth
  2. Dentures
  3. Implants
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9
Q

What problems can non shedding surfaces face

A

Heavy biofilm formation and build up if the bacteria isn’t controlled

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10
Q

How are microorganisms in dental biofilm organised

A

Structurally and functionally

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11
Q

List some key features of multi species biofilm

A
  1. Concerted and collaborative organisms
  2. Food chains
  3. Gradients present
  4. Matrix formation
  5. Cell- cell signalling
  6. Complex interactions occur to create balance
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12
Q

What are some of the beneficial qualities of biofilm

A
  1. The exclude extrogenous microbes providing colonisation residence
  2. Down regulation of potentially damaging pro inflammatory host responses
  3. Stimulates beneficial host responses
  4. Promotes host microbe balance
  5. Contributes to the salivary nitrate circulatory system
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13
Q

Name some healthy micro organisms

A
  1. Strep. Mitis/ oralis
  2. Actinomyces spp
  3. Haemophilus spp
  4. Neisseria spp
  5. Fusobacterium spp
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14
Q

Name a micro organism found in caries

A

Mutans streptococc

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15
Q

Caries is a m_______________ disease

A

Multifactorial

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16
Q

Why is caries described as multifactorial

A

As several factors play a role in the development of dental caries in an individual

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17
Q

list some factors that can lead to the formation of dental caries

A
  1. Key oral micro organisms must be present
  2. Environmental factors
  3. Susceptible host present
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18
Q

Give examples of some environmental factors that can cause dental caries

A
  1. Cariogenic diet
  2. Poor OH
  3. Reduced salivary flow
  4. Low/ no fluoride
  5. Non specific virulence traits
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19
Q

Give examples of bacteria found in dental caries

A
  1. Strep mutans
  2. Strep sobrinus
  3. Strep cricetus
  4. Strep rattius
  5. A neslundi
  6. A odontolyticus
  7. Lactobacillus spp
  8. Bifidobacterium
20
Q

Describe mutans streptococci

A
  1. Gram positive cocci/ short rods
  2. Found on hard non shedding surfaces
  3. Implicated I the initiation of caries
21
Q

Where does dental caries first begin to form

A

Just below the enamel surface- can appear as a white spot lesion

22
Q

Describe Veilllonela Spp

A
  1. Is a lactate utilising micro organism
  2. Gram negative coccus
  3. Anaerobic
23
Q

List some characteristics of cariogenic bacteria

A
  1. Transport sugar rapidly and produce acid rapidly
  2. Tolerate acid
  3. posses extracellular and intracellular polysaccharide
24
Q

At what pH do mutans streptococci produce acid?

A

pH 3.9-4.2

25
Q

Is the pathogen that causes dental caries/ gingivitis presenting health?

A

Yes most of the time

26
Q

How is dental caries describes

A

A dysbiosis of beneficial resident microbiota

27
Q

What can dysbiosis occur in the mouth

A

Due to ecological pressure eg frequent sugar and acid attacks. reduced saliva

28
Q

What are the key features acideogenic bacteria share

A
  1. They produce acid
  2. they can tolerate acid
  3. They produce intra and extra cellular polysaccharide
29
Q

Which plaque hypothesis theory is the most accepted

A

The ecological plaque hypothesis

30
Q

what is disease preventability and controllability determined by

A
  1. Direct inhibition of causative organisms
  2. Promotion of natural balance
  3. Interference with factors driving dysbiosis
31
Q

Give examples of oral environmental factors that can drive dysbiosis

A
  1. Low pH in biofilm (acidic)
  2. Sugar metabolism
  3. Low saliva flow
32
Q

What can an increase in sugar frequency lead to

A
  1. More frequent acid production
  2. Increase in low pH and acid attacks
  3. Concentration ofmutans-streps, lactobacilli, bifidobacteriaetc increases
    This leads to caries
33
Q

How can a cariogenic diet or low salivary flow lead to caries formation via the ecological plaque hypothesis

A
  1. Stress due to increase in sugar frequency
  2. Environmental shift as the pH decreases (Acidic)
  3. Ecological shift as the concentration of mutans-streps and lactobacilli
    bifidobacteria increases
  4. This eventually leads to disease ie caries
34
Q

What drives dysbiosis in dental caries

A

Sugar and pH

35
Q

What can the breakdown of sugar lead to

A
  1. Organisms can make sticky smile that stops saliva penetrating to the tooth surface
  2. Organisms can break down sucrose into arctic acid reducing pH leading to prolonged acid attack
36
Q

Define critical pH

A

pH at which enamel starts to demineralise faster than remineralise

37
Q

State the critical ph

A

5.5

38
Q

How can we control and manage dental caries

A
  1. Plaque control
  2. Fluoride
  3. Sugar substitutes
  4. Antimicrobial and anti plaque agents
  5. Vaccination
  6. Passive immunity
39
Q

How does fluoride help control dental caries

A
  1. It inhibits intra cellular polysaccharide synthesis
  2. This reduced glycolysis and therefore reduces acid production
  3. pH does not fall below critical pH
40
Q

What structure does fluoride form when it goes into enamel

A

fluorapatite

41
Q

What is special about fluorapatite

A

It is more tolerant to acid and promotes remineralisation

42
Q

What can we recommend to pts that like to have sugar

A

Sugar substitutes

43
Q

How do sugar substitutes help control dental caries

A
  1. They can not be converted to acid so they dont create an acidic environment
  2. They stimulate saliva flow
  3. They have weak antimicrobial activity
44
Q

Do we commonly control dental caries with antimicrobial and anti-plaque agents? explain your answer

A

no as we have a mixed community of good and bad bacteria and it is difficult to create an anti plaque agent that will only harm bad bacteria

45
Q

Name the gold standard anti plaque agent

A

chlorhexidine

46
Q

How can we delivery antiplaeu agents safely

A

Via toothpaste an mouthwashes

47
Q

What is the disadvantage of chlorhexidine

A

It is very potent so can only be used for short periods of Time

5th yr- Finals- CSA revision (19 decks)

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