The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
oral mucosa
The term mucous membrane is used to describe the moist lining of the gastrointestinal tract, nasal passages, and other body cavities that communicate with the exterior. In the oral cavity this lining is referred to as the oral mucous membrane, or oral mucosa. At the lips the oral mucosa is continuous with the skin; at the pharynx the oral mucosa is continuous with the mucosa lining the rest of the gut. Thus the oral mucosa is located anatomically between skin and gastrointestinal mucosa and shows some of the properties of each.
CLASSIFICATION
The classification based on these functional criteria, divides the oral mucosa into three major types:
1. Masticatory mucosa 25% (gingiva and hard palate)
2. Lining or reflecting mucosa 60% (lip, cheek, vestibular fornix, alveolar mucosa, floor of mouth and soft palate)
3. Specialized mucosa 10% (dorsum of the tongue and taste buds)
Based on keratinization:
KERATINIZED MUCOSA—
MASTICATORY MUCOSA
VERMILLION BORDER OF LIPS
NON KERATINIZED MUCOSA–
LINING MUCOSA
SPECIALIZED MUCOSA
DEVELOPMENT OF ORAL MUCOSA
The epithelium of the oral cavity is derived from both the ectoderm and the endoderm. The anterior part of the oral cavity is lined by the epithelium derived from the ectoderm.
By 13–20 weeks differences between keratinized and nonkeratinized mucosa becomes apparent. Keratohyaline granules in the keratinized mucosa and region specific cytokeratin appear.
Lingual papillae appear early at about 7th week; the circumvallate and foliate papillae appear earlier than filiform papillae, which can be recognized by 10–12 weeks.
FUNCTIONS OF ORAL MUCOSA
DEFENSE
1.Effective barrier for the entry of the microorganisms.
2.The oral mucosa is impermeable to bacterial toxins. It also secretes antibodies and has an efficient humoral and cell mediated immunity.
LUBRICATION
The secretion of salivary glands keeps the oral cavity moist and thus prevents the mucosa from drying and cracking thereby ensuring an intact oral epithelium.
A moist oral cavity helps in speech, mastication, swallowing and in the perception of taste.
SENSORY
The oral mucosa is sensitive to touch, pressure, pain and temperature.
The sensation of taste is a unique sensation, felt only in the anterior 2/3rd of the dorsum of the tongue.
Swallowing, gagging, retching and salivating reflexes are initiated by receptors in the oral mucosa.
Touch sensations in the soft palate results in gag reflex
PROTECTION
The oral mucosa protects the deeper tissues from mechanical forces resulting from mastication and from abrasive nature of foodstuffs.
The oral mucosa is the moist lining of the oral cavity that continues with the skin and esophagus. It has three main functions - protection, sensation, and secretion. It protects the deeper tissues from mechanical forces and toxins, senses stimuli like temperature and pain, and secretes saliva through minor salivary glands. The oral mucosa varies between keratinized mucosa covering areas like the gingiva and hard palate, non-keratinized mucosa in areas like the floor of the mouth and cheeks, and specialized mucosa bearing taste buds on the tongue.
2 main patterns: keratinisation and non keratinisation.
Kertinisation: mucosal surface result from formation of a surface layer of keratin and process of maturation is called kertinisation
Its tough, resistant to abrasion and tightly bound to lamina propria.
Shows 4 layers:
Stratum basele
Stratum spinosam
Stratum granulosam
Stratum corneum
Oral mucous membrane /certified fixed orthodontic courses by Indian dental ac...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
oral mucous membranes-2 /certified fixed orthodontic courses by Indian dental...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The document describes the anatomy and histology of the oral cavity. It discusses the boundaries and subdivisions of the oral cavity. It describes the layers of the oral epithelium including the stratum basale, stratum spinosum, stratum granulosum, and stratum corneum. It discusses the types of oral mucosa including masticatory, lining, and specialized mucosa. It also describes the lamina propria, submucosa, blood and nerve supply of the oral cavity.
Important topic for dentists, study of the topic not only describes the oral mucosa but also elaborates the uniqueness and differentiation of oral mucosa from rest of the skin parts. Gives the idea about the cell differention and its migration to the superficial layer and related abnormalities.
This document discusses the anatomy and histology of the oral mucosa. It describes the different types of oral mucosa including the lining, masticatory, and specialized mucosa. The major components and layers of the oral epithelium and lamina propria are outlined. Specific structures of the oral mucosa like the gingiva, lips, tongue, and palate are then examined in more detail.
oral mucosa
The term mucous membrane is used to describe the moist lining of the gastrointestinal tract, nasal passages, and other body cavities that communicate with the exterior. In the oral cavity this lining is referred to as the oral mucous membrane, or oral mucosa. At the lips the oral mucosa is continuous with the skin; at the pharynx the oral mucosa is continuous with the mucosa lining the rest of the gut. Thus the oral mucosa is located anatomically between skin and gastrointestinal mucosa and shows some of the properties of each.
CLASSIFICATION
The classification based on these functional criteria, divides the oral mucosa into three major types:
1. Masticatory mucosa 25% (gingiva and hard palate)
2. Lining or reflecting mucosa 60% (lip, cheek, vestibular fornix, alveolar mucosa, floor of mouth and soft palate)
3. Specialized mucosa 10% (dorsum of the tongue and taste buds)
Based on keratinization:
KERATINIZED MUCOSA—
MASTICATORY MUCOSA
VERMILLION BORDER OF LIPS
NON KERATINIZED MUCOSA–
LINING MUCOSA
SPECIALIZED MUCOSA
DEVELOPMENT OF ORAL MUCOSA
The epithelium of the oral cavity is derived from both the ectoderm and the endoderm. The anterior part of the oral cavity is lined by the epithelium derived from the ectoderm.
By 13–20 weeks differences between keratinized and nonkeratinized mucosa becomes apparent. Keratohyaline granules in the keratinized mucosa and region specific cytokeratin appear.
Lingual papillae appear early at about 7th week; the circumvallate and foliate papillae appear earlier than filiform papillae, which can be recognized by 10–12 weeks.
FUNCTIONS OF ORAL MUCOSA
DEFENSE
1.Effective barrier for the entry of the microorganisms.
2.The oral mucosa is impermeable to bacterial toxins. It also secretes antibodies and has an efficient humoral and cell mediated immunity.
LUBRICATION
The secretion of salivary glands keeps the oral cavity moist and thus prevents the mucosa from drying and cracking thereby ensuring an intact oral epithelium.
A moist oral cavity helps in speech, mastication, swallowing and in the perception of taste.
SENSORY
The oral mucosa is sensitive to touch, pressure, pain and temperature.
The sensation of taste is a unique sensation, felt only in the anterior 2/3rd of the dorsum of the tongue.
Swallowing, gagging, retching and salivating reflexes are initiated by receptors in the oral mucosa.
Touch sensations in the soft palate results in gag reflex
PROTECTION
The oral mucosa protects the deeper tissues from mechanical forces resulting from mastication and from abrasive nature of foodstuffs.
The oral mucosa is the moist lining of the oral cavity that continues with the skin and esophagus. It has three main functions - protection, sensation, and secretion. It protects the deeper tissues from mechanical forces and toxins, senses stimuli like temperature and pain, and secretes saliva through minor salivary glands. The oral mucosa varies between keratinized mucosa covering areas like the gingiva and hard palate, non-keratinized mucosa in areas like the floor of the mouth and cheeks, and specialized mucosa bearing taste buds on the tongue.
2 main patterns: keratinisation and non keratinisation.
Kertinisation: mucosal surface result from formation of a surface layer of keratin and process of maturation is called kertinisation
Its tough, resistant to abrasion and tightly bound to lamina propria.
Shows 4 layers:
Stratum basele
Stratum spinosam
Stratum granulosam
Stratum corneum
Oral mucous membrane /certified fixed orthodontic courses by Indian dental ac...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
oral mucous membranes-2 /certified fixed orthodontic courses by Indian dental...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The document describes the anatomy and histology of the oral cavity. It discusses the boundaries and subdivisions of the oral cavity. It describes the layers of the oral epithelium including the stratum basale, stratum spinosum, stratum granulosum, and stratum corneum. It discusses the types of oral mucosa including masticatory, lining, and specialized mucosa. It also describes the lamina propria, submucosa, blood and nerve supply of the oral cavity.
Important topic for dentists, study of the topic not only describes the oral mucosa but also elaborates the uniqueness and differentiation of oral mucosa from rest of the skin parts. Gives the idea about the cell differention and its migration to the superficial layer and related abnormalities.
This document discusses the anatomy and histology of the oral mucosa. It describes the different types of oral mucosa including the lining, masticatory, and specialized mucosa. The major components and layers of the oral epithelium and lamina propria are outlined. Specific structures of the oral mucosa like the gingiva, lips, tongue, and palate are then examined in more detail.
The oral mucosa lines the inside of the mouth and has several functions including protection, secretion, sensation, and proprioception. It consists of epithelium and connective tissue (lamina propria). The oral mucosa is classified into lining, masticatory, and specialized mucosa. The masticatory mucosa found on the gingiva and hard palate is keratinized to withstand chewing forces, while the lining mucosa is non-keratinized for flexibility. The junctional epithelium attached to teeth has the fastest turnover rate and protects by allowing fluid passage.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
To watch full lecture video please click the link
https://youtu.be/ZXcq3pweLjg
My youtube channel - Dr. deNto
We are discussing only the basics of oral mucosa membrane.
Definition
Classification
Components
1) Basement membrane
2) Lamina porpria
3) Submucosa
4) Epithelium
Keratinized and Nonkeratinized epithelium
Nonkeratinocytes
Histology of oral mucous membrane including gingiva/certified fixed orthodon...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The oral cavity is lined by oral mucosa which is continuous with the skin and pharyngeal mucosa. There are three types of oral mucosa - masticatory, lining, and specialized. Masticatory mucosa includes the gingiva and hard palate and is keratinized. Lining mucosa lines other areas like the lips, cheeks, and soft palate and is non-keratinized. The gingiva can be further divided into free gingiva and attached gingiva. Histologically, the oral mucosa consists of stratified squamous epithelium and an underlying connective tissue layer.
The oral cavity is lined by oral mucosa, which is continuous with the skin and pharyngeal mucosa. The oral mucosa consists of three types - masticatory, lining, and specialized mucosa. Masticatory mucosa covers areas involved in chewing and is keratinized, while lining mucosa covers other soft tissue areas and is non-keratinized. Specialized mucosa covers the dorsal tongue and contains papillae involved in taste. The oral mucosa provides protection, sensation, secretion, permeability and thermal regulation functions.
Oral mucous membrane/certified fixed orthodontic courses by Indian dental aca...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The oral mucosa lines the inside of the mouth and has several important functions. It protects underlying tissues, secretes saliva to keep the surface moist, senses temperature, touch, thirst and pain via receptors, and helps regulate temperature in some animals through panting. The oral cavity consists of two areas - the outer vestibule and inner oral cavity proper. The oral mucosa contains three main types: masticatory, lining, and specialized. It has a stratified squamous epithelium and underlying lamina propria. The oral mucosa protects, secretes saliva, senses stimuli, and helps regulate temperature.
The oral mucosa can be classified into three main types: masticatory mucosa, lining mucosa, and specialized mucosa. Masticatory mucosa covers areas exposed to force like the hard palate and gingiva, and is thick with dense collagen to resist pressure. Lining mucosa is thinner and more extensible, covering mobile areas like the tongue and cheeks. Specialized mucosa covers the tongue dorsum and has various papillae for taste and texture.
The term mucous membrane is used to describe the moist lining of the gastrointestinal tract, nasal passages, and other body cavities that communicate with the exterior. In the oral cavity, this lining is referred to as the oral mucous membrane, or oral mucosa. At the lips the oral mucosa is continuous with the skin; at the pharynx the oral mucosa is continuous with the mucosa lining the rest of the gut. Thus the oral mucosa is located anatomically between skin and gastrointestinal mucosa and
shows some of the properties of each.
Oral mucous membrane /certified fixed orthodontic courses by Indian dental ac...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
https://userupload.net/3ppacneii1wj
Toxicologic Pathology (Second Edition), 2010
INTRODUCTION
The oral mucosa is, in many ways, similar to the skin in its architecture, function, and reaction patterns. This section only emphasizes those characteristics of the oral mucosa that influence or result in a distinct group of pathologic entities.
Because of its location at the entrance of the digestive and respiratory tracts and its proximity to the teeth, the oral mucosa is subjected to numerous natural and man-made xenobiotics. The peculiar architecture and absorption characteristics of the oral mucosa, especially in areas of extreme thinness, coupled with the rich microorganism flora of the mouth, makes the oral mucosa a peculiar site deserving separate discussion.
The oral mucosa lines the inner surface of the mouth and consists of two layers - an epithelial layer and an underlying connective tissue layer. The epithelial layer is stratified squamous epithelium that is keratinized in areas like the gingiva and hard palate but non-keratinized elsewhere. The connective tissue layer contains papillae that extend into the epithelium. There are three types of oral mucosa - lining, masticatory, and specialized mucosa found on parts of the tongue. The oral mucosa develops from the embryonic stomatodeum and foregut and its structure is fully formed by 17-20 weeks of gestation.
The document discusses the oral mucosa, specifically describing its three main types, locations in the oral cavity, and classification. It notes that oral mucosa is classified based on both its primary function (masticatory, lining, specialized) and degree of keratinization (keratinized vs non-keratinized). The masticatory mucosa, which makes up 25% of the oral mucosa, includes the gingiva and hard palate. Lining mucosa, comprising 60%, includes the buccal, labial, alveolar mucosa and ventral tongue. Specialized mucosa (15%) includes the dorsal and lateral tongue. The document further details the epithelial maturation and keratinization processes that occur
This document provides an overview of oral histology. It discusses the structure and functions of oral mucosa, including the epithelium, basement membrane, lamina propria, and submucosa. It describes keratinized and non-keratinized oral mucosa, as well as the different types of oral mucosa based on function. The roles of non-keratinocytes like melanocytes, Langerhans cells, and Merkel cells are outlined. Details are given on the histology of gingiva, including the clinical appearance and characteristics of free gingiva, attached gingiva, and interdental papillae.
This document discusses the innate immune defenses of the oral cavity against periodontal pathogens. It describes the pattern recognition receptors (PRRs) found in oral tissues that recognize pathogen molecular patterns. Toll-like receptors (TLRs) on immune cells recognize pathogens and initiate inflammatory responses. Oral epithelium contains Langerhans cells that act as antigen presenting cells. Neutrophils and components of saliva and gingival crevicular fluid (GCF) also contribute to innate immunity. Saliva contains antimicrobial proteins, enzymes, mucins and antibodies that inhibit pathogens. GCF contains cells, electrolytes, enzymes and bacterial products that indicate periodontal health status.
The oral mucosa has two main tissue components - stratified squamous epithelium and an underlying connective tissue layer. It has three main functions: protection, sensation, and secretion. The oral mucosa is classified into three types - masticatory mucosa, lining mucosa, and specialized mucosa. Histologically, the oral epithelium consists of basal, prickle, and granular cell layers in keratinized areas, while non-keratinized areas lack granular and cornified layers. The connective tissue layer lies beneath the basement membrane and contains papillae.
This document provides information on the oral mucous membrane (oral mucosa). It begins by defining the oral mucosa as the moist lining of the oral cavity, which is a continuation of the skin and esophagus. The document then describes the layers and boundaries of the oral cavity. It discusses the histology and classification of the oral mucosa, including the different types of epithelia (keratinized, non-keratinized). It also covers the structure, layers and keratinization process of the oral epithelium, as well as the characteristics and functions of the oral mucosa.
Upload By : Ahmed Ali Abbas
Babylon University College of Dentistry
download this file from Website on google theoptimalsmile.wix.com/dentistry
Oral histology
The document discusses the etiology and causes of dental caries. It traces the theories around the causes from early beliefs that worms caused cavities to the modern understanding that it is a multifactorial disease involving plaque bacteria, fermentable carbohydrates, and host factors. Key evidence and experiments supporting the role of bacteria are described, including the lack of caries in germ-free animals and the development of caries when cariogenic bacteria are inoculated. The document concludes that while no single bacteria satisfies Koch's postulates, dental caries results from an ecological shift in the bacterial plaque toward more acidogenic and aciduric bacteria when exposed to fermentable carbohydrates.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
The oral mucosa lines the inside of the mouth and has several functions including protection, secretion, sensation, and proprioception. It consists of epithelium and connective tissue (lamina propria). The oral mucosa is classified into lining, masticatory, and specialized mucosa. The masticatory mucosa found on the gingiva and hard palate is keratinized to withstand chewing forces, while the lining mucosa is non-keratinized for flexibility. The junctional epithelium attached to teeth has the fastest turnover rate and protects by allowing fluid passage.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
To watch full lecture video please click the link
https://youtu.be/ZXcq3pweLjg
My youtube channel - Dr. deNto
We are discussing only the basics of oral mucosa membrane.
Definition
Classification
Components
1) Basement membrane
2) Lamina porpria
3) Submucosa
4) Epithelium
Keratinized and Nonkeratinized epithelium
Nonkeratinocytes
Histology of oral mucous membrane including gingiva/certified fixed orthodon...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The oral cavity is lined by oral mucosa which is continuous with the skin and pharyngeal mucosa. There are three types of oral mucosa - masticatory, lining, and specialized. Masticatory mucosa includes the gingiva and hard palate and is keratinized. Lining mucosa lines other areas like the lips, cheeks, and soft palate and is non-keratinized. The gingiva can be further divided into free gingiva and attached gingiva. Histologically, the oral mucosa consists of stratified squamous epithelium and an underlying connective tissue layer.
The oral cavity is lined by oral mucosa, which is continuous with the skin and pharyngeal mucosa. The oral mucosa consists of three types - masticatory, lining, and specialized mucosa. Masticatory mucosa covers areas involved in chewing and is keratinized, while lining mucosa covers other soft tissue areas and is non-keratinized. Specialized mucosa covers the dorsal tongue and contains papillae involved in taste. The oral mucosa provides protection, sensation, secretion, permeability and thermal regulation functions.
Oral mucous membrane/certified fixed orthodontic courses by Indian dental aca...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The oral mucosa lines the inside of the mouth and has several important functions. It protects underlying tissues, secretes saliva to keep the surface moist, senses temperature, touch, thirst and pain via receptors, and helps regulate temperature in some animals through panting. The oral cavity consists of two areas - the outer vestibule and inner oral cavity proper. The oral mucosa contains three main types: masticatory, lining, and specialized. It has a stratified squamous epithelium and underlying lamina propria. The oral mucosa protects, secretes saliva, senses stimuli, and helps regulate temperature.
The oral mucosa can be classified into three main types: masticatory mucosa, lining mucosa, and specialized mucosa. Masticatory mucosa covers areas exposed to force like the hard palate and gingiva, and is thick with dense collagen to resist pressure. Lining mucosa is thinner and more extensible, covering mobile areas like the tongue and cheeks. Specialized mucosa covers the tongue dorsum and has various papillae for taste and texture.
The term mucous membrane is used to describe the moist lining of the gastrointestinal tract, nasal passages, and other body cavities that communicate with the exterior. In the oral cavity, this lining is referred to as the oral mucous membrane, or oral mucosa. At the lips the oral mucosa is continuous with the skin; at the pharynx the oral mucosa is continuous with the mucosa lining the rest of the gut. Thus the oral mucosa is located anatomically between skin and gastrointestinal mucosa and
shows some of the properties of each.
Oral mucous membrane /certified fixed orthodontic courses by Indian dental ac...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
https://userupload.net/3ppacneii1wj
Toxicologic Pathology (Second Edition), 2010
INTRODUCTION
The oral mucosa is, in many ways, similar to the skin in its architecture, function, and reaction patterns. This section only emphasizes those characteristics of the oral mucosa that influence or result in a distinct group of pathologic entities.
Because of its location at the entrance of the digestive and respiratory tracts and its proximity to the teeth, the oral mucosa is subjected to numerous natural and man-made xenobiotics. The peculiar architecture and absorption characteristics of the oral mucosa, especially in areas of extreme thinness, coupled with the rich microorganism flora of the mouth, makes the oral mucosa a peculiar site deserving separate discussion.
The oral mucosa lines the inner surface of the mouth and consists of two layers - an epithelial layer and an underlying connective tissue layer. The epithelial layer is stratified squamous epithelium that is keratinized in areas like the gingiva and hard palate but non-keratinized elsewhere. The connective tissue layer contains papillae that extend into the epithelium. There are three types of oral mucosa - lining, masticatory, and specialized mucosa found on parts of the tongue. The oral mucosa develops from the embryonic stomatodeum and foregut and its structure is fully formed by 17-20 weeks of gestation.
The document discusses the oral mucosa, specifically describing its three main types, locations in the oral cavity, and classification. It notes that oral mucosa is classified based on both its primary function (masticatory, lining, specialized) and degree of keratinization (keratinized vs non-keratinized). The masticatory mucosa, which makes up 25% of the oral mucosa, includes the gingiva and hard palate. Lining mucosa, comprising 60%, includes the buccal, labial, alveolar mucosa and ventral tongue. Specialized mucosa (15%) includes the dorsal and lateral tongue. The document further details the epithelial maturation and keratinization processes that occur
This document provides an overview of oral histology. It discusses the structure and functions of oral mucosa, including the epithelium, basement membrane, lamina propria, and submucosa. It describes keratinized and non-keratinized oral mucosa, as well as the different types of oral mucosa based on function. The roles of non-keratinocytes like melanocytes, Langerhans cells, and Merkel cells are outlined. Details are given on the histology of gingiva, including the clinical appearance and characteristics of free gingiva, attached gingiva, and interdental papillae.
This document discusses the innate immune defenses of the oral cavity against periodontal pathogens. It describes the pattern recognition receptors (PRRs) found in oral tissues that recognize pathogen molecular patterns. Toll-like receptors (TLRs) on immune cells recognize pathogens and initiate inflammatory responses. Oral epithelium contains Langerhans cells that act as antigen presenting cells. Neutrophils and components of saliva and gingival crevicular fluid (GCF) also contribute to innate immunity. Saliva contains antimicrobial proteins, enzymes, mucins and antibodies that inhibit pathogens. GCF contains cells, electrolytes, enzymes and bacterial products that indicate periodontal health status.
The oral mucosa has two main tissue components - stratified squamous epithelium and an underlying connective tissue layer. It has three main functions: protection, sensation, and secretion. The oral mucosa is classified into three types - masticatory mucosa, lining mucosa, and specialized mucosa. Histologically, the oral epithelium consists of basal, prickle, and granular cell layers in keratinized areas, while non-keratinized areas lack granular and cornified layers. The connective tissue layer lies beneath the basement membrane and contains papillae.
This document provides information on the oral mucous membrane (oral mucosa). It begins by defining the oral mucosa as the moist lining of the oral cavity, which is a continuation of the skin and esophagus. The document then describes the layers and boundaries of the oral cavity. It discusses the histology and classification of the oral mucosa, including the different types of epithelia (keratinized, non-keratinized). It also covers the structure, layers and keratinization process of the oral epithelium, as well as the characteristics and functions of the oral mucosa.
Upload By : Ahmed Ali Abbas
Babylon University College of Dentistry
download this file from Website on google theoptimalsmile.wix.com/dentistry
Oral histology
The document discusses the etiology and causes of dental caries. It traces the theories around the causes from early beliefs that worms caused cavities to the modern understanding that it is a multifactorial disease involving plaque bacteria, fermentable carbohydrates, and host factors. Key evidence and experiments supporting the role of bacteria are described, including the lack of caries in germ-free animals and the development of caries when cariogenic bacteria are inoculated. The document concludes that while no single bacteria satisfies Koch's postulates, dental caries results from an ecological shift in the bacterial plaque toward more acidogenic and aciduric bacteria when exposed to fermentable carbohydrates.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
The white stuff on the patient's teeth is dental plaque, also known as a dental biofilm. It is a soft deposit that forms on teeth and consists of a wide variety of bacteria embedded in a matrix of polymers. Over time, if not removed by brushing, the plaque can harden into calculus (tartar). While plaque itself is not harmful, it can lead to issues like gingivitis and periodontitis if not kept in check by regular brushing and cleaning between the teeth.
Histopathology & microbiology of dental cariesAshish Karode
The document summarizes the histopathology of dental caries. It describes how dental caries is a microbial disease that causes demineralization of tooth enamel and dentin. It discusses the role of bacteria like Streptococcus mutans in producing acid that dissolves tooth structure. The summary describes the microscopic appearance of carious lesions in enamel and dentin, including the formation of zones of demineralization and bacterial invasion of dentin tubules over time. Advanced caries can ultimately lead to tooth cavitation and pulp involvement if left untreated.
The oral cavity contains hundreds of bacterial species that form complex biofilm communities on teeth and gums. Two key pathogens associated with dental caries are Streptococcus mutans and Lactobacillus casei. These bacteria produce acids by fermenting sugars that demineralize tooth enamel over time, leading to cavities. While everyone harbors caries-causing bacteria like S. mutans, dental caries only develops when there is an imbalance in the microbial community that allows these pathogens to dominate and lower the pH. Studying the oral microbiome provides insights into the pathogenesis of oral diseases and opportunities for prevention and treatment strategies.
Describe relationship between plaque and oral diseases
Describe role of plaque in development of caries
Define Dental Caries
Describe the aetiology and the role different factors play in ini4a4on and progression of the disease
Describe the role played by different microorganisms
Detection, diagnosis and prevention of dental cariesMasuma Ryzvee
The document discusses the diagnosis and prevention of dental caries. It covers the development and features of caries, methods for detection including examination, radiographs, and devices. It also discusses caries risk in patients, the role of plaque, diet, and fluoride in prevention. Specific fluoride modalities like toothpaste, mouthwashes, and professionally applied treatments are outlined. The use of pit and fissure sealants for caries prevention in teeth pits and grooves is also summarized, along with patient selection and the application method.
The document discusses the normal microbial flora found in the oral cavity. It notes that the oral cavity contains a mixture of bacteria, fungi, protozoa, and occasionally viruses. The bacteria found include both aerobic and anaerobic species. Among the bacteria, streptococci are the most predominant group, including Strep. mutans and Strep. sanguis. Lactobacilli, veillonella, and fusobacteria are also commonly found. The normal flora is acquired shortly after birth and diversifies as the teeth erupt providing surfaces for colonization.
Dental plaque is a sticky biofilm that forms on teeth daily. It is made up of bacteria and other microorganisms from saliva. If plaque is not removed regularly through brushing, it can build up and the bacteria nearest the teeth produce acids. These acids demineralize the enamel and cause cavities. Plaque also irritates gums and can lead to gingivitis or periodontitis if left unchecked. Dentists can identify plaque using instruments or dye tablets to check if brushing and flossing have effectively removed it.
At the end of this lecture, the student should be able to:
Develop understanding of the classification
Describe how a cyst develops.
Describe the origin and identifying characteristics of the radicular cyst.
Describe the origin and identifying characteristics of the Dentigerous cyst.
Describe the origin and identifying characteristics of the Odontogenic Keratocyst cyst.
Describe the radiographic characteristics of the dentigerous cyst and the odontogenic keratocyst.
Discuss the radiographic appearance of the lateral periodontal cyst. 8. List the factors involved in the nevoid basal cell carcinoma syndrome.
State the histologic finding that is a key diagnostic feature of Radicular, Dentigerous & Keratocysts.
Describe the origin and identifying characteristics of non odontogenic cysts.
Describe different treatment options available, and their clinical importance.
The normal flora of the oral cavity is diverse and includes over 350 cultivable species of bacteria. The most common gram positive cocci found are streptococci, including the mutans, salivarius, anginosus, and mitis groups. These bacteria preferentially colonize different sites in the oral cavity like the teeth, tongue, and cheeks. The composition of the normal flora is influenced by factors like age, sex, diet, and oral hygiene. Imbalances in the flora can lead to oral diseases such as dental caries.
The document discusses the normal flora, which are the microorganisms that normally inhabit human tissues without causing disease. It notes that internal tissues are usually sterile, while surface tissues like skin and mucous membranes harbor various microbial species. The normal flora consists mainly of bacteria and helps protect against pathogens by occupying ecological niches and stimulating the immune system. It provides examples of the normal flora found in the oral cavity and discusses the relationships between humans and their indigenous microbiota.
Dental caries is a progressive bacterial disease that causes damage to teeth. It is caused by bacteria in dental plaque that produce acid by fermenting sugars from the diet. This acid causes demineralization of tooth enamel and dentin. If left untreated, it can lead to tooth decay, pain, and potentially serious systemic infections.
There are several theories that attempt to explain the process of dental caries:
1) The chemical (acid) theory proposes that acids formed by the fermentation of food particles around the teeth destroy the teeth.
2) The parasitic (septic) theory associates microorganisms with the carious process.
3) The acidogenic theory describes dental decay as a two-stage chemoparasitic process involving decalcification of enamel and subsequent destruction of softened enamel and dentin, supported by the presence of carbohydrates, microorganisms, and dental plaque.
Clinical features and histopathology of dental cariesSAGAR HIWALE
This document provides an overview of the classification of dental caries based on various factors such as anatomical site, progression, extent of involvement, number of tooth surfaces affected, chronology, and whether caries was fully removed during treatment. It discusses 12 different classification systems for dental caries and provides details on types of caries such as pit and fissure, smooth surface, root surface, incipient, occult, and others based on these classification criteria. The document also covers the histopathology of caries in enamel and dentin.
This document discusses the pathogenesis of dental caries. It begins by explaining that dental caries is caused by the interaction of sugars, teeth, and microorganisms. It then discusses the roles that various factors play in the disease process, including sugars/carbohydrates, microorganisms like Streptococcus mutans, lactic acid production, dental plaque, and the buffering effects of saliva. The document also explains the cycles of demineralization and remineralization that can occur, and the histological changes seen in carious lesions over time.
EPIDERMOLOGY AND PREVENTION OF DENTAL CARIESVajid Kurikkal
Dental caries is caused by an interaction between microorganisms, host factors, and the diet. Key microorganisms involved are Streptococcus mutans and lactobacilli, which produce acid as a byproduct of metabolizing sugars in the diet, leading to demineralization of enamel and dentin. Host factors like saliva and tooth morphology can increase or decrease risk of caries by impacting pH, cleansing, and ability to remove food debris. Increased consumption of fermentable carbohydrates, especially without proper oral hygiene, greatly increases the risk of dental caries. Prevention strategies aim to modify these risk factors, such as reducing sugar intake, increasing fluoride exposure, and improving plaque removal.
Dental caries is caused by bacterial damage to teeth from plaque and acid production when exposed to fermentable carbohydrates like sugar. The major bacteria involved are Streptococcus mutans and lactobacilli, which adhere to teeth and produce acid from sugars, lowering the pH and demineralizing enamel and dentin. If left untreated, caries can spread to the pulp, causing inflammation and pain. Consequences of untreated dental caries include local infections and possible systemic illnesses.
This document discusses dental plaque formation at the ultrastructural level. It begins by describing how a saliva-derived acquired pellicle forms on the tooth surface within nanoseconds. Bacteria then initially adhere reversibly to this pellicle via molecular interactions. They can then irreversibly attach through specific adhesins. Once attached, the bacteria begin colonizing the surface and forming a biofilm through multiplication and sequential adsorption of organisms.
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This document discusses microorganisms found in the oral cavity and their role in oral infections. It begins by describing the normal oral flora, including the most common bacteria present in healthy individuals. It then discusses factors that determine bacterial growth in the mouth and how the oral flora develops from infancy to adulthood. The document also describes how microorganisms can be retained in the oral cavity and form biofilms. It discusses pathways of endodontic infections and microorganisms commonly found in infected root canals and periapical tissues.
The oral cavity hosts a complex ecology of microbial populations that compete for available nutrients. While most oral bacteria grow best at a narrow pH range, some aciduric bacteria can grow at low pH levels and are favored in acidic environments. Sugar is the main energy source, but some bacteria can use other substrates like carboxylic acids. Key bacterial adaptations include maintaining metabolism at low pH, rapidly transporting sugars, and producing extracellular and intracellular polysaccharides. Major cariogenic bacteria associated with dental caries include Streptococcus mutans, Lactobacillus, Actinomyces, and Veillonella. Dental caries results from the net acid production of the overall plaque microflora through multiple bacterial interactions, competitions,
- Dental plaque begins as a biofilm that forms on teeth in several stages: pellicle formation, initial bacterial adherence, aggregation, and maturation.
- Early colonizers like Streptococcus attach within minutes and allow later colonizers like Actinomyces to adhere in about 2 hours.
- As plaque thickness increases due to bacterial proliferation, the microenvironment shifts from aerobic to anaerobic, changing the bacterial composition. Certain bacteria are implicated in dental diseases like gingivitis and periodontitis.
The document discusses the oral microbiota. It begins by explaining that the mouth is a diverse microbial habitat containing over 700 bacterial species. Key factors that support microbial growth in the oral cavity include teeth, saliva, specialized mucosal surfaces, and gingival crevicular fluid. The microflora is acquired early in life and remains stable, though it can be impacted by factors like pH, nutrients, temperature and host defenses. The major groups of bacteria found endogenously in the oral cavity are also outlined.
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Oral health is inextricably linked to general health, and vice versa.
The mouth is the gateway of the body to the external world and represents one of the most biologically complex sites in the body.
Dental plaque is a biofilm that forms on teeth and consists of bacteria, salivary components, and food debris embedded in an extracellular matrix. As plaque matures it develops a complex structure resembling a corn cob. Bacteria in plaque exist in diverse microenvironments and communicate through quorum sensing. Certain pathogens in plaque below the gumline can cause periodontal disease by triggering an inflammatory host response. Plaque plays a key role in periodontal diseases according to various plaque hypotheses that have been proposed over time.
Periodontal diseases are caused by a complex interplay between multiple local and systemic factors that influence the host response to the bacterial biofilm (plaque) that forms on the teeth. The plaque is composed of hundreds of bacterial species organized in a matrix on the tooth surface. As plaque matures, the proportion of gram-negative anaerobic bacteria increases, enhancing its pathogenicity. Subgingival plaque is more pathogenic than supragingival plaque due to its protected location below the gumline. The composition and virulence of the plaque, as well as the host immune response, determine the severity and progression of periodontal disease.
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Dental plaque is a biofilm that forms on teeth and consists of bacteria, salivary and host cells embedded in an extracellular matrix. It develops in stages - initially the tooth pellicle forms, then bacteria attach reversibly before irreversible attachment. As more bacteria colonize, the plaque matures into a complex structure. Dental plaque is classified as supragingival or subgingival depending on location. Various hypotheses have been proposed to describe plaque's role in periodontal diseases, from early non-specific hypotheses to more modern theories highlighting specific pathogenic bacteria and microbial dysbiosis. Maintaining adequate plaque control remains important for periodontal health.
Oral microbiology:normal oram microflora and Dental plaqueKarishma Sirimulla
This document discusses oral microbiology and dental plaque. It begins by introducing the types of microorganisms found in the oral cavity, including bacteria, fungi, and protozoa. It then discusses the normal oral microflora, including indigenous, supplemental, and transient flora. Key topics covered include the various types of oral bacteria; factors that affect bacterial growth such as temperature, pH, nutrients, and host defenses; bacterial metabolism of carbohydrates, proteins, oxygen, and nitrogen; and the definition and formation of dental plaque.
Dental plaque forms through sequential colonization of microorganisms on tooth surfaces. It is made up of bacteria, epithelial cells, and extracellular matrix. Plaque formation involves acquired pellicle formation, reversible bacterial attachment, irreversible attachment through adhesins, microbial succession through coaggregation, and maturation of the biofilm and matrix. The microbial composition of plaque varies by oral site and influences diseases like periodontitis and dental caries. Periodontitis results from an imbalance in homeostasis allowing pathogenic bacteria to overgrow. Dental caries occurs when frequent sugar consumption in plaque favors acid-tolerant bacteria like mutans streptococci, changing the microbiota and predisposing to demineralization.
This document summarizes a seminar presentation on dental plaque as an oral biofilm. It defines plaque, describes its structure and composition, and explains the process of plaque formation. Plaque is defined as a bacterial biofilm that adheres to tooth surfaces. It has a stratified organization and is composed of bacteria, water, extracellular matrix, and host cells. Plaque formation begins with the development of an acquired pellicle on the tooth surface, which bacteria then attach to initially through non-specific interactions. This leads to the development of dental biofilm.
This document discusses the microbial flora of the oral cavity. It describes the various microbial habitats in the mouth and the acquisition of normal flora beginning at birth. The major types of flora are discussed as well as factors that modulate microbial growth. The document also examines the oral microbiome's role in oral diseases and conditions like dental caries, periodontal disease, and infections. Additionally, it summarizes how orthodontic appliances can impact the oral microbiome by facilitating plaque accumulation and altering the microbial environment. Maintaining proper oral hygiene is emphasized when wearing orthodontic appliances.
This document discusses dental plaque/biofilm, including its definition, classification, composition, properties, and factors that affect its composition. It begins by defining dental plaque as a host-associated biofilm that adheres tenaciously to intraoral hard surfaces. Plaque is classified as supragingival or subgingival based on its location relative to the gingival margin. The composition of plaque includes water, organic constituents like bacteria and carbohydrates, and inorganic constituents like calcium and phosphorus. Properties include its structure, exopolysaccharides that form its backbone, physiological heterogeneity, quorum sensing, and increased antibiotic resistance of bacteria within it. Factors like periodontal disease status, the local environment, transmission from other individuals,
1. The infant mouth is initially sterile at birth but is quickly colonized by bacteria from the mother or environment, usually streptococci that bind to oral surfaces.
2. As more bacteria colonize and their metabolic activity increases, the environment changes to allow colonization by other genera and species in a dynamic ecological system.
3. By age one, the normal oral flora includes streptococci, staphylococci, neisseriae, lactobacilli, and some anaerobes, with composition changing as teeth erupt and providing new niches for colonization.
The document discusses the ecology of the oral microbial flora. It describes the various ecological niches in the oral cavity like mucosal surfaces, teeth, and saliva that are colonized by different microbial species. The oral flora is acquired initially from the mother and environment then develops into a climax community as the individual is exposed to different microbes over time. A variety of factors like pH, nutrients, oxygen levels etc determine what bacteria can colonize different oral surfaces. The resident flora plays an important role in colonization resistance against pathogens.
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2. CONTENTS OF THE SEMINAR
Introduction.
Ecological Terminologies.
Mouth as a habitat for microbial growth.
Factors affecting the growth of the microorganisms in the oral cavity.
Distribution of the resident oral micro flora.
Adhesion, acquisition, metabolism.
Dental plaque.
Microflora in disease.
Opportunistic infections.
Conclusion.
3. Introduction
The mouth is continually exposed to organisms
from the external environment ,beginning with
the passage through the birth canal. In time a
ecological balance is reached that serves to
establish a resident microbial flora that remains
fairly stable throughout life.
4. In general, these microflora’s live in harmony
with humans and, indeed, all parties benefit from the
association. It has been proposed recently that this
harmonious relationship is a result of complex
molecular
signaling
between
resident microflora and host cells.
members
of
the
5. It has been estimated that the human body is
made up of over 1014 cells of which only around 10%
are mammalian. The remainder are the microorganisms that comprise the resident microflora of
the host. This resident microflora does not have
merely a passive relationship with its host.
7. THE INDIGENOUS (RESIDENT) FLORA
The indigenous flora comprise those indigenous
species that are almost always present in high
numbers, that is, greater than 1 percent of the
total viable count .
SUPPLEMENTAL FLORA
The supplemental flora are those bacterial species
that are nearly always present, but in low
numbers, that is, less than 1 percent of the total
viable count .
8. TRANSIENT FLORA
Transient flora comprise organisms "just passing
through" a host. At any given time a particular
species may or may not be represented in the
flora.
AUTOCHTHONOUS
Species found characteristically
habitat.
in a particular
ALLOCHTHONOUS
organisms which originate from elsewhere and
are generally unable to colonize successfully
unless the ecosystem is severely disturbed.
9. SYMBIOSIS
When both the host and the bacteria benefit from
their inter-relationship it is termed "symbiotic."
ANTIBIOSIS
An antibiotic relationship is the opposite of a
symbiotic relationship. Instead of helping each
other, the bacteria and the host are antagonistic
to, each other.
10. PATHOGENS
Micro-organisms that have the potential to cause
disease are termed pathogens.
OPPORTUNISTIC PATHOGENS
Micro-organisms that cause disease only under
exceptional circumstances .
TRUE PATHOGENS
Micro-organisms that are consistently associated with a
particular disease .
11. AEROBIC
Micro-organisms that require oxygen for growth.
ANAEROBIC
Micro-organisms that require reduced condition for
growth .
CAPNOPHILIC
Micro-organisms that require carbon dioxide for
growth.
HABITAT
Site where the micro-organisms grow.
12. MICRO- AEROPHILIC
Micro-organisms that require low concentration of
oxygen for their growth.
FACULTATIVE
Micro-organisms that can grow in the presence or
absence of a specific environment
E.g. facultative aerobes
OBLIGATORY
Micro- organisms that require a specific environment
for growth.
E.g. obligatory anaerobes
13. The Mouth As a Habitat For Microbial Growth
Not all of the micro-organisms that enter the mouth
are able to colonize. The properties of the mouth
make it ecologically distinct from all other surfaces of
the body, and dictate the types of microbe able to
persist. Habitats that provide obviously different.
ecological conditions include mucosal surfaces (such
as the lips, cheek, palate and tongue) and teeth.
14. Ecological conditions within the mouth will also
vary during the change from the primary to the
permanent dentition. and following the extraction of
teeth, the insertion of prostheses such as dentures,
and any dental treatment, including scaling, polishing
and fillings.
15. Transient fluctuations in the stability of the
oral ecosystem may be induced by the frequency
and type of food ingested, variations in saliva flow
and periods of antibiotic therapy.
16. Four features that make the oral cavity distinct
from other areas of the body are:
Teeth
Specialized mucosal surfaces
Saliva
Gingival crevicular fluid (GCF).
17. TEETH
Is the only normally accessible site in the body
that has hard non-shedding surface for microbial
colonization.
These
unique
tissues
allow
the
accumulation of large masses of micro-organisms
(predominantly bacteria) and their extra cellular
products, termed dental plaque.
18. Plaque is an example of a biofilm, and, while it
is found naturally in health, it is also associated with
dental caries and periodontal disease. In disease,
there is a shift in the composition of the plaque
microflora away from the species that predominate
in health.
19. The ecological complexity of the mouth is
increased still further by the range of habitats
associated with the tooth surface. Teeth do not
provide a uniform habitat but possess several
distinct surfaces, each of which is optimal for
colonization and growth by different populations
of micro-organisms.
20.
21. MUCOSAL SURFACES
Although the mouth is similar to other ecosystems in
the digestive tract in having mucosal surfaces for
microbial colonization, the oral cavity does have
specialized surfaces which contribute to the diversity
of the microflora at certain sites.
22. The papillary structure of the dorsum of the
tongue provides refuge for many micro-organisms
which would otherwise be removed by mastication
and the flow of saliva. Such sites on the tongue can
also have a low redox potential, which enables
obligatory anaerobic bacteria to grow. Indeed, the
tongue may act as a reservoir for some of the Gramnegative anaerobes.
23.
24.
25. The mouth also contains keratinized (e.g. the
palate)
as
well
as
non-keratinized,
stratified
squamous epithelium which may affect the intra-oral
distribution of micro-organisms.
26. Distinct microbial habitats within the mouth
Site
Comments
Lips, cheek, palate Biomass restricted by desquamation;
different surfaces have specialized host
cell types.
Tongue
Highly papillated surface; acts as a
reservoir for anaerobes.
Teeth
Non-shedding surface enabling large
masses of microbes to accumulate (e.g.
biofilms such as dental plaque). Teeth
have distinct surfaces for microbial
colonization; each surface (e.g. fissures,
smooth surfaces, approximal, gingival
crevice) will support a distinct microflora
because of their intrinsic biological
properties.
27. SALIVA
The mouth is kept moist and lubricated by
saliva which flows over all the internal surfaces of
the oral cavity. Saliva enters the oral cavity via ducts
from the major paired parotid, submandibular and
sublingual glands as well as from the minor glands
of the oral mucosa (labial, lingual, buccal and palatal
glands) where it is produced.
28. There
are
differences
in
the
chemical
composition of the secretions from each gland, but the
complex mixture is termed 'whole saliva'. Saliva
contains several ions including sodium, potassium,
calcium, chloride, bicarbonate and phosphate .
29. Some of these ions contribute to the buffering
property of saliva which can reduce the cariogenic
effect
of
acids
produced
from
the
bacterial
metabolism of dietary carbohydrates. Bicarbonate is
the major buffering system in saliva but phosphates,
peptides and proteins are also involved.
30. The mean pH of saliva is between pH 6.75 and
7.25, although the pH and buffering capacity will vary
with the flow rate. Within a mouth, the flow rate and
the concentration of components such as proteins and
calcium and phosphate ions have circadian rhythms,
with the slowest flow of saliva occurring during sleep.
33. GINGIVAL CREVICULAR FLUID (GCF)
Serum components can reach the mouth by
the flow of a serum-like fluid through the junctional
epithelium of the gingivae .The flow of GCF is
relatively slow at healthy sites, but increases during
inflammation.
34. GCF can influence the site by acting as a novel
source of nutrients, while its flow will remove nonadherent microbial cells. Many bacteria from subgingival
plaque
are
proteolytic
and
interact
synergistically to break down the host proteins and
glycoprotein's to provide peptides, amino acids and
carbohydrates for growth.
35. GCF also contains components of the host
defenses which play an important role in regulating
the microflora of the gingival crevice in health and
disease. The neutrophils in GCF are viable and can
phagocytose bacteria within the crevice.
36. Factors affecting the growth of
micro-organisms in the oral
cavity
Temperature
Redox potential
pH
Nutrients
Adherence and agglutination
Anti-microbial agents.
Host defence
Host genetics
37. TEMPERATURE
The human mouth is kept at a relatively
constant temperature (35-36
C), which provides
◦
conditions suitable for the growth and metabolism of
a wide range of micro-organisms. Temperature can
also affect key parameters associated with the
habitat, such as pH, ion activity, aggregation of
macro-molecules and gas solubility.
38. Periodontal pockets with active disease have a higher
temperature (up to 390 C) compared with healthy
sites (mean value 36.80 C). Such changes in
temperature affect gene expression in periodontal
pathogens, such as Porphyromonas gingivalis.
39. A
large
rise
in
temperature
down-regulates
expression of fimbriae (which mediate attachment of
the bacterium to host cells) and the major proteases
of this micro-organism, and up regulates synthesis of
superoxide
dismutase,
oxygen metabolites.
which
neutralizes
toxic
40. Temperature has been shown to vary between
different sub gingival sites, even within the same
individual, and may influence the proportions of
certain bacterial species, such as the putative
periodontal pathogens P. gingivalis, Bacteroides
forsythus' and Campylobacter rectus.
41. REDOX POTENTIAL
It is the level of the electrical potential of a site
relative to a standard hydrogen electrode. This
potential, called the Eh, is the tendency for a medium
or compound to oxidize or reduce an introduced
molecule by the removal or addition of electrons..
42. Tissues or microbes that need a positive Eh for
viability are termed "aerobes," and those that need a
negative Eh are "anaerobes”. Despite the easy
access to the mouth of air with an oxygen
concentration of approximately 20%, it is perhaps
surprising that the oral microflora comprises few, if
any, truly aerobic species
44. Some anaerobes can survive at aerobic
habitats by existing in close partnership with oxygen
consuming
species.
Obligate
anaerobes
also
possess specific molecular defence mechanisms
that enable them to cope with low redox potential
(highly reduced).
45. The development of plaque in this way is
associated with a specific succession of microorganisms . Early colonizers will utilize O 2 and
produce CO2; later colonizers may produce H2 and
other reducing agents such as sulphur containing
compounds and volatile fermentation products,
46. Thus, as the redox potential is gradually
lowered, sites become suitable for the survival and
growth of a changing pattern of organisms, and
particularly anaerobes. Differences have been found
between the Eh of the gingival crevice in health and
disease.
47. Periodontal pockets are more reduced ( - 48
m V) than healthy gingival crevices in the same
individuals (+ 73 m V). Approximal areas (between
teeth) will also have a low Eh although values for
the redox potential at these sites have not been
reported. Gradients of O2 concentration and Eh will
exist in the oral cavity, particularly in a thick biofilm
such as plaque.
48. Thus, plaque will be suitable for the growth of
bacteria with a range of oxygen tolerances. The
redox potential at various depths will be influenced
by the metabolism of the organisms present and
the ability of gases to diffuse in and out of plaque.
49. Similarly, the redox potential will also affect
bacterial metabolism, e.g. the activity intracellular
glycolytic enzymes and the pattern of fermentation
products of Streptococcus mutants varies under
strictly anaerobic conditions. Thus, modifications to
the habitat that disturb such gradients may
influence the composition and metabolism of the
microbial community.
50. pH
Many micro-organisms require a pH around
neutrality for growth, and are sensitive to extremes
of acid or alkali. The pH of most surfaces of the
mouth is regulated by saliva so that, in general,
optimum pH values for microbial growth are
provided at sites bathed by this fluid.
51. Bacterial population shifts within the plaque
microflora can occur following fluctuations in
environmental pH After sugar consumption, the
pH in plaque can fall rapidly to below pH 5.0 by
the production of acids (predominantly lactic acid)
by bacterial metabolism
slowly to base-line values.
the pH then recovers
52. Depending on the frequency of sugar intake, the
bacteria in plaque will be exposed to varying
challenges of low pH. Many of the predominant
plaque bacteria from healthy sites can tolerate only
brief conditions of low pH, and are inhibited or killed
by more frequent or prolonged exposures to acidic
conditions.
53. This can result in the enhanced growth of, or
colonization by, acid-tolerant
species, especially
mutans streptococci and Lactobacillus species,
which are normally absent or only minor components
in dental plaque at healthy sites. Such a change in
the bacterial composition of plaque predisposes a
surface to dental caries.
54. In contrast, the pH of the gingival crevice becomes
alkaline during the host inflammatory response in
periodontal disease, e.g. following deamination of
amino acids and ammonia production. The mean
pH may rise to between pH 7.2 and 7.4 during
disease, with a few patients having pockets with a
mean pH of around 7.8.
55. This degree of change may perturb the balance of
the resident microflora of gingival crevice by
favouring the growth and metabolism of periodontal
pathogens, such as Porphyromonas gingivalis, that
have pH optima for growth above pH 7.5.
56. NUTRIENTS
The association of an organism with a particular
habitat is direct evidence that all of the necessary
growth-requiring nutrients are present. The mouth
can support a microbial community of great
diversity and satisfy the requirements of many
nutritionally demanding bacterial population.
57. ENDOGENOUS NUTRIENTS
The persistence and diversity of the resident oral
microflora is due primarily to the metabolism of the
endogenous nutrients provided by the host, rather
than by exogenous factors in the diet. The main
source of endogenous nutrients saliva, which
contains amino acids, peptides, proteins and
glycoproteins, vitamins and gases.
58. In addition, the gingival crevice is supplied with GCF
which, in addition to delivering components of the
host defences, contains potential sources of novel
nutrients, such as albumin and other host proteins
and
glycoproteins,
including
haeme
containing
molecules. The difference in source of endogenous
nutrients is one of the reasons for the variation in the
microflora of the gingival crevice compared with
other oral sites .
61. Superimposed upon these endogenous nutrients is
the
complex
array
of
food
stuffs
ingested
periodically in the diet. Fermentable carbohydrates
are the main class of compounds that influence
markedly
the
ecology
of
the
mouth.
Such
carbohydrates can be broken down to acids while,
additionally,
62. sucrose can be converted by bacterial enzymes into
two classes of polymer (glucans and fructans)
which can be used to consolidate attachment or act
as extra cellular nutrient storage compounds,
respectively. Dairy products (milk, cheese) have
some influence on the ecology of the mouth.
63. The ingestion of milk or milk products can
protect the teeth of animals against caries This
may be due to the buffering capacity of milk
proteins or due to decarboxylation of amino acids
after proteolysis since several bacterial species
can metabolize casein.
64. Sugar
substitutes
are
sweet-tasting
compounds that cannot be metabolized to acid by
oral bacteria. Xylitol, for example, is inhibitory to
Xylitol
the growth of S. mutans, and lower levels of this
species are found in plaque and saliva of those that
frequently
consume
alternative sweetener.
products
containing
this
65. ADHERENCE AND AGGLUTINATION
Chewing and the natural flow of saliva (mean rate =
19 ml/h) will detach microorganisms not firmly
attached to an oral surface. Although saliva contains
between 108 and 109 viable micro-organisms per ml,
these organisms are all derived from the teeth and
mucosa, with plaque and the tongue being the main
contributors.
66. Salivary components can aggregate certain bacteria
which facilitates their removal from the mouth by
swallowing.
Bacteria
are
unable
to
maintain
themselves in saliva by cell division because they
are lost at an even faster rate by swallowing.
67. The molecules responsible for agglutination
are mucins. Mucins are high molecular weight
glycoprotein's. These Mucins not only agglutinate
oral bacteria, but can also interact with exogenous
pathogens such as Staphylococcus aureus and
Pseudomonas aeruginosa, as well as viruses (e.g.
aeruginosa
influenza virus)
68. Dental plaque formation involves an ordered
colonization by a range of bacteria. The early
colonizers interact with, and adhere to, saliva coated
enamel, while later colonizers bind to already
attached species (co-aggregation).
69. ANTIMICROBIAL AGENTS AND INHIBITORS
Anti-plaque
agents
are
distinguished
from
antimicrobials on the basis of their mode of action.
Anti-plaque agents remove already attached cells, or
prevent adhesion of new cells to the tooth surface.
Unlike antimicrobials which are designed to kill
(bactericidal) or inhibit the growth (bacteriostatic) of
the bacteria.
70. Both types of agent can be delivered from
toothpastes
(dentifrices)
and
mouthwashes.
Antibiotics given systemically or orally for problems
at other sites in the body will enter the mouth via
saliva or GCF and affect the stability of the oral
microflora
71. Within a few hours of taking prophylactic high
doses of penicillin's, the salivary microflora can be
suppressed permitting the emergence of antibioticresistant bacteria.
72. Host defences
The health of the mouth is dependent on the integrity
of the mucosa (and enamel) which acts as a physical
barrier to prevent penetration by micro-organisms or
antigens . The host has a number of additional
defence mechanisms which play an important role in
maintaining the integrity of these oral surfaces.
73.
74.
75.
76. HOST GENETICS
Gender
and
race
can
influence
disease
susceptibility, and possibly also affect the microflora.
In an adult periodontitis group, P. gingivalis and
Peptostreptococcus anaerobius were associated
more with black subjects whereas, Fusobacterium
nucleatum was found more commonly in white
individuals.
77. The reasons for this are unknown, but may
reflect some variation in the local immune response.
The microflora of twin children living together was
more similar than that of unrelated children of the
same age. Further analysis showed that the micro
flora of identical twins was more similar than that of
fraternal twins, suggesting some genetic control.
80. The foetus in the womb is normally sterile.
During delivery the baby comes into contact with
the normal microflora of the mother's uterus and
vagina, and at birth with the micro-organisms of the
atmosphere and of the people in attendance.
81. Despite
the
widespread
possibility
of
contamination, the mouth of the new born baby is
usually sterile. From the first feeding onwards,
however, the mouth is regularly inoculated with
micro-organisms and the process of acquisition of
the resident oral microflora begins.
82. Acquisition
depends
on
the
successive
transmission of micro-organisms to the site of
potential colonization. Initially, in the mouth, this is by
passive contamination from the mother, from food,
milk and water, and from the saliva of individuals in
close proximity to the baby. S. salivarius, mutans
salivarius
streptococci
and
some
other
species
transmitted from mother to child via saliva.
are
83. Mutans streptococci found in children appeared
identical to those of their mothers in 71 % of 34
infant-mother
father
to
pairs examined. No evidence of
infant
transmission
of
mutans
streptococci was observed, although transmission
between spouses may occur with some periodontal
pathogens, such as P. gingivalis.
gingivalis
84. The first micro-organisms to colonize are termed
pioneer species, and collectively they make up the
pioneer
microbial
community.
These
pioneer
species continue to grow and colonize until
environmental resistance is encountered. This can
be due to several limiting forces (including physical
and chemical factors) which act as barriers to
further development.
85. In the oral cavity, physical factors include the
shedding of epithelial cells (desquamation), and the
shear forces from chewing and saliva flow. Nutrient
requirements,
redox
potential,
pH,
and
the
antibacterial properties of saliva can act as chemical
barriers limiting growth. One genus or species is
usually predominant during the development of the
pioneer community.
86. The pioneer micro-organisms are S. salivarius, S.
mitis and S. oralis. With time, the metabolic activity
of the pioneer community modifies the environment
providing conditions suitable for colonization by a
succession of other populations, by:
Changing the local Eh or pH.
Modifying or exposing new receptors for
attachment.
Generating novel nutrients.
87. Eventually a stable situation is reached with a high
species
diversity;
this
is
termed
the
climax
community. A climax community reflects a highly
dynamic situation and must not be regarded as a
static state. The diversity of the pioneer oral
community increases during the first few months of
life, and several Gram-negative anaerobic species
appear .
88. When the infants were followed longitudinally during
the eruption of the primary dentition, gram-negative
anaerobic bacteria were isolated more commonly,
and a greater diversity of species were recovered
from around the gingival margin of the newly
erupted teeth (infant mean age = 32 months).
89. These findings confirmed that the eruption of
teeth has a significant ecological impact on the oral
environment, and its resident microflora. The
acquisition of some bacteria may occur optimally
only at certain ages.
90. Studies of the transmission of mutans streptococci
to children have identified a specific 'window of
infectivity' between 19 and 31 months (median
age = 26 months). This opens up the possibility of
targeting preventive strategies over this critical
period to reduce the likelihood of subsequent
colonization in the infant.
91. ALLOGENIC AND AUTOGENIC SUCCESSION
The development of a climax community at an
oral site can involve examples of both allogenic and
autogenic succession. In allogenic succession,
factors of non microbial origin are responsible for an
altered pattern of community development.
92. For
example,
species
such
as
mutans
streptococci and S. sanguis only appear in the
mouth once teeth have erupted .The increase in
number and diversity of obligate anaerobes once
teeth are present is an example of autogenic
succession in which community development is
influenced by microbial factors
93. AGEING AND THE ORAL
MICROFLORA
Birth
Infancy and early childhood
Adolescence
Adulthood
104. DEFENITION
Dental plaque can be defined as the soft deposits
that form the biofilm adhering to the tooth surfaces
or other hard surfaces in the oral cavity, including
removable and fixed prosthesis.
The term Biofilm is used to describe communities
of micro-organisms attached to a surface.
116. CLASSIFICATION OF PLAQUE BASED
ON THE SITE
Supra gingival (Smooth surface) plaque.
Sub gingival plaque.
Approximal plaque
Fissure plaque
Denture plaque
122. MICROFLORA IN DISEASE
INFECTIONS OF THE MOUTH
Infection
Dental caries
Periodontal diseases
Surgical infection
a) Dry socket
b) Dental abscess
c) Osteomyelitis
d) Ludwig’s angina
e) Pericoronitis
Organism
Streptococcus mutans
Bacteroides, Actinomyces
Actinomyces
Oral streptococci
Staphylococcus aureus
β -haemolytic streptococci
Bacteroides
123. INFECTIONS OF THE MOUTH
Infection
Organism
Soft tissue infections
a) Diphtheria
C. Diphtheriae
b) ANUG
Fuso-spirochaetes
c) Cancrum oris
Fuso-spirochaetes
d) Tuberculosis
M. Tuberculosis
e) Leprosy
M. Leprae
Viral infections
a) Herpetic stomatitis
b) Herpes Zoster
c) Mumps
d) Measles
Herpes simplex
Varicella-zoster
Mumps virus
Measles virus
124. INFECTIONS OF THE MOUTH
Infection
Organism
Fungal infections
a) Candidosis
Candida albicans
b) Histoplasmosis
H. Capsulatum
c) Sporotrichosis
Sporotrichum schenkii
Miscellaneous
a) Erythema multiforme
b) StevensJohnson
syndrome
144. Budtz-Jorgensen E, Theilade. E, Theilade J:
Quantitative
relationship
between
yeasts
and
bacteria in denture induced stomatitis. (1983)
They conducted an electron microscope study on
denture plaque. A smear was prepared from
denture
scraping
and
examined
by
light
microscope. Most organisms were gram negative
cocci or rods, Some filaments were also seen. In
one subject only yeast were seen. The acquired
deposits was not seen to invaginate the denture
base.
145. Further he concluded that denture plaque may be
present without clinically demonstrable signs of
stomatitis.
He also stated that the presence of denture plaque
constitutes the principal cause leading to the
inflammation of the palatal mucosa.
146. Thomas E Rams, Thomas W, Roberts, Helt
tatun & Paul H.Keyer(1984) conducted a
study
on
the
subgingival
microbial
flora
associated with human dental implants. They
concluded that the microorganisms around
protruding dental implants are similar to the
bacterial population around natural teeth.
147. FRANK R. M. et. aI, Transmission electron
microscopy of plaque accumulations in denture
stomatitis(1985)
They found that in general the ultrastructure of
denture plaque in patients with denture stomatitis,
was quite different from that of dental plaque with
respect to the pellicle and plaque matrix, as well
as the distribution and nature of the organisms
present.
149. Michael G, Newman ThomasF, Flemig 1988
The microbiota associated with stable and
failing implants is similar to the microbiota of
periodontally
respectively
healthy
and
diseased
teeth
150. Quirynen M, Listgarten MA, 1990
No
significant changes in the distribution of bacterial
morphotypes could be found between implants
and natural teeth.
Srinivas Koka, Michael E.Razzog,Thomas
J.Blocess, Salam Syed (1993)
Conducted a study on the microbial colonization
of dental implants in partially edentulous
subjects. They concluded that Branemark dental
implants placed in partially edentulous patients
may be colonized by disease associated bacteria
within 14 days of second stage surgery.
151. Hajishengallis G, Michalek SM.( 1999)
Current status of a mucosal vaccine against dental caries
Research efforts towards developing an effective and safe
caries vaccine have been facilitated by progress in molecular
biology, with the cloning and functional characterization of
virulence factors from mutans streptococci, the principal
causative agent of dental caries, and advancements in mucosal
immunology, including the development of sophisticated
antigen delivery systems and adjuvants that stimulate the
induction of salivary immunoglobulin A antibody responses.
151
152. Cell-surface fibrillar proteins, which mediate
adherence
to
the
salivary
pellicle,
and,
glycosyltransferase enzymes, which synthesize
adhesive
glucans
accumulation,
are
and
virulence
allow
microbial
components
of
mutans streptococci, and primary canidates for a
human caries vaccine
152
153. Ueta E, Tanida T, Yoneda K, Yamamoto T, Osaki T
(2001)
Increase of Candida cell virulence by anticancer drugs
and irradiation.
The influence of anticancer drugs and irradiation on
Candida cell proliferation, adherence to HeLa cells
and susceptibility to antifungal drugs (amphotericin B
IIld miconazole) and neutrophils were examined using
two Candida albicans.
153
154. Correspondingly,
surviving
Candida
cells
after
these
treatments were resistant to nentrophils, with a reduction to
half of the killing.
These results indicate that anti-cancer drugs and irradiation
potentiate the virulence of Candida cells, or eliminate
Candida cells with low virulence, thereby enhancing the risk
of oral and systemic candidiasis.
154
155. Ling L-J, Hung S-L, Tseng S-C, Chen Y-T, Chi LY, Wu K-M, Lai Y-L. (2001)
Association between betel quid chewing,
periodontal status and periodontal pathogens.
This
investigation
examined
whether
an
association exists between betel quid chewing
and
signs
of
periodontal
disease
and
determined the prevalence of Actinobacillus
actinomycetemcomitans and Porphyromonas
gingivalis by polymerase chain reaction .
155
156. This
investigation
examined
whether
an
association exists between betel quid chewing and
signs of periodontal disease and determined the
prevalence
of
actinomycetemcomitans
Actinobacillus
and
Porphyromonas
gingivalis by polymerase chain reaction . The
periodontal status of 34 betel quid chewers and 32
non-betel quid chewers were compared.
156
157. A significantly higher prevalence of bleeding
on probing was found in betel quid chewers
than non-chewers among the subjects with
higher
plaque
level,
greater
gingival
inflammation, deeper probing depth or greater
attachment loss. Also, the results suggested
that betel quid chewers may harbor higher
levels
of
infection
with
A.
actinomycetemcomitans and P.gingivalis than
non-betel quid chewers.
157
158. Vitkov L, Krautgartner WD, Hannig M, Weitgasser R,
Stoiber W (2002)
Candida attachment to oral epithelium.
Inflamed oral mucosa biopsies from patients with
thrush and high candidal density were observed in a
transmission electron microscope (TEM) using ultrahistochemical staining with ruthenium red for
glycocalyx visualization. Candida adhesion itself is
assumed to induce mucosal inflammation
158
159. Ersin NK, Kocabas EH, Alpoz AR, Uzel A.(2004 )
Transmission of Streptococcus mutans in a group
of Turkish families
.
Eight mothers who had high S. mutans levels in
unstimulated saliva and 8 children aged between 2
and 3 years participated in the study. Plaque
samples from each child were collected with the
tips of sterile toothpicks for S. mutans counts.
Although not part of the original study design, S.
mutans samples were also obtained from the
unstimulated saliva of the three fathers who
shared the same households. .The mothers or the
fathers could be the source for the transmission
of S. mutans to their children.
159
161. The mouth has a resident microflora with a
characteristic composition that exists, for the most
part, in harmony with the host. This microflora is of
benefit to the host and contributes to the normal
development of the physiology and host defences.
Components of this microflora can act as
opportunistic pathogens when the habitat is
disturbed or when micro-organisms are found at
sites not normally accessible to them. Dental
diseases, caused by imbalances in the resident
microflora, are highly prevalent and extremely costly
to treat.
162. Emphasis has to be given for
maintenance of good oral
hygiene
“PREVENTION IS BETTER THAN CURE”
163. References –
1.Oral Microbiology 4 th edition
Philip Marsh, Michael V Martin.
2. Oral Microbiology and Immunology
Newman and Nisengard .
3. Microbiology for Dental students 3 rd edition
T H Melville and C Russell.
4. Basic Medical Microbiology
Robert F Boyd and Brian G .
5. Oral Microbiology and Infectious disease.3 rd ed
Schuster
164. 6. Kees Mcyoledjh, Menny J.A Merija, Wila
A.Vas der rcijcles Gerry M.Raghobar, Arjan
Vissis, Boundwijn stegesga “Microbiota around
root-forms endosseous implants’ a review of
the literature Int. J.Oral Maxillofacial implants
2002; 17:829-838 .
7. Mombelli A, Buser, D Lang N.P ”Colonization
of osseointgrated titanium implants in
edentulous patients early results” Oral
Microbiology & Immunology 1988; 3-113-120
8. Quirjnen M listgarters M.A” the distribution of
bacterial morphotoypes around natural teeth
and titanium implants ad modum branemark”.
Clinical oral Implants Research 1990; 1:8-12.
165. 9. Sreenivas Koka, Michael Razziig, Thomas
J.Bolem, Salam Syed , “ Microbial colonization
of dental implants in partially edentulous
subjects” J.Prosthet Dent 1993; 70;141-4
10.Thomas E, Rams, Thomas W.Roberts, Helt
Tatum & Paul H.Keys “The Gingival microbial
flora associated with human dental implants”.
J.Prosthet Dent 1984
11.Budtz-Jorgensen E , Theilade E, Theilade J “
Quantative relationship between yeast and
bacteria in denture induced stomatitis. J Dent
Research 1983; 91; 134 – 142.
166. 12. Frank RM et al Transmission electron
microscopy of plaque accumulation in denture
stomatitis. JPD 1985 ; 53: 115-124