Microbiology 43 - Oral Infections

Front 1

What are the predisposing factors for dental caries?

Back 1

Carbohydrate consumption
-Incidence in developing nations increases with increased carbohydrate consumption
-Incidence in developed nations decreases with increased awareness and oral hygiene improvements
• Low socio-economic status

Front 2

What are the characteristics of Meth Mouth?

Back 2

Methamphetamine use
-Xerostomia (dry mouth)
-Extended periods of poor oral hygiene
-Consumption of highly-sugared beverages
-Tooth grinding and clenching

Front 3

Your patient is a new mom and has been putting honey on her kids pacifier, you advice her to not to continue this practice why?

Back 3

Development of Baby bottle tooth decay:
Predominantly affects the front teeth, but other teeth can also be involved
• Repeated ingestion of sweetened liquids sugar sticks to teeth
-Avoid letting the child fall asleep with a bottle, especially if filled with juice, milk, formula, etc.
-Avoid dipping pacifier in sweetened liquids
• Importance of baby teeth
-Needed for chewing food and speaking properly
-Needed to hold place for permanent teeth

Front 4

What are the required organism components needed for dental caries and their roles?

Back 4

Strep. mutans: Initiator Glucosyltransferase: sucrose-->glucan (sticky polymer that adheres to the tooth)
Lactobacillus spp: Progression
Actinomyces viscosus: Root surface caries
Veillonella spp: Anticariogenic

Front 5

What are the factors in Caries Development?

Back 5

Plaque organisms
Diet (carbs)
Time
Host factors: teeth, saliva, hygiene

Front 6

What are some ways to diagnose caries?

Back 6

Visual:
-White spots, dark, leathery lesions
-Cavitation (radiographs)
-Quantitative light-induced flourescence
-Tactile (probe)
-Quantify bacteria (S.mutans, Lactobacillus)

Front 7

How do you treat caries?

Back 7

Prevention
Remineralization
Removal

Front 8

What is your advice on preventing caries?

Back 8

Decrease carb consumption
Control bacteria - aimed at S.mutans
Use of sealants
Fluoride (caution)

Front 9

As periodontal disease progresses, what are the stages and floral changes that are seen?

Back 9

Healthy (G+ cocci),
Chronic gingivitis(less G+ cocci),
Chronic periodontitis(G-, strict anaerobes),
Aggressive periodonitits(G- bacilli, assoc with genetic defects)

Front 10

What are the s/s of gingivitis?

Back 10

Red/swollen gingiva
bleeding
halitosis

Front 11

What is the next stage that gingivitis progresses into and what structures does it involve?

Back 11

Peridontitis: Connective tissue, bone

Front 12

What are the s/s of chronic peridontitis?

Back 12

Inflammation
Gingival recession
Bleeding
Bone loss/tooth migration
Halitosis/unpleasant taste

Front 13

What are the bacteria associated with chronic peridontitis?

Back 13

Porphromonas gingivalis: G-, black anaerobe, virulence factors (FHHPPO)
Prevotella and Tannerella: saccarolytic
Capnocytophaga: G-, capnophilic

Front 14

What are the treatments for chronic periodontitis?

Back 14

Mechanical therapy
Oral hygiene
Antimicrobial agents

Front 15

What is Aggressive periodontitis?

Back 15

Possibly genetic, young Asian/AA female population,
bone loss (no inflammation, bleeding, or plague

Front 16

Aggressive Peridontitis has been associated with what organism?

Back 16

Aggregatibacter actinomyecetemcomitans

Front 17

What are your reasons for diagnosing ANUG?

Back 17

Gingiva:red, shiny, ulcers
Lesions:pseudomembrane
Halitosis
metallic taste
No lymphnodes, fever, malaise

Front 18

What organisms cause ANUG?

Back 18

Fusobacterium nucleatum (cigar shaped)
Treponema

Front 19

What is needed to diagnose ANUG?

Back 19

Fusobacteria, Spirochetes (Treponema), Leukocytes

Front 20

NOMA (Cancrum oris/gangrenous stomatitis) is associated with?

Back 20

Severe malnurished
Recent viral/TB infection

Permanent dissfigurement

Front 21

What organisms are responsible for dentoalveolar abscess? Treatment?

Back 21

Prevotella, Porphyromonas, Fusobacterium

Drain pus + penicillins

Front 22

Your pt has "bull neck" and fever along with a recent history of dental work. Your primary diagnosis is?

Back 22

Ludwig's angina

Front 23

Your patient reports that it hurts to bite into food, and you think periodontal abscess. What are s/s and pathogenesis of this dx?

Back 23

Red, swollen, tender, local infection, pain is continuous or hurts to bite;
Polymicrobial cause

Front 24

What organism is responsible for Cervicofacial Actinomycosis? What are the s/s?

Back 24

Actinomyces israelii,
Lumpy jaw, sulphur granules, local swelling, fibrosis

Front 25

Patient comes to you with "cottage cheese curds", difficulty swallowing, and the cells formed pseudohyphae microscopically. What do they have?

Back 25

Primary oral candidiasis (Oral thrush)

Front 26

An elderly man has a film buildup on his lower jaw and wears dentures. What's the diagnosis?

Back 26

Candida associated denture stomatitis

Front 27

Patient comes in with lesions on the lips and gums, they dont hurt but are very concerning to the patient. What are you thinking this is?

Back 27

HSV-1 (HHV1) or HSV2, but HSV-2 is typically below the waist

Front 28

On your pediatric rotation a kid comes in with a sore thumb and some lesions on her face. What is the name of the lesions on her thumb and is this primary or secondary infection?

Back 28

Herpetic Whitlow, Primary; HSV is related to the trigeminal ganglion distribution.

Front 29

What kind of smear do you perform when suspecting HSV, and what are you looking for?

Back 29

Tzanck smear with
Multinucleated Giant Cells
Cowdry type A intranuclear inclusions

Front 30

Your patient has lesions on his face, that are very painful but do not cross the midline. Your dx?

Back 30

VZV (HHV-3)

Front 31

What is the presentation of Coxsackie A? and what organism is responsible?

Back 31

Herpangina
Hand-foot-mouth disease
Aseptic meningitis

Enterovirus (eg poliovirus): seasonal, school children, fecal/oral transmission