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51 Cards in this Set
- Front
- Back
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whats a carie?
who gets them? how? |
cavity
when acid destroys an area of a tooth, the acid comes form bacterial fermentaiton COMMON IN KIDS increased sugar consumptions (carb), decreased tooth brushing, low SES, and ...METH MOUTH Plaque organisms, Hosts teeth, saliva, hygeins, TIME, diet--> lots of things play a role in developing a cavity |
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whts meth mouth
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lots of cavities bc you take meth
xerostomia- dry, saliva is protective- wash away bacteria and buffers acids no hygeine cravings for high sugar foods |
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whats baby bottle tooth decay
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when front teeth of babies rot out bc their bottle is sugary
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what bug INITIATES caries
what bug PROGRESSES caries what bug has an UNCLEAR ROLE |
1. Strep mutans: it uses glucosyltransferase to make glucan from sucrose. GLucan is what adheres to the tooth. decreases pH. facultative anerobe
2. Lactobacillus: gram + 3. actinomyces **veillonella is ant cavity MICRO, HOST, DIEST, and TIME all play into carie formation |
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strep mutans
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cavitiy INITITATOR
normal flora 88converst sucrose into GLUCAN, glucan adheres to the tooth |
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what is used to stick to the tooth when you get a cavity
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glucan
Sucrose ---> glucan via strep mutants (glucosyltransferase) |
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what is lactobacillus
what is actinomyces viscosus what is Veillonella |
gram +
progression of carries role in caries is unclear but IS associated with carries perhaps is ANTI- carie. will increase the pH |
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what may be anti cavity
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veillonella
increases the pH |
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is the old addage true, if you eat sugar you will increase cavities
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yep, the bugs (S. mutans, lactobacillus,actinomyces) all use carbs/sugar to ferment and decrease the pH. buts its more about hte FREQUENCY, if you soak your teeth is sugar its worse
sucrose is hte worst bc strep mutans can use it directly to make the adherent glucan MICRO, HOST, DIEST, and TIME all play into carie formation |
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does tooth structure have anything to do with caries? whats the role of saliva?
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of course, can hold sugar in places
also the saliva washes away food particles and buffers acidity WASH YOUR MOUTH to decrease caries MICRO, HOST, DIEST, and TIME all play into carie formation |
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whats the time progression of cary
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1. white spot- demineralization, REVERSIBLE
2. Leision- enamel is soft with probe 3. Can be filled or continue to demineralize 4. continued demineralization leads to tooth fracture |
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how are carreis dx?
how are they treated? |
1. white spot/soft pot
LOTS of strep mutans and lactobacillus **if you have lower levels of these bugs you can decrease caries TREATMENT: remove leision, fill them. remineralization agents PREVENTION- vaccines |
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how can we prevent cavities
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VACCINE. lol silly microbiologists (strep mutans). also can have passive immunization
**decrease sugary food (frequency) **clean your teeth **flouride- lots of minerals (can be overdone) **sealants |
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what are the stages of peridontal disease
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1. Healthy Gums
2. Gingivitis 3. Peridontitis 4. Advanced Peridontitis **shift from gram + rods/cocci to gram - rods |
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in what disease do we see a shift from gram + to gram - in the flora
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peridontal disease
progression from healthy gums to gingivitis, peridontitis, to advanced peridontitis |
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tell me about chronic gingivitis
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reversible- remove plaque, increase hygeine
**seen in older patients, no complaint of pain or discomfort *no bone loss, no pockets **bad breath, red swollen gums |
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what stage of peridontal disease?
1. Actinomyces, Capnocytophaga 2. porphryromonas, prevotella, tannerella, capnocytophaga 3. actinibacillis antinomycetemcomitians |
1. chronic gingivitis- reversible
2. chrinic peridontitis- start to loose bone/collagen, teeth not painful but are loose 3. aggressive peridontitis- rare, usually genetic. only several teeth are involved, wont look nasty. no inflammation, tx with AB |
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tell me about porphyromonas gingivalis
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increased in chronic peridontitis
black pigemeted on streak plate- needs hemin to make porphoryn OBLIGATE ANEROBE, can only change when environment has been changed. normal flora lots of virulence can live on carb metabolism alone- needs vit K and peptides |
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whats peridontitis (chronic)
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progression of gingivitis, seen in older ppl, common
* have bone nad teeth affeted, deep peridontal pockets. gums inflammed/recession *NO PAIN *plaque spreads and created pockets of anerobic areas **prophyromonas, prevotella, tannerella, capnocytiphaga |
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whats aggressive peridontitis
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rare, inherited
associated with the longest namend bacteria ever- actinibacillis antinomy..... |
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whats the bug that is totally anerobic streaks black and has lots of virulence, what oral disease
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porphyromonas gingivalis
chronic peridontitis |
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other than porphyromonas gingivalis what bugs are associated with chronic peridontitis
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1. prevotella
2. Tannerella 3. Capnocytophaga- likes CO2 |
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how is chronic peridontitis treated
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remove the plaque--> can be surgery,
replace lost teeth brush more can stick AB into the deep pockets |
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what is the rate peridontitis that is seenin younger ppl
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aggressive,
bone loss but NO inflammation, bleeding, plaque clustered in famililes- genetic or immunodeficient can be generalized or localized Aggregatibacter actinomycetemcomitans (Actinobacillus actinomycetemcomitans) pretty star shaped!!! tx the same as chronic peridontitis |
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tell me about ANUG
acute necrotizine Ulcerating gingivitis |
AKA trench mouth
predisposing factorrs: dont brush, malnutrition, heavy smokers, emotional stress, recent infections red inflamed SHINY gingevae, bleeding, ulcers, bad breath, METALLIC taste, no LN, fever, maliase Fusobacterium nucleatum and Treponema |
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what are the bugs associated with trench mouth (ANUG)
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fusobacterium nucleatum- normal flora
treponema **both are OBLIGATE anerobes, gram - |
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tell em about fusobacterium nucleatum
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trench mouth- polymicrobial infection, needs treponema also *fusobacteria, spirochetes, leukocytes)
obligate anerobe gram - virulence: adhesions, endotoxin |
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tell me about treponema
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trench mouth- polymicrobial infection, needs treponema also. (fusobacteria, spirochetes, leukocytes)
obligate anerobe gram - motile |
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whats NOMA
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really severe form of ANUG (trench mouth) also called: cancrum oris, gangrenous stomatitis
**seen in young kids with severe malnutrition, infection spreads but cant be stpopped, needs reconstructive surgery **usually has a recent infection and their immune system is weak so it spreads all over. |
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what is teh severe form of ANUG called
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NOMA
**its seen in young kids who are malnourished and immunocomprimised, they get an infections and then their whole mouth is taken over. AB can stop spread but they need reconstructive surgery |
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what are dentoalveolar infections
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pyogenic infections in teeth and supporting structures
caused by normal flora that enters via cavity, peridontal disease, surgery dendoalveolar abcess lugwigs angina peridontal abcess cervicofacial actinomucosis |
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whats dentoalveolar ABCESS
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spread of carious leision into bone or soft tissue
can be prevotella, porphymonas, fucobacterium tx by draining pus and remove source of infection, use AB |
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whats ludwigs angina
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fever and swollen neck
polymicrobial infection- prevotella, porphyromonas, fusobacterium usually an infection you get after extraction- infection spreads BL can tx with AB, drainiage, ensure irway remains open |
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what is a peridontal abcess
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painful, starts in gums. infection is LOCAL- intermittent pus drainiage into the pockt can destroy bone
polymicrobial infection: prevotella, porphyromonas, fusobacterium, anerobic streptococci, spirochetes, capnocytophaga, actinomyces Tx: pull tooth, drain pus, AB |
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whats cervicofacial actinomycosis
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not common
SANDY pus, yellow "sulphur" granules Associated with TRAUMA, invasive oral procedures. see a LUMPY JAW caused by Actinomces israelii, anerobic. colonies are ronded tx with drainiage, LONG TERM AB |
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whats oral candidia
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opprotunistic
thrush- pseudomembrane, red, hyperplastic can be caused by ill fitting dentures |
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who gets oral candida, what does it look like
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young, old, sick
cottage cheese curds, can be painful and make swallowing hard lots of pseudohyphea/germ tubes that penetrate underlying tissue |
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how is thrush treated
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its that cottage cheese curd. the yeasts pseudohyphea and germ tubes adhere to the ECM of us and make this nasty pseudomembrane
paunful, hard to swallow tx with antifungals- liquid or lozenge (nystatin, fluconazole, GENTIAN VIOLET- otc) |
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whats candida associated denture stomatitis
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when you get a biofilm with yeast and bacteria on your dentures, usually poor hygeins, DM, ill fitting appliance, carb diet, TREAT with antifungal. candida is normal flora and will keep coming back
upper denture usually affected |
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whats HSV I and II
whats the 1 and recurrent infections |
I- oral
II- genital BUT.... there is lots of cross talk Primary: aysmptomatic, or gingivostomatitis, Recurrence: cold sore, fever blister caused by large enveloped virus, dsDNA. infection lives dormant in neurons and hten recurrs |
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ok so HVS lives in neurons as...
where are lytic infection |
latent, lysogenic
in epithelium/fibriblasts it is lytic large dsDNA virus |
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is HSV common
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yep!!!
80% of ppl test + for 1 and 20% + for 2 HUMAN resevoir, not seasonal. spread by fluid Horizontal, vertical transmission |
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what happens with HSV infection: 1 infection
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virus replicated in mucoepithelial cells- can then get neuron infectioed. it will got trigeminal gang. latent til reactivation- the virus then travels to the epithelium, imune reposne limits spread/severity
1. asymptomatic usually 2. gingivostomatatitis: leision in mucoca, feverm LN enlargement, pain 3. pharyngotonsilitis: in kids or adults, leision on tonsil 4. Herpetic whitlow- finger leision can be primary infection |
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how can we get a 2 HSV infection
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ok so we get viral replication in the epithelium and 1 infection can be nothing, gingivostomatotaiss, pharyngotonsilitis, or herpatic whitlow.
the virus the makes its way backwards on a neuron to the trigeminal gang. then when stressed or triggered in another way the virus makes its way back to the epithelium and makes a blise. infeciton limited by immune system |
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ok is serology helpful with HSV
whats a Tzanck smear |
only if its the first infection but most ppl are +
examination of cells at the base of the HSV leision, multinucleated giant cell, cowdry A intracellular inclusions |
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how can you tx/prevent HSV
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acycloovir/aciclovir
DONT TOUCH A LEISION |
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hats VZV
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HSV 3, its a type of herpes that shows sharp lines of demarcation usually at midline
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whats it called when you have HSV only on ONE sude, sharp line of demarkation
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VZV
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what causes hand foot and mouth disease
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coxsackie A, herpangina. leisions at back of mouth
aseptic meningiits ssRNA, small (contrast the the large dsDNA HSZ virus) |
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ok so coxsackie vs HSV
1. genome 2. sesonality 3. cause/spread 4. resevoir 5. tx |
1. HSV- large dsDNA. Coxsackie: small ssRNA
2. only coxsackie is seasonal 3. HSV- spread via body fluid. never goes away Coxsackie: seen in crowded areas with poor sanitaiton. oral to fecal transmission. can shed for like 6 weeks 4. BOTH are human only 5. HSV- antiviral Cox- none self limited |
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do you get a fever with coxsaxkie (hand foot and mouth)
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yep
**its when you eat your poo, more common in kids No serology no tx, self limited |
