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AU 15- Oral Micro > The Oral Microbiome & Systemic Disease > Flashcards

The Oral Microbiome & Systemic Disease Flashcards

1
Q

The human microbiome consists of ________ of microbes living in and on the human body.

A

trillions

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2
Q

The Human Genome Project of 1993-2003 identified all ________ genes in human DNA.

A

20,000

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3
Q

True or False: There are more bacterial cells than human cells.

A

True

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4
Q

True or False: There is more human genetic information than microbial.

A

False

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5
Q

What were the aims of the Human Microbiome Project?

A

To characterize microbial communities from specific human body sites and to find correlations between microbiome changes and human health.

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6
Q

At the genus level, there is ______ overlap among body sites.

A

very little

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7
Q

What is the difference between alpha- and beta- diversity?

A

alpha: within a habitat
beta: among habitats

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8
Q

Which five body sites were studied during the microbiome project?

A 
oral cavity
GI tract
vagina
skin
anterior nares
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9
Q

Explain the paradigm shift in microbiology that originally viewed bacteria as “germs” or pathogenic invaders. How are bacteria viewed now?

A

Now microbes are seen as essential and adaptive parts of the “human microbiome super-organism”

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10
Q

Name three ways in which microbes are beneficial.

A
  1. resistance against pathogens
  2. assist in metabolic functions
  3. immune activation
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11
Q

Explain how Fecal Transplantation of clostridium dificile exemplifies a new concept in microbiology.

A

Bacterial goals used to include the maintenance of a sterile environment. Now, we know that it is important to preserve native microbes. Treatment for C.dificile wiped out all bacteria and the patient did not get better because pathogenic bacteria took over. Fecal transplant reintroduced good bacteria.

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12
Q

Rather than focusing on single-species causing acute disease, it is understood that chronic diseases are caused by ______________.

A

microbial community disruptions and loss of healthy species

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13
Q

Therapies are now focused on encouraging healthy communities of bacteria instead of broad eradication. What are three such therapies?

A
  1. probiotics
  2. prebiotics
  3. targeted antimicrobials
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14
Q

________ treatment is the practice of introducing live microorganisms that confer health benefits for the host.

A

Probiotic

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15
Q

The evidence for a connection between oral infections and systemic diseases began 25 years ago with which disease?

A

Cardiovascular Disease

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16
Q

What is infective endocarditis?

A

infection of heart valves that originates with bacteria

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17
Q

What are the two direct mechanisms for oral-systemic connections?

A
  1. Translocation of bacteria

2. Translocation of toxin

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18
Q

“Oral bacteria gaining entry to the circulatory system or airway” is an example of which method of oral-systemic spread?

A

Translocation of bacteria

i.e.: distant site seeded by oral bacteria

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19
Q

“Endotoxin from gram negative bacteria in periodontal pocket enters the circulatory system and promotes inflammation” is an example of which oral-systemic connection/spread?

A

Translocation of toxin

i.e.: distant site effected by toxin of oral bacteria

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20
Q

How could phenotype influence manifestation of disease?

A

Host hyper-inflammatory phenotype has been shown to have a common pathway to disease. For example, a genetic hyper-reactive host innate immune response may be a common predisposing factor for periodontitis, CVD, diabetes, and cancer

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21
Q

Epidemiologic studies show ______ but do NOT establish _______.

A

association

causation

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22
Q

‘Presence of oral bacteria at a disease site and human trials that demonstrated treatment effectively preventing systemic disease’ are evidence of _________.

A

causality

23
Q

How do oral bacteria contribute to infective endocarditis pathogenesis?

A
  • Platelets/fibrin adhere to exposed connective tissues, producing nonbacterial thrombotic endocarditis (NBTE)
  • oral bacteria enter blood stream and adhere to NBTE
  • Bacteria multiply and cause valvular injury
  • Discharge into circulation causes emboli & stroke
24
Q

True or False: Oral bacteria contribute much more to infective endocarditis than do skin bacteria.

A

True (skin bacteria only account for 25%)

25
Q

Which oral bacteria is most prevalent in infective endocarditis?

A

Streptococci (60%)

-sanguis, mitis, and mutans

26
Q

True or False: Streptococci, A.actinomycetemcomitans, and Gemella are oral bacteria associated with Infective Endocarditis.

A

True

27
Q

Which skin bacteria is commonly associated with Infective Endocarditis?

A

staphylococci

28
Q

Antibiotic Prophylaxis prevents ________, not initiation of _______.

A

spread

bacteremia

29
Q

True or False: Dental procedures have been associated with infective endocarditis but antibiotic prophylaxis is unlikely to prevent it.

A

False: there is NO solid evidence that dental procedures are associated with Infective Endocarditis and AP is unlikely to prevent many cases of it.

30
Q

Rather than antibiotic prophylaxis, what is the recommended action for reducing risk for IE?

A

Poor oral hygiene and gingival disease increase the risk of bacteremia; therefore, it is recommended that regular oral hygiene be optimized to keep bacterial load low.

31
Q

“Aspiration Pneumonia” is caused by ______ and is more common in _____ or ______.

A

Aspiration of oral secretions and oral bacteria

Physically handicapped or elderly

32
Q

True or False: There is high quality evidence that shows oral hygiene measure can prevent lung infection (pneumonia).

A

True

33
Q

True or False: Current evidence for a causal relationship between oral bacteria and preterm births is not strong.

A

True (clinical trials did not prove that periodontal treatment reduces the risk of Preterm or low birth weight)

34
Q

What is neutropenia?

A

an abnormally low count of neutrophils

35
Q

The immunosuppressed individual is at a high risk for disseminated _____ or _____ of oral origin.

A

strep

candida (yeast)

36
Q

Is there evidence for using antibiotics during dental treatment for those with immunosuppression?

A

No, there is a lack of evidence. Focus on achieving good oral health and consider the invasiveness of the procedure.

37
Q

Is there a proven associated between periodontitis and diabetes?

A

Yes, there is a higher prevalence of perio in diabetics.

Treatment for perio improves glycemic control. Evidence is strong, although effect is moderate (doesn’t cure)

38
Q

There is a moderate association between coronary heart disease, stroke and peripheral vascular disease with _______.

A

periodontitis

link, not causative

39
Q

Evidence for causality of heart disease includes ________ lodged in atherosclerotic lesions.

A

P. gingivalis and other perio pathogens

40
Q

True or False: Studies show increased risk of pancreatic cancer in patients with periodontitis.

A

True

41
Q

Infections on Cardiovascular Implantable Electronic Devices are caused by bacteria from _____. Is AP recommended for dental procedures?

A

Skin on patients or hands of hospital workers

No

42
Q

Infections of vascular grafts or stents are caused by bacteria native to _________. Is AP recommended for dental procedures?

A

skin or bowel

No

43
Q

Infections of intravascular access devices are caused by ______. Is AP recommended for dental procedures?

A

Staph or other skin bacteria

No

44
Q

Most infections of joint prostheses occur in the _______period from ______ contamination.

A

perioperative

wound

45
Q

Is there a recommendation for antibiotic prophylaxis in individuals with joint prostheses?

A 
Primary Prophylaxis (at the time of device placement) is recommended because of possible skin bacteria entry.
Secondary (during dental treatment) is NOT supported by evidence because the joint is surrounded by synovial fluid, not blood.
46
Q

Is AP recommended for dental procedures in individuals with bone pins, plates, and screws?

A

No

most infections are caused by skin bacteria

47
Q

Cerebrospinal Fluid Shunts are penetrated by ____ bacteria. Is AP recommended during dental procedures?

A

skin

No

48
Q

Which three (possibly four) diseases are connected to oral bacteria that are directly transfered?

A

Infective Endocarditis
Pneumonia (in compromised)
Immunosuppression
(Preterm Birth ?)

49
Q

What is the primary preventive strategy for Directly Transferred Bacteria?

A

Improve oral habits to reduce bacterial load

AP in high risk situations

50
Q

Which three diseases are associated with transfer of oral bacteria and their toxins or with the common inflammatory pathway?

A

Type II Diabetes
Cardiovascular Disease
Pancreatic Cancer

51
Q

What is the primary preventative strategy for bacteria spread via toxin or inflammatory pathways?

A

Treat periodontal disease

Improve overall health to address risk factors

52
Q

What is human biogeography and how does it relate to oral bacteria and disease?

A

The human microbiota is Niche-Specific. Oral bacteria have a limited range and limited ability to cause systemic diseases

53
Q

Rather than focusing on eradication of germs to prevent disease, now it is important to encourage ________.

A

Healthy bacterial communities

oral hygiene, healthy diets, fluoride, repair dentitions

AU 15- Oral Micro (11 decks)

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