Systemic influence of Oral Microbiota

Question 1

Describe infective endocarditis

Answer 1

Infection of the heart tissue

• Bacteria enter blood stream from dental procedures
• Spontaneous bacteraemia from ulcerations or periodontal disease
• Bacteria colonize damage or prosthetic heart valves
• Most common bacteria is streptococci: also most common bacteria in mouth
• Consequences:
  1) Congestive heart failure (valvular leakage)
  2) Thromboembolism: blockage of arteries
  3) Infection of surrounding cardiac tissue
• Prevention:
  1) If patient has high risk of IE, use antibiotic prophylaxis
  2) Antibiotic prophylaxis = have patient take some antibiotics before procedure so that any bacteria that reach blood is killed before it can colonize
  3) Standard prophylaxis = 2g of amoxicillin 1 hr before treatment

Question 2

Describe linkage of Periodontal disease with cardiovascular disease

Answer 2

• PD causes atherosclerosis (thickening and hardening of arteries due to inflammatory plaque build-up)
• P. gingivalis invades artery endothelial cells
• P. gingivalis causes fatty plaque build-up in arterial walls

Question 3

Periodontal disease is linked with diabetes.

Answer 3

True

Question 4

Periodontal disease is linked with pneumonia.

Answer 4

True

Question 5

Periodontal disease is linked with cancer and Alzheimer’s disease

Answer 5

True

Question 6

Describe linkage of PD with rheumatoid arthritis

Answer 6

• 4x more likely to get PD if you have RA
• 1.5x more likely to get RA if you have PD
• P. gingivalis in mouth can trigger production of CCP self-antigens:
  1) P. gingivalis has PAD enzyme
  2) PAD enzyme produces CCP antigens
  3) The body produces anti-CCP antibodies in response
  4) Anti-CCP antibodies are antibodies responsible for autoimmune response in joints of RA
  5) Once body starts producing anti-CCP AB, they react at joints and cycle continues.