ORAL MICROFLORA FROM BIRTH TO ADOLESCENT

1. 1

2. 100,000,000,000,000 bacteria/per mouth , > 600 bacterial species
2
Mouthville

3. Oral Microbiology
from
Birth to Adolescence
with Emphasis on
Dental Caries and
Periodontal Diseases.
Presented by
Khushboo
Barjatya 3

4. Contents• Introduction
• History
• The mouth as a
microbial habitat .
• The resident oral
Microflora
• Acquaintance,
adherence,
distribution
• Microbiology of
Dental plaque
Dental caries
Periodontal
infections
Microflora of
common infections.
• Conclusion.
• References.
4

5. 5
Oral
Microb
iology• Willoby Miller—
Father of Oral
Microbiology

6. History
6

7. 7
Antony van LEEUWENHOEK
(1632-1723)
Robert HOOKE(1635-1703):
application of simple lens.

8. 8
• JENNER, Edward (1749-1823)
vaccination against smallpox (1798)
• PASTEUR, Louis (1822-1895)
• 1877-1887: Foundation of MICROBIOLOGY (the
role of staphylococci, streptococci and
pneumococci in different infectious diseases.
• Development of vaccines against Cholera, Anthrax
(1879), Rabies.

9. 9
In 1876, Robert Koch established that
microbes can cause disease.
• Koch's postulates are:
1) Abundance
2) Isolated
3) Disease
4) Reisolated

10. The Normal
Oral Microflora
10

11. 11
Types of
microflora
Pathogens
Bacteria
Viruses
Parasites
Fungi

12. Oral Microflora
BENEFITS
• Synthesis and excretion of
vitamins.
• Competition with pathogens
for nutrients.
• Direct antagonism.
• Stimulate the immune system
by production of natural
antibodies.
HARMFUL
EFFECTS
• Competition with host for
nutrients.
• Bacterial synergism
between normal flora and
potential pathogens.
• Low grade toxemia
produced in host.
12

13. The Resident Oral
Microflora
13

14. The oral microhabitat
Prosthodontic or Orthodontic Appliances 14
Buccal mucosa1
2
3
4
5

15. Factors modulating growth
15
Specific
and
nonspecific factors
pH
Antimicrobial activity
Diet
Iatrogenic factors

16. The oral flora
includes-• Gram-positive cocci
• Aerobic or facultative
Streptococcus
Staphylococcus
Enterococcus
• Obligate anaerobes
Peptostreptococcus
Peptococcus
16
Gram-positive rods
Aerobic or facultative
Lactobacillus Corynebacterium
Actinomyces
Obligate anaerobes
Eubacterium Propionibacterium
Bifidobacterium
Bacillus
Clostridium

17. • Gram-negative cocci
• Aerobic or facultative
Neisseria/Branhamella
• Obligate anaerobes
• Veillonella
17
Gram-negative rods
Aerobic or facultative
Enterobacteriaceae
Campylobacter
Eikenella
Actinobacillus
Capnocytophaga
Haemophilus
Simonsiella
Obligate anaerobes
Bacteroides
Fusobacterium
Porphyromonas

18. Acquisition of
the normal Oral
flora
18

19. •Foetus
•Babies
mouth at
birth-
Sterile
•At one(Socransky and Manganiello,
1971). 19

20. •At 1st
b’day
•When all
teeth
erupt.
•Puberty 20

21. Adulthood
microbial homeostasis
•In old
age –
oral
candidiasis.
Denture
plaque. 21

22. Dental Plaque
A Microbial
Bioflim
22

23. Microbial
adherence and
plaque
formation
23

24. Stages of plaque
formationFormation of a pellicle
• Bacteria attach to the
pellicle
• Bacterial multiplication
and colonization
• Plaque growth and
maturation
• Matrix formation
24

25. 25
Glycoprotein
deposition

26. 26

27. 27

28. 28

29. THE ROLE OF ORAL
MICROORGANISM
IN SYSTEMIC
INFECTIONS
29

30. ‘Focal Infection
Theory’• Cardiovascular disease
• Infective endocarditis
• Coronary heart
disease(atherosclerososis and
myocardial infection)
• Bacterial pneumonia
• Diabetes mellitus
• Low birth weight babies
30

31. MICROBIOL
OGY OF
DENTAL
31

32. Dental caries – A
multifactorial
etiology.
32

33. Dental Plaque in Caries
Etiology
• Non-specific plaque hypothesis
• Specific plaque hypothesis
(Loesche)
• Ecological plaque hypothesis
(Marsh-1994)
33

34. 34

35. 35

36. Stephen Curve as a Function of
Plaque Thickness and Critical pH
36

37. Cariogenic Bacteria
• Mutans Streptococcus (mutans
streptococci ,S. sobrinus )
• Lactobacillus spp. (post cavitation)
• Actinomyces spp. (root caries)
37

38. STREPTOCOCCUS
MUTANS
1st described by - J. Kilian
Clarke in 1924.
38

39. 7-species and 8- serotypes
• S.mutans (serotypes c, e and f),
• S.rattus (serotype b),
• S.cricetus (serotype a),
• S.sobrinus (serotypes d and g),
• S.ferus (serotype c),
• S.macacae (serotype c)
• S.downei (serotype h)
39

40. Dental Caries, an indigenous
infection causing an
endogenous disease.• Germ free animals do not develop
dental caries.
• Antibiotics prevent caries.
• Its infectious and transmissible. (Paul
Keyes-1960)
40

41. Distribution and
Transmission of
S.mutans• MS first colonize infants’ teeth from 19-
31months of age, a period described by
Caufield et al as the ‘window of
infectivity’
• Primary oral infection by MS- may occur
in predentate infant.
• Vertical and horizontal transmission.
Berkowitz RJ. Mutans streptococci: acquisition and transmission. Pediatric
Dentistry. 28(2):106-9; 2006 Mar-Apr 41

42. Cariogenic attributes of
Mutans streptococci
• Extracellular polysaccharide synthesis,
• Acidogenicity (acid production),
• Aciduricity (ability to survive in an acidic
environment),
• Intracellular polysaccharide synthesis,
• Endodextranase production.
Dental caries is a preventable infectious disease.
Mayooran Balakrishnan,* Robin S. Simmonds,† John R Tagg
Australian Dental Journal 2000;45:(4):235-245
42

43. Role of
lactobacilli• Pioneer bacteria –
advancing front .
• Dentin caries
43

44. Role of
Actinomyces.
• A. viscosus
• Associated with root
caries.
44

45. Microbiology
of Periodontal
diseases
45

46. Periodontal
diseases
Gingivitis
Periodontitis
MICROBIAL ETIOLOGY OF PERIODONTAL DISEASE – MINI REVIEW
Ljiljana Kesic1, Jelena Milasin2, Marija Igic3, Radmila Obradovic146

47. Periodontal health
and disease
47
F cocci +
40%
F rods+
30%
A rods+
15%
A cocci +
5%
A rods -
10%
health
F cocci +
25%
A rods -
25%F rods +
20%
F rods -
15%
A cocci -
5%
A rods +
10%
Gingivitis
A rods -
70%
F rods +
5%
F cocci +
10%
A rods +
15%
periodontitis

48. Dental plaque in
periodontal etiology
• The specific plaque hypothesis.
• Non –specific plaque hypothesis.
Loesche, 1976.
48

49. Ecological plaque
hypothesis
49

50. Socransky's criteria
for Periodontal
PathogensASSOCIATION:
 ELIMINATION:
HOST RESPONSE:
VIRULENCE FACTORS:
 ANIMAL STUDIES:
Socransky & Haffajee, 1992 50

51. Currently recognized key
periodontopathogens
Porphyromonas gingivalis (P.g),
Prevotella intermedia (P.i),
Bacteroides forsythus (B.f),
Aggregatibacter actinomycetemcomitans
(A.a),
Fusobacterium nucleatum (F.n),
Capnocytophaga species (C.sp),
 Campylobacter rectus (C.r).
51

52. Periodontopathogen
• The following bacteria could also be
isolated:
• Eubacterium spp,
• Peptostreptococcus micros,
• Selenomonas spp,
• Spirochaetes.
52

53. Microbiology of
Gingivitis
Initial Gram +ve
Streptococci
In early
lesion-
Actinomyces
Capnocytoph
-agia
Established
lesion- Black
pigmented
Anerobes-
Prophyromonas
gingivalis,
Prevotella
intermedia.
53

54. Chronic
Periodontitis
54

55. • The subgingival plaque forms 2
zones:-
55
• Close to toothGram +ve cocci
• In gingival crevice.Gram –ve .
• Porphyromonas G,
• Prevotella intermedius,
• A actinomycetescomitans,
• Fusobacterium nucleatum
In active
pockets

56. Aggressive
Periodontitis• A actinomycetescomitans
• Several virulence factors are reported:
the leukotoxin is the most important.
56
Necrotizing
Ulcerative
Gingivitis
This is specific, anaerobic,polymicrobial
infection –
Fusospirochaetal complex.

57. Dentoalveolar
abscess• Common species –
• porphyromonas ,
• Prevotella,
• Fusobacterium spp.
• Anaerobic streptococci
• Facultative anerobe
Streptococcus milleri - 2nd largest
group.
57

58. Oral candidiasis
58

59. Oral viral
infections
• Herpes simplex by Herpes simplex
viruses ; (HSV-1) &(HSV-2)
• Varicella zoster virus (VZV - causes
chicken-pox in children and both shingles
and postherpetic neuralgia in adults.
• The Epstein-Barr Virus (EBV- infectious
mononucleosis
59

60. • Mumps or epidemic parotitis- by
Paramyxovirus.
60

61. CONCLUS
ION
61

62. The mind is
like parachute…
62
… it only works when open
If plaque were not
allowed to stagnate or
build-up in risk sites,
neither caries nor
Inflammatory
periodontal
diseases would occur.

63. 63

64. References
• Oral microbiology and Immunology-Nisengard
Neumann
• Essential of microbiology for dentistry by
Samarnayake 2nd edition.
• Oral microbiology by Philip marsh.
• Microbiology for dental students Rajesh Bhatia- 3rd
edition.
• Textbook of microbiology by Anantnarayan and
Paniker.
• Carranza clinical Periodontology.
• Rosebury T (1962). Microorganisms indigenous to
man. New York: McGraw-Hill.
64

65. • Dental caries is a preventable infectious disease. Mayooran
Balakrishnan,Robin S. Simmonds, John R Tagg Australian
Dental Journal 2000;45:(4):235-245.
• Carlsson J, Grahnén H, Jonsson G (1975). Lactobacilli and
streptococci in the mouth of children. Caries Res 9:333–339.
• Berkowitz RJ. Mutans streptococci: acquisition and
transmission. Pediatric Dentistry. 28(2):106-9; 2006 Mar-Apr
• Microbial etiology of periodontal disease – mini review.
Ljiljana Kesic1, Jelena Milasin2, Marija Igic3, Radmila
Obradovic,Medicine and Biology Vol.15, No 1, 2008, pp. 1 - 6
65

66. QUESTIONS
By khushboo barjatya 66