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MicroorganismsinOralMucosalDiseaseand
ItsPathogenesis
drg. Shanty Chairani, M. Si
The healthy mouth supports the growth
of a wide range of microorganisms
including bacteria, yeasts, mycoplasmas,
viruses and even protozoa.
FACTORSAFFECTINGTHEGROWTHOF
MICROORGANISMSINTHEORALCAVITY
TEMPERATURE
35° to 36°C
pH
OXYGEN
NUTRIENTS
CARBOHYDRATES,
PROTEIN
HOSTLIFESTYLE
DIET, SMOKING
HOSTDEFENCES
NONSPECIFIC AND
SPECIFIC IMMUNITY
MICROORGANISMS
01
BACTERIA
VIRUS
FUNGI
02
03
01
OROFACIALBACTERIAL
INFECTIONS
ORALBACTERIA
● At least 700 species of bacteria are supported by the habitats within
the mouth, such as the surfaces of the teeth and oral mucosa
● Bacteria cause diseases by two major mechanisms: (1) invasion and
inflammation and (2) toxin production.
Pathogenesisofbacterialdisease
Transmission
(Inhalation,
ingestion,
inoculation)
Adherence to
host surfaces
Biofilm formation
Invasiveness
(spread into tissue
and avoid host
defense mechanism)
Toxin production
(result in cell and
tissue destruction)
Infection
Transmission
Inhalation
01 03
02
Inoculation
Ingestion
Adherencetohostsurfaces
Adhesin
01 03
02
Lipoteichoicacid
Pili
Invasiveness
Proteolyticenzymor
protease
01 03
02
Proteincellwall
Capsule
Collagenase,
hyaluronidase,
coagulase
Toxinproduction
Endotoxins
• The cell wall
lipopolysaccharides of
Gram negative bacteria
Exotoxins
• Secreted from cell, both
Gram positive and
Gram-negative bacteria
• Neurotoxin, enterotoxin
ORALBACTERIALINFECTION
ANGULARCHEILITIS
Staphylococcus aureus
CHANCRES
Treponema pallidum
TUBERCULOUSULCER
Mycobacterium tuberculosis
01
02
03
04
Fusobacterium necrophorum
CANCRUMORISORNOMA
02
OROFACIALVIRAL
INFECTIONS
ORALVIRUS
● Viruses are some of the smallest microorganisms
(100 to 300 nm) consisting of a core (genome)
containing either deoxyribonucleic acid (DNA) or
ribonucleic acid (RNA) surrounded by a protein shell
(capsid) and can cause a range of important human
diseases.
● Virus infects the cells that have receptors for the virus
ViralPathogenesis
● In lytic infections, virus multiplication in the host cell results in the lysis
of the cell and the release of the newly synthesized virions.
● In persistent infections, the virus survives in the host cell by
synthesizing a small number of virions that do not kill the cell. It can be
followed by a latent infection where the viral genome is maintained in
the cell, and no virions are produced. The viral genome may be
activated at a later time point to produce new virions that may result in
cytopathology.
● Some viruses can transform the host cell into a cancer cell that can
divide without the regular control mechanisms in a normal cell
Avirusinfectedcellmaydieasaresultof:
● ’Shut-down’ of host cell protein and nucleic acid
synthesis
● Cell lysis, by the release of progeny virions
● Intracellular release of lysosomal enzymes
● Damage to cell membranes.
Oncogenic viruses
● Transform or immortalize the infected cells
● Increasing the cell growth rate
● Causing the loss of contact-inhibition of growth
● Removing growth suppressor molecules in the
cell
● Altering cellular morphology
Virus Classification
DNAVIRUSES
1. Herpes simplex virus
2. Varicella-zoster virus
3. Epstein–Barr virus
4. Cytomegalovirus
5. Human papillomaviruses
6. Human herpes virus
RNAVIRUSES
1. Paramyxoviruses : Measles
virus, mumps virus
2. Human immunodeficiency
viruses
3. Coxsackievirus
OROFACIALVIRALINFECTION
Herpes simplex virus 1
Herpes labialis
Herpes simplex virus 1
Zoster (shingles)
Varicella-zoster virus
01
02
03
04
Human papillomavirus
Primary herpetic
gingivostamatitis
Papilloma
03
ORALFUNGAL
INFECTIONS
ORALFUNGI
● Candida are fungi that are considered members of the normal oral
microbiota.
● When conditions in the mouth alter to one that favours proliferation of
Candida, a shift to a pathogenic relationship with the host may occur 
opportunistic occurrence  CANDIDIASIS
● The most prevalent Candida species in mouths is Candida albicans
● Other species : C. glabrata, C. krusei, C. tropicalis, C. parapsilosis ,
etc
CANDIDAVIRULENCEFACTORS
Evasion of host defences
Phenotypic switching
Hyphal development
Secreted aspartyl proteinase production
01
02
03
Adherence
Invasion and destruction of host tissue
to the oral epithelium or
surfaces of prosthetic
devices (dentures and
orthodontic appliances)
Adhesin
Hyphal development
Secreted aspartyl proteinase production
Phospholipase production
Carcinogenic nitrosamines production
ORALCANDIDIASIS
Pseudomembranous
candidosis (thrush)
Acute erythematous
candidosis
Chronic erythematous candidosis
(denture stomatitis )
01
02
03
04
Chronic hyperplastic candidosis
ORALCANDIDIASIS
Angular cheilitis
Median rhomboid glossitis
05
06
07
CHRONIC MUCOCUTANEOUS
CANDIDOSIS
THANKYOU

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Microorganisms Role in Oral Disease Pathogenesis