molecular diagnositcs

Question 1

what is an appropriate clinica l specimen to take for caries

Answer 1

• general swab of saliva or tooth surface

- minimal invasiveness

Question 2

what organisms are important to detect for cariess

Answer 2

• could be anything really, but probably focus on what old literature states = streptococcus mutans, lactobacillus species

Question 3

what method would you use to isolate bacteria from aries

Answer 3

• probably would not

- difficult to sample hundred of kids and differentiate colonies

Question 4

what techniques could be used for isolating bacteria from caries

Answer 4

• next generation sequencing (NGS)

- microbiome analysis of 16S rDNA sequences would enable accurate picture of bacteria present

Question 5

what preventative measures could be implemented to minimise carriage of caries

Answer 5

• improved diet advice
• behaviour advice
• public health measures

Question 6

what specimens could you investigate for bleeding gums

Answer 6

• sub gingival plaque biofilm

Question 7

where would you take specimen from for bleeding gums

Answer 7

• paper point from gingival crevice on site of inflammation

Question 8

what organisms are important for gingivits/perio

Answer 8

• P. gingivalis and many others

Question 9

what methods could be used to identify culprit organisms in perio

Answer 9

• selective agars, PRC, NGS

- ideally grown on plates and undertake sensitivity testing

Question 10

how do you determine cause and effect

Answer 10

• removal of culprits organisms leads to resolution of disease

Question 11

what treatment options are available for perio

Answer 11

• oral hygien, antisepsis (chlorohexidine), potentially antibiotics if non-responsive

Question 12

does the knowledge you have obtained about the species present in the disease make a difference to your decisions on clinical management

Answer 12

• probably not

- you will sitll treat them the same way as no clear way of stating on bacteria is responsible

Question 13

what is the cause of inflammation in denture stomatitis

Answer 13

• denture associated biofilm

Question 14

what microorganisms are associated with denture stomatitis

Answer 14

• Candida albicans, candida glabrata, any oral bacteria

Question 15

what types of specimens could be taken to isolate these microorganisms in denture stomatitis

Answer 15

• oral rinse or swab from localised area, foam pad for imprint

Question 16

why is it important to identify the microorganisms in denture stomatitis

Answer 16

• differentiation Candida albicans from glabrata is important as glabrata is insensitive to azoles

Question 17

are there systemic implications of an indwelling prosthesis for the patient

Answer 17

• possibility of aspiration pneumonia, possible (though low) links to cardiovascular disease

Question 18

what type of clinical specimen would you are for an abscess

Answer 18

• looking to obtain pus sample

- needle aspirate

Question 19

what types of microorganisms are you looking for in an abscess

Answer 19

• possibility of oral anaerobes

Question 20

does the microorganism have a bearing on you take the specimen

Answer 20

• obligate anaerobes are oxygen sensitive, so if you want to grow these you must be weary

Question 21

is timing of specimen collection/transport important for asbcess

Answer 21

• must have correct anaerobes transport media

Question 22

what techniques would you use to identify the microorganisms from abscess

Answer 22

• standard plate culture and possibility of microscopy

Question 23

are there systemic implications if an abscess is not dealt with effectively

Answer 23

• spreading odontogenic infection, possibility of sepsis

- patient could die