Plaque mediated disease Flashcards
Where can you find plaque?
Gingival (above the gumline), subgingival (below the gumline), smooth surface (side of tooth), approximal (inbetween teeth), fissure, crevice of gingiva
What is the initial phase of dental caries and is it reversible?
a white spot appears and yes
Which area of the mouth is most vulnerable?
molars, harder to reach
What are some causes of human caries?
eating sugar, low salivary flow, low exposure to fluoride
What causes dental caries?
bacteria are involved in the formation of lesions on the basis of their function
Which type of bacteria causes the most problems in terms of caries?
acidogenic as they can produce acid from sugar
Which two bacteria are best at being acidoduric and acidogenic?
mutans streptococci and lactobacilli
What does the ecological plaque hypothesis explain?
the polymicrobial nature of caries
What is disease a result of?
the shift in balance of the resident microflora
What is demineralization?
loss of calcium and phosphate
Below which pH are you at risk of caries?
5.5
How can we prevent sugars from producing cariogenic species?
eat less sugar
How can we prevent selection for cariogenic species?
physical removal by oral hygiene techniques such as flossing or by increasing the host’s capacity to clear the cariogenic species
How can we prevent low pH from increasing risk of caries?
fluoride exposure, enamel repair
How can we prevent an increase in organic acids from sugar fermentation to decrease pH?
buffer capacity of host saliva, some bacteria use organic acids in food chain
What does periodontal disease refer to?
disease of supporting tissues of the tooth
The environment of gingival crevices is aerobic. True or false?
False
Anaerobic
There is lack of protein in gingival crevices. True or false?
False, an abundance of proteins
Gingivitis is irreversible. True or false?
False, it is a reversible inflammation of the gums
What is the fluid that surround the gingiva called?
Gingival curricular fluid, which is very proteinaceous in nature
The bacteria in the gingival crevice need to be able to metabolise what?
Protein
The bacteria in the gingival crevice need to be able to metabolise what?
True
Is gingivitis a precursor for periodontal disease?
Yes
According to the ecological plaque hypothesis, what are the characteristics of periodontal disease?
high subgingival biofilm levels, strong inflammatory response, high GCF flow, bleeding, high pH & temp, obligately anaerobic proteolytic biofilm
According to the ecological plaque hypothesis, what are the characteristics of effective oral hygiene?
low subgingival biofilm levels, minimal inflammation, low GCF flow, presence of gram positive , facultative, saccharolytic biofilm, periodontal health
How are periodontal diseases classified?
gingival diseases, chronic periodontitis, necrotising periodontal disease, aggressive periodontitis
In chronic periodontitis, in addition to gingivitis what else occurs?
loss of attachment, which is irreversible, alveolar bone loss may also occur, leads to increased depth and bleeding on probing
Why is the flora in healthy gingivae and in periodontal disease very different?
Some periodontopathogens can attach to the mucosa and form a biofilm coating on the tongue as there are lots of nutrients and large surface area. Thought to be a reservoir of infection
Could tongue piercings be a risk factor for periodontal disease?
yes as they increase number of bacteria in the mouth
What does necrotising mean?
to destroy tissue
What are the characteristics of necrotising periodontal disease?
underlying systemic infection, painful, causes halitosis, grey pseudo-membrane forms on the gingivae
What are the bacteria responsible for necrotising periodontal disease?
spirochaetes and fusobacteria
Aggressive periodontitis is associated with high levels of what?
AA, which produces a very potent leukotoxin which destroys WBCs
What are the characteristics of aggressive periodontitis?
Rare condition, usually in female teenagers, leads to a rapid loss of attachment
How can aggressive periodontitis be treated?
with tetracycline/ metronidazole/ amoxicillin because of anaerobic nature of bacteria
What is pregnancy gingivitis caused by?
presence of steroid hormones in GCF
What is Group A Strep gingivitis?
Gingivitis caused when bacteria that causes sore throats gets into the gingival crevices
What are the features of diabetes gingivitis?
inflammation, impaired healing and may increase insulin resistance
What is HIV periodontal disease characterised by?
presence of opportunistic pathogens
Is there an association between periodontal disease and general health?
yes, linked to CVD, respiratory disease, diabetes, risk of premature labour and risk of low birth weight
Why does periodontal disease put you at risk of other conditions?
inflammation related to gram negative species results in toxic metabolites and increased LPS, the periodontium is very vascular so inflammatory mediators can reach far sites and oral bacteria can enter bloodstream
