This document provides an overview of the oral microflora from birth to adolescence. It begins with an introduction and history section describing early discoveries in oral microbiology. The oral cavity naturally hosts a variety of microorganisms that typically exist in a balanced relationship. During development from infancy to adolescence, the composition of the oral microbiota changes as different microorganisms colonize the mouth depending on the sites available. Pioneer species like streptococci are usually the first to colonize, followed by succession of other species as the environment changes. Factors like vertical transmission from caregivers can also affect the acquisition of certain bacteria like streptococcus mutans during windows of infectivity.
The document discusses the oral microflora, including the different oral habitats that microorganisms inhabit, such as the teeth, oral mucosa, tongue, and saliva. It describes the various microorganisms commonly found in the oral cavity, including streptococci, actinomyces, and candida albicans. It also defines several terms related to oral microflora and their ecology.
The document discusses the oral microbiome. It begins by introducing key terms and describing the oral ecosystem and habitats that support diverse microbial communities. It then details the development of the normal oral flora from birth through adulthood and how factors like teeth eruption influence community composition over time. Major groups of bacteria, fungi and other microbes that comprise the oral microbiome are also outlined. Physicochemical factors like temperature, oxygen levels, and pH that shape microbial colonization are explained.
This document discusses oral habits such as thumb sucking, pacifier use, tongue thrusting, mouth breathing, and bruxism. It focuses on defining and classifying different types of tongue thrusting, including anterior, lateral, physiologic, habitual, functional, and anatomic tongue thrusting. The prevalence, etiology, clinical features, diagnosis, and treatment of both simple and complex tongue thrusting are described. Treatment involves training correct swallowing and tongue posture, using appliances to guide the tongue, and fixed or removable orthodontic appliances with cribs or spikes to restrain anterior tongue movement and retrain the swallowing pattern.
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.
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.
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.
This document provides an overview of oral habits, focusing on thumb sucking. It begins with definitions of oral habits and classifications of useful versus harmful habits. It then discusses the etiology, prevalence, and development of habits. Specific sections cover thumb sucking phases, effects on dentofacial structures, diagnosis, and treatment approaches. Treatment may involve psychological therapy using techniques like habit awareness and reward systems, or devices like thumb guards to discourage the habit. The goal is to help children overcome thumb sucking and support healthy oral development.
Bruxism and its effect on periodontiumRamya Ganesh
This document provides an overview of bruxism, including its definition, etiology, classification, clinical features, effects on teeth, muscles, TMJ, and diagnosis and treatment approaches. Bruxism is defined as the habitual grinding or clenching of teeth and can occur during sleep (sleep bruxism) or while awake. The causes of bruxism are multifactorial, including genetic factors, stress, sleep disorders, and malocclusions. Bruxism can lead to tooth wear, muscle pain, headaches, and damage to dental restorations, implants, and the TMJ. Diagnosis involves assessing clinical signs and symptoms, with complementary methods including questionnaires, dental wear analysis, and polysomnography. Treatment
The document discusses the oral microflora, including the different oral habitats that microorganisms inhabit, such as the teeth, oral mucosa, tongue, and saliva. It describes the various microorganisms commonly found in the oral cavity, including streptococci, actinomyces, and candida albicans. It also defines several terms related to oral microflora and their ecology.
The document discusses the oral microbiome. It begins by introducing key terms and describing the oral ecosystem and habitats that support diverse microbial communities. It then details the development of the normal oral flora from birth through adulthood and how factors like teeth eruption influence community composition over time. Major groups of bacteria, fungi and other microbes that comprise the oral microbiome are also outlined. Physicochemical factors like temperature, oxygen levels, and pH that shape microbial colonization are explained.
This document discusses oral habits such as thumb sucking, pacifier use, tongue thrusting, mouth breathing, and bruxism. It focuses on defining and classifying different types of tongue thrusting, including anterior, lateral, physiologic, habitual, functional, and anatomic tongue thrusting. The prevalence, etiology, clinical features, diagnosis, and treatment of both simple and complex tongue thrusting are described. Treatment involves training correct swallowing and tongue posture, using appliances to guide the tongue, and fixed or removable orthodontic appliances with cribs or spikes to restrain anterior tongue movement and retrain the swallowing pattern.
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.
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.
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.
This document provides an overview of oral habits, focusing on thumb sucking. It begins with definitions of oral habits and classifications of useful versus harmful habits. It then discusses the etiology, prevalence, and development of habits. Specific sections cover thumb sucking phases, effects on dentofacial structures, diagnosis, and treatment approaches. Treatment may involve psychological therapy using techniques like habit awareness and reward systems, or devices like thumb guards to discourage the habit. The goal is to help children overcome thumb sucking and support healthy oral development.
Bruxism and its effect on periodontiumRamya Ganesh
This document provides an overview of bruxism, including its definition, etiology, classification, clinical features, effects on teeth, muscles, TMJ, and diagnosis and treatment approaches. Bruxism is defined as the habitual grinding or clenching of teeth and can occur during sleep (sleep bruxism) or while awake. The causes of bruxism are multifactorial, including genetic factors, stress, sleep disorders, and malocclusions. Bruxism can lead to tooth wear, muscle pain, headaches, and damage to dental restorations, implants, and the TMJ. Diagnosis involves assessing clinical signs and symptoms, with complementary methods including questionnaires, dental wear analysis, and polysomnography. Treatment
Genetics- Principles & Disoreders in Paediatric DentistryDrSusmita Shah
The document discusses genetics principles and disorders relevant to pediatric dentistry. It begins with an overview of the history of genetics including discoveries by Mendel, Watson, Crick and others. It then covers basic genetics terminology, DNA structure, karyotyping, chromosomal abnormalities, inheritance patterns, genetic disorders and genetic counseling. Specific topics discussed in more depth include trisomies, Klinefelter syndrome, chromosomal deletions, duplications and other structural abnormalities. The document provides foundational information on genetics and inheritance patterns important for pediatric dentistry.
The document discusses the oral microbiome and factors that influence it. It begins by defining key terms like microbiota, habitat, and ecology. It then describes the four major ecosystems in the oral cavity and how they each support different microbial communities. Factors that affect microbial growth like temperature, pH, nutrients, and host defenses are also examined. The document outlines the succession of bacterial colonization from pioneer species in infants to the climax community of diverse bacteria in adults. It provides an overview of the normal oral microbiome and its development.
Joining Discovery on Target 2018 in Boston, for Targeting the Microbiome, DrBonnie presents new discoveries in research, technology, and upcoming companies. Most importantly, DrBonnie360 focuses on the oral microbiome--what is is, the parts of the mouth involved, and its possible relations to heart disease, lung disease, cancer and autoimmune disease.
Topics include: Oral Microbiome, Microbial Composition, Dysbiosis, Oral Health, Chronic Disease, Crowdscience, and Oral Probiotics
Prenatal and postnatal growth & development of maxilla and palate presented b...Dr. Himanshu Gorawat
This document summarizes the prenatal and postnatal growth and development of the maxilla and palate. It discusses how the maxilla develops from the first pharyngeal arch and the palate develops from the palatal shelves and frontonasal process prenatally. Postnatally, it describes how the maxilla and palate grow through processes like displacement, growth at sutures, and surface remodeling, which increases their size and changes their shape to accommodate tooth eruption. The midpalatal suture fuses by age 20. Overall, the document provides a comprehensive overview of the structural development and growth patterns of the maxilla and palate over prenatal and postnatal periods.
Cariology and caries risk assessment. by Dr.Kazhan O. abdulrahman.abas_lb
(1) Dental caries is a multifactorial disease caused by an imbalance between cariogenic and protective factors in the oral environment over time.
(2) Cariogenic bacteria in dental plaque metabolize sugars to produce acid, lowering plaque pH and demineralizing tooth enamel.
(3) A caries risk assessment evaluates both risk indicators and protective factors to determine a patient's caries risk level and develop an individualized prevention plan.
This document discusses biofilms and dental plaque. It begins by defining biofilms as self-produced extracellular matrices composed of biopolymers that allow microorganisms to stick to surfaces. Biofilms are found in various environments and contain diverse microbial communities embedded in a protective glycocalyx layer. As more microbes colonize the surface, mushroom-shaped structures called microcolonies form within the biofilm. Fluid channels also develop to transport nutrients and waste. Dental plaque is a specific oral biofilm that forms on teeth and other surfaces. It has both supragingival and subgingival components composed primarily of streptococci and other bacteria. Coaggregation and coadhesion between early and late colonizers aid in plaque maturation over time
The document discusses the defense mechanisms of the periodontium. It describes the innate and adaptive defense systems. The innate system includes bacterial balance, surface integrity, surface fluids like GCF and saliva, phagocytosis, and the inflammatory response. The adaptive system involves cell-mediated and humoral immunity. Key components that provide protection include the junctional epithelium barrier, antimicrobial peptides and cytokines in GCF, lysozymes and antibodies in saliva, and phagocytic cells like neutrophils and macrophages. Together, these multilayered defenses effectively counter the bacterial challenges in the oral cavity.
This document discusses oral habits commonly seen in children. It defines oral habits and classifies them based on different criteria proposed by various authors. The prevalence of common oral habits like thumb sucking, tongue thrusting, mouth breathing, bruxism, lip biting, and nail biting are discussed based on previous studies. Thumb sucking is described in detail, including its classification, theories on its development, etiological factors, and phases of development from normal to clinically significant. The document emphasizes that oral habits should be addressed before age 3-4 to prevent potential dental issues, and habits persisting beyond age 5 may require psychological intervention.
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.
AGGREGATIBACTER ACTINOMYCETEMCOMITANS is a bacterium with an array of diverse potential virulence characteristics, including multiple immune evasion mechanisms and novel mechanisms for binding to host matrices and invading host cells, any one of which may play a crucial role in the local tissue pathology of Localized aggressive periodontitis.
Hi, I am Dr Komal Ghiya, pediatric dentist by profession, I am here to share some of my own presentations for educational purposes. I hope you a presentation on ANTIBIOTICS IN PEDIATRIC DENTISTRY will be useful for all the dental and medical students. Comments are welcome if you like the presentations and if not please suggest some ways I could make them better for you. All the best
This document discusses oral habits in children. It defines oral habits as repeated muscular contractions that are learned behaviors. Common oral habits include thumb sucking, finger sucking, tongue thrusting, and nail biting. Oral habits are classified based on factors like their psychological roots and whether they apply pressure. The causes of oral habits are debated but may involve psychological, learning, oral drive, and genetic factors. Oral habits can impact facial growth and dental development if persistent. Treatment involves psychological counseling, reminder therapies, and mechanotherapies like intraoral appliances.
This document provides an overview of space maintainers used in pediatric dentistry. It begins with definitions of space maintenance, space control, and space maintainers. It then discusses Nolla's classification of primary teeth and causes of premature loss of primary teeth. Key points include that space closure occurs most rapidly in the first 6 months after loss and more so in the maxilla compared to mandible. The document describes effects of premature loss of individual primary teeth and factors influencing malocclusion development. It provides a classification of space maintainers and discusses various fixed and removable appliance designs like band and loop, lingual arch, and distal shoe space maintainers. Treatment considerations and case indications for different appliances are also summarized.
This document discusses different types of space maintainers used in orthodontics. It defines space maintainers and describes their purpose in maintaining space after premature loss of primary teeth. The document categorizes space maintainers as either removable or fixed, and lists examples of common types, their advantages and disadvantages, ideal requirements, indications and contraindications. Key space maintainers mentioned include acrylic partial dentures, lingual arches, Nance holding arches, and band and loop appliances.
This document summarizes oral microbial flora and bacterial morphology. It discusses the difference between prokaryotic and eukaryotic cells and describes bacterial size, shape, anatomy including cell wall, cytoplasm membrane, nucleus, capsule and flagella. The document also covers bacterial growth, staining techniques, normal oral flora and the most predominant bacterial taxa found in the oral cavity. It explains how the oral cavity acquires bacteria initially and how the flora varies with age and eruption of teeth.
traumatic injuries in children: trauma to teeth and softJeena Paul
This document discusses traumatic injuries to children's teeth and soft tissues. It notes that trauma occurs frequently in children, with the highest incidence between ages 2-3. Common causes of trauma include falls, accidents, and sports. Examination of injured children should involve a thorough history, clinical examination of soft tissues and teeth, and radiographs to check for fractures or displaced teeth/bone. Proper documentation of findings is important for diagnosis and treatment planning.
The document discusses the roles and classifications of dental auxiliaries. It notes that dental auxiliaries assist dentists and take on tasks that require less skill, helping to improve access to dental care. Dental auxiliaries discussed include dental assistants, hygienists, technicians, and other roles with varying levels of training and supervision. The use of auxiliaries benefits communities by improving coverage of preventive services and increasing the productivity and efficiency of dental care delivery.
Introduction
Prevention of caries
Brief introduction about types of Immunity
Causative factors of dental caries
Virulance of S mutans
Natural immune barriers
Salivary secretion and its composition
Natural barriers
Innate immune responses of dental pulp to caries
Acquisition of oral microbes
Factors affecting oral microbial colonization
Innate salivary factors found in oral cavity
Adaptive immunity
Secretary IgA
Types of Immunization
Routes of Immunization
Conclusion
- The human body is inhabited by many microorganisms, mostly bacteria, that normally do not cause harm and may provide benefits. These make up the normal microbiota.
- The oral cavity specifically contains a variety of microbes including bacteria, viruses, fungi and protozoa. In infancy, colonization begins with bacteria like streptococcus salivarius transmitted from caregivers.
- As teeth erupt, the microbiota becomes more complex with bacteria like streptococcus mutans and increases in anaerobic bacteria. The "window of infectivity" for mutans streptococci transmission is between 19-31 months of age, making early childhood an important time for preventing cavities.
This document summarizes the history and causes of dental caries. It discusses how dental caries were rare among ancient humans and early societies due to diets low in carbohydrates. The rise of agriculture led to increased carbohydrate consumption and a proliferation of cariogenic bacteria like Streptococcus mutans in the mouth. Transmission of these bacteria often occurs from parent to child. While dental caries have afflicted humans for millennia, their understanding of the bacterial causes and development of preventative treatments have gradually increased over time.
Genetics- Principles & Disoreders in Paediatric DentistryDrSusmita Shah
The document discusses genetics principles and disorders relevant to pediatric dentistry. It begins with an overview of the history of genetics including discoveries by Mendel, Watson, Crick and others. It then covers basic genetics terminology, DNA structure, karyotyping, chromosomal abnormalities, inheritance patterns, genetic disorders and genetic counseling. Specific topics discussed in more depth include trisomies, Klinefelter syndrome, chromosomal deletions, duplications and other structural abnormalities. The document provides foundational information on genetics and inheritance patterns important for pediatric dentistry.
The document discusses the oral microbiome and factors that influence it. It begins by defining key terms like microbiota, habitat, and ecology. It then describes the four major ecosystems in the oral cavity and how they each support different microbial communities. Factors that affect microbial growth like temperature, pH, nutrients, and host defenses are also examined. The document outlines the succession of bacterial colonization from pioneer species in infants to the climax community of diverse bacteria in adults. It provides an overview of the normal oral microbiome and its development.
Joining Discovery on Target 2018 in Boston, for Targeting the Microbiome, DrBonnie presents new discoveries in research, technology, and upcoming companies. Most importantly, DrBonnie360 focuses on the oral microbiome--what is is, the parts of the mouth involved, and its possible relations to heart disease, lung disease, cancer and autoimmune disease.
Topics include: Oral Microbiome, Microbial Composition, Dysbiosis, Oral Health, Chronic Disease, Crowdscience, and Oral Probiotics
Prenatal and postnatal growth & development of maxilla and palate presented b...Dr. Himanshu Gorawat
This document summarizes the prenatal and postnatal growth and development of the maxilla and palate. It discusses how the maxilla develops from the first pharyngeal arch and the palate develops from the palatal shelves and frontonasal process prenatally. Postnatally, it describes how the maxilla and palate grow through processes like displacement, growth at sutures, and surface remodeling, which increases their size and changes their shape to accommodate tooth eruption. The midpalatal suture fuses by age 20. Overall, the document provides a comprehensive overview of the structural development and growth patterns of the maxilla and palate over prenatal and postnatal periods.
Cariology and caries risk assessment. by Dr.Kazhan O. abdulrahman.abas_lb
(1) Dental caries is a multifactorial disease caused by an imbalance between cariogenic and protective factors in the oral environment over time.
(2) Cariogenic bacteria in dental plaque metabolize sugars to produce acid, lowering plaque pH and demineralizing tooth enamel.
(3) A caries risk assessment evaluates both risk indicators and protective factors to determine a patient's caries risk level and develop an individualized prevention plan.
This document discusses biofilms and dental plaque. It begins by defining biofilms as self-produced extracellular matrices composed of biopolymers that allow microorganisms to stick to surfaces. Biofilms are found in various environments and contain diverse microbial communities embedded in a protective glycocalyx layer. As more microbes colonize the surface, mushroom-shaped structures called microcolonies form within the biofilm. Fluid channels also develop to transport nutrients and waste. Dental plaque is a specific oral biofilm that forms on teeth and other surfaces. It has both supragingival and subgingival components composed primarily of streptococci and other bacteria. Coaggregation and coadhesion between early and late colonizers aid in plaque maturation over time
The document discusses the defense mechanisms of the periodontium. It describes the innate and adaptive defense systems. The innate system includes bacterial balance, surface integrity, surface fluids like GCF and saliva, phagocytosis, and the inflammatory response. The adaptive system involves cell-mediated and humoral immunity. Key components that provide protection include the junctional epithelium barrier, antimicrobial peptides and cytokines in GCF, lysozymes and antibodies in saliva, and phagocytic cells like neutrophils and macrophages. Together, these multilayered defenses effectively counter the bacterial challenges in the oral cavity.
This document discusses oral habits commonly seen in children. It defines oral habits and classifies them based on different criteria proposed by various authors. The prevalence of common oral habits like thumb sucking, tongue thrusting, mouth breathing, bruxism, lip biting, and nail biting are discussed based on previous studies. Thumb sucking is described in detail, including its classification, theories on its development, etiological factors, and phases of development from normal to clinically significant. The document emphasizes that oral habits should be addressed before age 3-4 to prevent potential dental issues, and habits persisting beyond age 5 may require psychological intervention.
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.
AGGREGATIBACTER ACTINOMYCETEMCOMITANS is a bacterium with an array of diverse potential virulence characteristics, including multiple immune evasion mechanisms and novel mechanisms for binding to host matrices and invading host cells, any one of which may play a crucial role in the local tissue pathology of Localized aggressive periodontitis.
Hi, I am Dr Komal Ghiya, pediatric dentist by profession, I am here to share some of my own presentations for educational purposes. I hope you a presentation on ANTIBIOTICS IN PEDIATRIC DENTISTRY will be useful for all the dental and medical students. Comments are welcome if you like the presentations and if not please suggest some ways I could make them better for you. All the best
This document discusses oral habits in children. It defines oral habits as repeated muscular contractions that are learned behaviors. Common oral habits include thumb sucking, finger sucking, tongue thrusting, and nail biting. Oral habits are classified based on factors like their psychological roots and whether they apply pressure. The causes of oral habits are debated but may involve psychological, learning, oral drive, and genetic factors. Oral habits can impact facial growth and dental development if persistent. Treatment involves psychological counseling, reminder therapies, and mechanotherapies like intraoral appliances.
This document provides an overview of space maintainers used in pediatric dentistry. It begins with definitions of space maintenance, space control, and space maintainers. It then discusses Nolla's classification of primary teeth and causes of premature loss of primary teeth. Key points include that space closure occurs most rapidly in the first 6 months after loss and more so in the maxilla compared to mandible. The document describes effects of premature loss of individual primary teeth and factors influencing malocclusion development. It provides a classification of space maintainers and discusses various fixed and removable appliance designs like band and loop, lingual arch, and distal shoe space maintainers. Treatment considerations and case indications for different appliances are also summarized.
This document discusses different types of space maintainers used in orthodontics. It defines space maintainers and describes their purpose in maintaining space after premature loss of primary teeth. The document categorizes space maintainers as either removable or fixed, and lists examples of common types, their advantages and disadvantages, ideal requirements, indications and contraindications. Key space maintainers mentioned include acrylic partial dentures, lingual arches, Nance holding arches, and band and loop appliances.
This document summarizes oral microbial flora and bacterial morphology. It discusses the difference between prokaryotic and eukaryotic cells and describes bacterial size, shape, anatomy including cell wall, cytoplasm membrane, nucleus, capsule and flagella. The document also covers bacterial growth, staining techniques, normal oral flora and the most predominant bacterial taxa found in the oral cavity. It explains how the oral cavity acquires bacteria initially and how the flora varies with age and eruption of teeth.
traumatic injuries in children: trauma to teeth and softJeena Paul
This document discusses traumatic injuries to children's teeth and soft tissues. It notes that trauma occurs frequently in children, with the highest incidence between ages 2-3. Common causes of trauma include falls, accidents, and sports. Examination of injured children should involve a thorough history, clinical examination of soft tissues and teeth, and radiographs to check for fractures or displaced teeth/bone. Proper documentation of findings is important for diagnosis and treatment planning.
The document discusses the roles and classifications of dental auxiliaries. It notes that dental auxiliaries assist dentists and take on tasks that require less skill, helping to improve access to dental care. Dental auxiliaries discussed include dental assistants, hygienists, technicians, and other roles with varying levels of training and supervision. The use of auxiliaries benefits communities by improving coverage of preventive services and increasing the productivity and efficiency of dental care delivery.
Introduction
Prevention of caries
Brief introduction about types of Immunity
Causative factors of dental caries
Virulance of S mutans
Natural immune barriers
Salivary secretion and its composition
Natural barriers
Innate immune responses of dental pulp to caries
Acquisition of oral microbes
Factors affecting oral microbial colonization
Innate salivary factors found in oral cavity
Adaptive immunity
Secretary IgA
Types of Immunization
Routes of Immunization
Conclusion
- The human body is inhabited by many microorganisms, mostly bacteria, that normally do not cause harm and may provide benefits. These make up the normal microbiota.
- The oral cavity specifically contains a variety of microbes including bacteria, viruses, fungi and protozoa. In infancy, colonization begins with bacteria like streptococcus salivarius transmitted from caregivers.
- As teeth erupt, the microbiota becomes more complex with bacteria like streptococcus mutans and increases in anaerobic bacteria. The "window of infectivity" for mutans streptococci transmission is between 19-31 months of age, making early childhood an important time for preventing cavities.
This document summarizes the history and causes of dental caries. It discusses how dental caries were rare among ancient humans and early societies due to diets low in carbohydrates. The rise of agriculture led to increased carbohydrate consumption and a proliferation of cariogenic bacteria like Streptococcus mutans in the mouth. Transmission of these bacteria often occurs from parent to child. While dental caries have afflicted humans for millennia, their understanding of the bacterial causes and development of preventative treatments have gradually increased over time.
The document discusses the normal oral microflora and dental plaque. Regarding normal oral microflora, it describes the different bacterial species present in different areas of the oral cavity and factors that determine their distribution. Regarding dental plaque, it defines plaque, describes its classification and the successive stages of development from pellicle formation to maturation of the microbial community. Key bacterial species involved in early and late colonization are mentioned.
The human oral cavity contains a diverse ecosystem that is colonized by many microorganisms. Over time, a resident microbiota is established that typically remains stable throughout life. This microbiota includes bacteria, viruses and fungi that exist in complex biofilms. The makeup of the oral microbiota changes with age as different habitats form in the mouth. Imbalances in the normal microbiota have been linked to oral diseases as well as systemic conditions. Research continues to uncover relationships between the oral and total body microbiota and how they impact overall health.
This document provides an overview of the microbiology of the oral cavity. It discusses the resident oral microflora including the major groups of microorganisms found, such as streptococci. Specifically, it focuses on the Streptococcus mutans group, detailing their role in dental caries, characteristics, ecology, physiology and screening tests. It also briefly discusses other streptococcal groups commonly found in the oral cavity like S. salivarius and S. milleri groups.
The primary goal of the present book is to produce a comprehensive text that fully integrates the latest concepts and techniques in management of odontogenic infections. The main aim is to provide the readers with an update information regarding pathophysiology, clinical and radiographic presentation, microbiology, diagnosis, management, and complications of odontogenic infections. Accordingly, the text has been divided into six chapters. Chapter one is concerned with oral microbiology and immunology. Chapter two is dealing with the pathophysiology of odontogenic infections. In chapter three, management of odontogenic infections is presented. In chapter four, antibiotic therapy of odontogenic infections is given. Chapter five deals with life-threatening complications. In chapter six osteomyelitis of the jaws is discussed.
Oral micro flora/certified fixed orthodontic courses by Indian dental academy 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 micro flora/dental crown &bridge course by Indian dental academyIndian dental academy
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.
This document discusses oral microbiology and the microorganisms associated with dental diseases. It begins by introducing the normal oral microflora and then discusses the microflora found in dental caries, root canals, and the periodontal pocket. It explores the importance of studying bacterial pathogenesis and how microbiology relates to dentistry. Key findings are that dental caries and periodontal disease are caused by shifts in the microbial environment that allow pathogenic bacteria like Streptococcus mutans and Porphyromonas gingivalis to dominate. Maintaining a balanced oral microbiome is important for oral health.
Dental caries is caused by an interaction between oral bacteria, fermentable carbohydrates, and tooth surfaces over time. Miller's chemico-parasitic theory is the most widely accepted explanation of the etiology. It states that acids produced by oral bacteria from carbohydrates lead to enamel demineralization and destruction. Clinical presentation varies and includes pit and fissure caries, smooth surface caries, and root caries. Histologically, caries progresses through zones of demineralization and remineralization in both enamel and dentin. Prevention focuses on modifying the oral environment, bacteria, and substrate to reduce acid production and demineralization.
Aggregatibacter actinomycetemcomitans is a gram-negative bacterium associated with aggressive periodontitis. It possesses various virulence factors that help it colonize the oral cavity and evade the host immune system, including adhesins, invasins, bacteriocins, and a potent leukotoxin. Leukotoxin is a secreted protein toxin that binds to and forms pores in the membranes of neutrophils, monocytes, and lymphocytes, killing these immune cells. A. actinomycetemcomitans' ability to adhere firmly and invade host cells, coupled with suppression of the host immune response via leukotoxin, allows it to persist in the oral cavity and contribute to periodontal
This document summarizes the epidemiology of dental caries. It discusses the epidemiological triad of host, agent, and environment as related to dental caries. For the host factors, it describes how characteristics like tooth morphology, saliva composition, age, and nutrition can influence caries susceptibility. It then examines the role of microbial agents like streptococcus mutans and environmental factors like fluorides, climate, and nutrition that can impact the development of dental caries. The summary provides an overview of the key factors involved in the occurrence of this prevalent dental disease.
The document discusses the normal human flora or microbiome. It notes that the human microbiome includes bacteria, fungi, and other microorganisms that reside on and inside the human body. While some of these organisms are beneficial to the host, most have no known effect. Those expected to be present without causing disease are considered part of the normal flora. The normal flora is established shortly after birth and provides benefits like aiding digestion and stimulating immune system development. It varies between body sites and can be influenced by factors like age, diet, and health status.
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.
The document discusses the oral microbiota and its role in various oral diseases. It begins with an introduction to oral microbiology and a brief history. It then describes the normal microbial flora of the oral cavity including bacteria, fungi and protozoa. Several key bacteria associated with dental diseases like dental caries and periodontal disease are mentioned. The document also discusses the development of oral flora from infancy to adulthood. Various diseases caused by oral microbes like dental plaque, caries, periodontitis and endodontic infections are summarized. Sample collection and diagnostic methods for oral pathogens are also outlined.
1 - ECC, Nursing Caries and Rampant Caries.pptxEUROUNDISA
This document discusses early childhood caries, nursing caries, and rampant caries. It defines each condition and describes their etiology, clinical features, diagnosis, and management. Early childhood caries is defined as having one or more decayed, missing, or filled tooth surfaces in a child under 6 years old. Nursing caries is caused by prolonged bottle feeding and is characterized by lesions on the maxillary anterior teeth. Rampant caries occurs rapidly and affects surfaces usually resistant to decay. Diagnosis involves visual-tactile-radiographic examination. Management focuses on emergency relief, preventing further decay, and restoring carious lesions.
Caries activity test - caries prediction,caries susceptibility and clinical i...Karishma Sirimulla
this seminar includes various caries activity tests and key caries risk factors caries susceptibility,cariogram and caries prediction along with its applications
Oral microbiology/ rotary endodontic courses by indian dental academyIndian dental academy
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.
This document discusses vital pulp therapy and treatments for caries in young permanent and primary teeth. It describes apexogenesis and apexification procedures used to encourage root development and closure. It defines rampant caries and early childhood caries, noting the involvement of proximal surfaces and cervical cavities. Causative factors discussed include inappropriate feeding habits, prolonged breastfeeding, and sucrose consumption. Prevention focuses on education, fluoride application, and dietary changes, while treatment involves caries removal, pulpotomies, pulp capping, and restorations.
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2. CONTENTS
• Introduction
• History
• Terminologies
• Oral cavity as microbial habitat
• Development of residual
microflora
2
• Oral Microbiota In Various Sites At
Different Stages Of Human
Development
• Factors affecting growth of
microorganisms
• Conclusion
• References
3. INTRODUCTION
• Human beings harbour a wide range of
microorganisms.
• Mouth is the gateway of the body to the external
world
• Easily accessible part of the body and acts as a major
site of entry.
• Mouth has its own natural microflora.
Ref :Marsh and Martin :Oral microbiology 6 Edition
3
4. • Most of the microorganisms in the oral
cavity are oppurtunistic.
• Diseases occur as a result of imbalance in
the normal microflora.
4
5. HISTORY
• W. D. Miller - Father Of Oral Microbiology.
• Louis Pasteur- Father Of Bacteriology.
• Anton von Leeuwenhoek (1683) - First to observe microbes in saliva and teeth.
• K. Clark (1924) - studied coccus from a caries lesion – S. mutans.
• Leon Williams (1897) - showed microorganisms attached to tooth sections.
• G. V. Black (1898) - Term microbial plaque.
• Refernce :Anant Narayan- 5th edition, textbook of microbiology
5
7. Interaction Between Normal Microbiota And Host
• Symbiosis: “Living together”.
• Commensalism: One organism benefits, the other is not affected (+/0).
• Mutualism: Both organisms benefit from living together (+/+).
• Parasitism: One organism benefits, the other is harmed (+/-).
7
8. • Oral microflora has a characteristic composition and is existing in a
harmonious relationship with the host.
• The relationship can breakdown in mouth and disease can occur when:
a. Major changes to biology of mouth from exogenous or endogenous
sources.
b. The presence of microorganisms at sites not normally accessible to them
8
9. • Most endogenous bacterial disease are Opportunistic Infections.
• Commonest clinical manifestations include: Dental caries and Periodontal
diseases.
• Dental caries is the dissolution of enamel and dental plaque is associated with
the etiology of periodontal disease.
9
10. NORMAL FLORA
BENEFICIAL EFFECT
1. Synthesize & excrete vitamins
2. Prevent colonization by
pathogens
3. Antagonize other bacteria
4. Stimulate development of
certain tissues
5. Production of antibodies.
HARMFUL EFFECTS
1. Bacterial synergism
2. Competition for nutrients
3. Induction of low-grade toxemia
4. May be agents of disease
5. Transfer to susceptible host.
10
Reference :KMK Masthan- 1st edition, textbook of oral microbiology
13. Resident flora
• Species that are almost
always present in high
numbers (>1%) in a
particular site;
supragingival plaque/
surface of the tongue.
• Don’t compromise the
host survival.
• Oral flora is dominated
by anaerobic &
facultative bacteria
which exhibit optimal
growth at about 37°C .
Intermidiate
flora
• Comprises species that
are nearly always
present, but in low
numbers (<1%)
• May become
indigenous if
environment changes.
• Eg.lactobacillus
species.
Transient flora
• Comprise organism
“just passing through
the host”
• At a given time a
particular species may
or may not be present
in the flora.
• Bacteria present in
food or drink may be
temporarily established
in the mouth.
• Quickly disappear.
13
15. • Study indicated that neonates can acquire strict anaerobes, such as C. difficile,
within the first 2 days of stay on a neonatal ward.
• Breast-fed infants have predominant populations of bifido bacteria in their stools
and formula-fed neonates had a more complex mixture of organisms
• By 2 years of age, children have a similar complexity and range of microbes as a
adults.
Ref :Ullah S, Rahman K, Hedayati M. Hyperbilirubinemia in Neonates: Types, Causes, Clinical Examinations, Preventive Measures and Treatments: A
Narrative Review Article. Iran J Public Health. 2016 May;45(5):558-68. PMID: 27398328; PMCID: PMC4935699.
15
16. • Microbes find suitable environments, either on outer or inner body surfaces, quickly
multiply and establish themselves.
• Each part of human body with its special environmental conditions, has its own
particular mixture of microbes.
16
17. DEVELOPMENT OF ORAL FLORA
• The process begins with the colonization of habitat by pioneer microbial
populations.
• In oral cavity of newborns, streptococci are the pioneer organisms.
• They fill the niche of the new environment and modify the habitat and new
population develops.
• When no additional niche is available for new population, a stable
assemblage of bacterial population is achieved called as climax community.
Reference Marsh & Nyvad,2008 p.165
17
19. PIONEER COMMUNITY & MICROBIAL SUCESSION
• Predominant pioneer organisms are streptococci and in particular, S. Salivarius, S.
mitis and S. oralis.
• Their metabolic activity modifies the environment:
(a) Changing the local pH
(b) Modifying or exposing new receptors on surfaces for attachment
(c) Generating novel nutrients
• Microbial succession eventually leads to a stable situation (climax community).
19
20. WINDOW OF INFECTIVITY
• “Time period in which the initial acquisition of streptococcus mutans takes
place on either primary or permanent tooth”
• Caufield (1993) monitored oral cavity levels from birth to 5 years.
• Where he noted initial acquisition of streptococcus mutans.
• As the primary teeth erupt into the oral cavity, they provide a completely
virgin habitat.
• Thus window of infectivity in deciduous teeth is established by 7-31
months.
22
21. • Krass et al (1967) and Edrman et al (1975) - at 2-6 yrs of age is less
susceptible to acquire MS.
• Klock & Kroske (1977) - “Second window of infectivity” present in
permanent dentition between 6-12 years of age.
• 90% of teenagers have MS colonization while others found only 3% of
adults (mothers).
23
22. • Children aquire additional strain of MS as they get older & new teeth emerge but remain
undetected since they are low in numbers.
24
23. Vertical Transmission
• Vertical transmission is the transmission of microbes from caregiver to child. The
major reservoir from which infants acquire MS is their mothers.
• Colonization may be related to several factors –
frequency of small dose inoculations,
a minimum infective dose.
Study reported that,
• when mothers harbored greater than 105 CFUs of MS per mL of saliva, the
frequency of infant infection was 58%.
• While at 103 CFUs of MS per mL of saliva or more, the frequency was 6%.
These data clearly demonstrate that
mothers with dense salivary
reservoirs of MS are at high risk for
infecting their infants early in life.
Berkowitz et al. Mutans Streptococci: Acquisition and Transmission. Pediatric Dentistry – 28:2 2006
25
24. Horizontal Transmission
• The presence of matching genotypes of S mutans among children attending
one nursery school strongly suggests horizontal transmission.
• Van Loeveren and colleagues reported data which bacteriocin typed isolates
of MS obtained from children 5 years of age and their parents.
• The results showed that, even when a child acquires MS after the age of 5,
there may be similarity between MS in mother, father, and child—indicating
that horizontal transmission can occur between family members.
Berkowitz et al. Mutans Streptococci: Acquisition and Transmission. Pediatric Dentistry – 28:2 2006
26
25. Currently drafted recommendations for dental providers addressing the issue:
1. Reduce the MS reservoir in the mother, sibling(s), and all of the infant’s
caretaker(s) by eliminating active dental caries lesions and using agents such as
fluorides and chlorhexidene.
2. Alter saliva-sharing activities, such as tasting food before feeding and sharing
toothbrushes.
3. Twice daily tooth-brushing of the dentate infant with an appropriate amount
of an ADA-approved fluoridated toothpaste.
4. Avoid decay-promoting feeding behaviors.
5. Oral health evaluation of the infant by a dental professional should occur
before the first birthday. 27
27. The Composition Of The Oral Microbiota In Various Sites At
Different Stages Of Human Development.
Infant
• At birth, the oral cavity is essentially sterile and the number of
organisms appear to remain low for the first 6 hours.
• From 6-10 hours following birth there is a rapid increase in the
number of detectable organisms.
• However, at least one organism can be detected culturally with
some degree of regularity, Streptococcus salivarius.
• Zinner et al using immunofluorescence techniques - salivarius
was found in 80% of infants at approx. one day of age and
remained high consistently thereafter.
29
28. Infant….
• S. salivarius normally resides on the tongue. It is not dependent upon the
teeth for survival.
• On the other hand, one would not expect to detect spirochetes in the
edentulous infant since the gingival crevice, its primary ecologic niche, is
absent.
• Also, one may detect organisms such as S. mutans or lactobacilli since they
are constantly being introduced to the infant,
30
29. An evolutionary change occurs during & after tooth eruption enamel / hard-tissue &
gingival crevice .
• Organism prefer hard tissue colonization – s. mutans, s. sanguis & actinomyces.
• Gingival crevice colonization by: Prevotella, Porphyromonas and spirochaetes
Child and Adolescent
The presence of teeth would provide surfaces for the
attachment of organisms best adapted to this niche.
The dominant flora of oral cavity –
• Before eruption of teeth – facultative aerobes in nature
• After eruption – Increase in anaerobic forms
31
30. • Spirochetes also appear to increase in
incidence with age and are universally
present in adults.
Adult
• The cultivable microbiota of the gingival
crevice, dental plaque, dorsum of the
tongue, and saliva of the adult has been
fairly well described.
32
31. • The presence of nutrients, epithelial debris and secretions makes the mouth a
favorable habitat for a great variety of bacteria.
• Oral bacteria include streptococci, lactobacilli, staphylococci and
corynebacteria, with a great number of anaerobes, especially bacteroides.
• The mouth presents a succession of different ecological situations with age,
and this corresponds with changes in the composition of the normal flora.
33
33. THE ORAL
ECOSYSTEMS
Buccal epithelium
Dorsum of the tongue
Supragingival tooth surface
Subgingival tooth and
crevicular epithelial surfaces
Nasopharynx
• S. pneumoniae
Vestibular mucosa
• S. vestibularis
Buccal mucosa
• S. mitis
• mitis group
• anginosus group
Tonsils
• S. sanguis
• S. mitis
• S. mutans
• mitis group
• anginosus group
Tooth surface
• mitis group
• mutans group
• anginosus group
Saliva
• S. salivarius
• S. mitis
• S. oralis
• mitis group
• anginosus group
Tongue
• S. salivarius
• S. mitis
35
Ref :Marsh and Martin :Oral microbiology 6 Edition
34. • The buccal epithelium has gram positive streptococci in contrast to tongue
which has more of gram positive filaments.
• The subgingival region is anaerobic as compared to the
supragingival region.
• Mutans streptococci (S. mutans, S. sorbinus, S. cricetus, S. rattus) and S.
Sanguis are found in large number on teeth.
• S. Salivarius is isolated mainly from the tongue.
• S. mutans and S. sanguis appear only after eruption of teeth.
36
39. GRAM POSITIVE BACTERIA
• Streptococci constitute the largest group.
• Streptococcus mutans – most important role in dental caries.
• Lactobacilli are widely present.
• Saliva has lactobacilli count of 70,000/ml.
• 27 recognized species of the genus.
41
40. STREPTOCOCCI
• Most important organism to initiate dental caries.
• This name of this genus means "pliant berry.”
• S.species have spherical cells that may be oval or
elongated to short rods.
• The cells are nonmotile and do not form endospores.
• Some species produce hyaluronic acid or
polysaccharide capsules.
42
41. • Streptococci – gram positive cocci
• Arranged in chain or pairs.
• Billroth (1874) - Cocci in chains first seen in
erysipelas & wound infection;
Streptos – twisted or coiled.
• Ogston (1881) isolated them from acute
abscesses.
• Rosenbach (1884) – isolated the cocci from
human suppurative lesions & gave them name
streptoccoccus pyogens
43
43. • Colonial morphology varies between species and ranges from 0.5 to 1 mm,
convex, smooth to 5 to 10 mm, low convex, flecked, with radial and
concentric striations.
• Oral streptococci are major components of supragingival dental plaque and
are also found in subgingival plaque.
45
45. I. MUTANS-GROUP
• Originally isolated from human carious teeth by
Clarke in 1924.
• Cells can lose their coccal morphology and often
appear as short rods.
• Nine serotypes have been identified( a-h , and k)
• Recovered exclusively from hard, non – shedding
surfaces in the mouth.
• Can act as opportunistic pathogens.
• Regularly isolated from dental plaque but
prevalence is low on sound enamel.
S. mutans S. sobrinus
47
46. VIRULENCE FACTORS
• Specific adherence to tooth surface using antigen I/II adhesin and GTF
(glycosyl transferase)
• Rapid metabolism of sugars to lactic acid and other organic acids
• Lower the pH to below 5.5, the critical pH.
• Able to maintain microbial growth and continue acid production at low pH
values.
• Accumulation of intracellular polysaccharides (carbon/energy reserve)
48
47. II. SALIVARIUS GROUP
• Strains of S.salivarius commonly isolated from different
areas of mouth.
• Preferably, colonizes the mucosal surfaces especially the
tongue.
• S.vestibularis isolated mainly from the vestibular
mucosa.
• Produce urease and hydrogen peroxide and inhibit other
bacteria.
S.
salivarius
S. vestibularis
49
48. III. ANGINOSUS GROUP
• Sometimes also referred to as the milleri group.
• Readily isolated from dental plaque and mucosal surfaces.
• Important in causing serious, purulent maxillo-facial infections.
S.constellatus S.intermedius
S.anginosus S.pharyngis
50
49. IV. MITIS GROUP
• Typically small, round, blue colonies about 0.2–0.5
mm in diameter.
• Colonize hard surfaces in the oral cavity and also
mucous membranes.
• Contribute to plaque formation and also can break
down starch.
• Non - motile, do not form spores and lack group -
specific antigens.
S. sanguis S. gordonii
51
50. Composition Of The Oral Streptococcal Flora In
Healthy Children
• To identify the predominant streptococcal species in the mouths of healthy children
and to investigate the composition of the oral streptococcal flora over a period of
4 months.
• The predominant species were Streptococcus salivarius, S. oralis and S. mitis.
• No significant variation in the composition of the oral streptococcal flora.
• Within a few hours bacteria may be isolated from the oral cavity e.g. streptococci,
lactobacilli and Veillonella.
Reference :Journal of Dentistry : Volume 28, Issue 1, January 2000 52
51. Prevalence Of Different Streptococci Species In The
Oral Cavity Of Children And Adolescents
• S.salivarius was isolated from infants 18 hours after birth and from 75% of children
aged 1 to 5 years.
• With age, this microbiota differentiates, although the species S.salivarius continues
to predominate on the tongue and oral mucosa.
• The prevalence of Streptococci in saliva were: S. salivarius (89.31%) and S.
mutans (73.28%) by the standard method.
• The tongue depressor method showed S. mutans (62.59%) and S. salivarius
(77.86%).
Reference :Braz J Oral Sci. January/March 2013 - Vol. 2 - Number 4
53
53. LACTOBACILLI
• Anaerobic Gram positive bacilli; alpha hemolytic or non hemolytic.
• Found commonly in normal mouth and comprise less than 1% of total
microflora.
• Highly acidogenic and aciduric.
• Associated with advanced caries lesions and carious dentin.
L. casei L. rhamnosus L. acidophilus L. oris
55
54. • Lactobacilli are absent from the oral cavity of newborns and appear during
the first year of the life.
• McCarthy et al. observed the presence of this species in 50% of newborns
during their first year with a rate from 200 to 30000 bacteria/sample.
• The higher the DMF index, the higher the number of children harboring a
high Lactobacillus count.
• Among children, the presence of lactobacilli in coronal caries is
incontestable. Among adults, lactobacilli are found in root caries.
Reference :lactobacilli and the oral cavity
the open microbiology journal, 2008, volume 2
56
55. GRAM NEGATIVE BACTERIA
• Anaerobic gram negative bacilli are another important group.
• 5 genera of these bacteria frequently seen in oral cavity:
• Veilonellae account for about 10% of microflora on tongue & saliva.
Bacteroide
s
Fusobacterium Leptotrichia Veilonella Selenomonas
57
56. GRAM NEGATIVE RODS & FILAMENTS
ACTINOMYCES
• Actinomyces are facultatively
anaerobic or strictly anaerobic.
• They have been associated with root
surface caries and gingivitis.
• The most representative species in
plaque is A.naeslundii.
58
57. • A. israelli can act as opportunistic pathogen & causes actinomycosis.
• A. viscosus and A. naeslundii differ in both the host age at which they
establish in the human mouth and their preferences for colonizing various
intraoral sites
• Catalase-negative isolates resembling A. naeslundii were found to colonize
most infants.
• A. odontolyticus & A. meyeri have also been reported occasionally.
59
58. Most Important Gram Negative Bacteria
• Porphyromonas: P. gingivalis major periodontal pathogen and causes
significant bone loss.
• Prevotella: P. intermedia a periodontal pathogen pregnancy gingivitis.
• Actinobacillus/Aggregatibacter: A.actinomycetemcomitans associated with
aggressive periodontitis
• Treponema: group important in acute periodontal conditions i.e ANUG
60
59. • F.nucleatum - most regularly occuring in the gingival crevices and
subgingival plaque.
• 4 species of Haemophilus are usual inhabitants of oral cavity.
• H.segnis - recently recognized as causative organism of dental plaque.
• Seven species of oral Spirochaetes are common in gingival crevices.
61
62. 1. Temperature
• Human mouth - constant temperature - 35-36°C.
• Periodontal pockets with active disease - higher temp. 39°C
• Rise in temperature - alter bacterial gene expression and possibly the
competitiveness of individual species
64
63. 2. Redox Potential (Eh)
• It is an oxidation - reduction potential.
• Majority of organisms are either facultatively anaerobic or obligately
anaerobic.
• Oxygen concentration - limits the growth of obligately anaerobic bacteria
• Anaerobic species require reduced conditions for their normal metabolism
It is a degree of oxidation reduction at a site that governs the survival and
relative growth of these organisms 65
64. 3. pH
• Many organisms require a pH around neutrality for growth
• pH of most surfaces of mouth is regulated by saliva.
• After sugar consumption pH in plaque can fall rapidly below 5.0 by production of
acids by bacterial metabolism
pH of Palate - 7.34
pH of tongue - 6.8
Floor of mouth - 6.5
Buccal mucosa - 6.3
66
65. • pH of the gingival crevice can become alkaline during the host inflammatory
response in periodontal disease
• pH of healthy gingival crevice - approx. 6.90
• Rises during disease - 7.2 and 7.4
67
66. 4. Nutrients
• Populations within a microbial community are dependent solely on the
habitat for the nutrients essential for their growth.
• Two types of nutrients :-
Endogenous
Exogenous
68
67. Endogenous Nutrients
• Persistence and diversity of the resident oral microflora is due to primarily
the metabolism of endogenous nutrients.
• Main source - saliva
• Gingival crevice is supplied - GCF contains novel nutrients
69
68. Exogenous Nutrients
• Complex array of foodstuffs ingested periodically in the diet
• Fermentable carbohydrates are the only class of compound markedly
influence the ecology of mouth
• Carbohydrates can be broken down acids
• Sucrose by bacterial enzymes Glucans
Fructans
70
69. • Frequent consumption of dietary carbohydrates is associated with a shift in the
proportions of microflora and dental plaque
• Xylitol is a sugar substitute that has been added to some confectionery -
- can’t be metabolised by oral bacteria
- inhibit growth of streptococcus mutans
Level of acid tolerating species
(mutans streptococci and lactobacilli)
growth of acid sensitive species
is inhibited
71
70. 5. Host Defences
• Health of the mucosa is dependent on the integrity of the mucosa - acts as
physical barrier to prevent penetration by micro-organisms or antigens
• In maintaining the integrity of these oral surfaces, many of which have more
than one function.
• Defences are divided into non-specific and specific factors
Innate
immunity Adaptive
immunity 72
71. Innate Immunity
When saliva flow is blocked in sedated patients in intensive
care, there will be shift in the composition of oral microflora
Chewing and natural flow of saliva - remove micro-
organisms not firmly attached to an oral surface
Micro-organisms are unable to maintain themselves by cell
division alone.
73
72. Adaptive Immunity
• Specific host defences are found on and within the mucosa
• Predominant immunoglobin in the healthy mouth - IgA
• IgA is considered to be first line of defense
• Other components can be found in saliva
74
73. 6. Host Genetics
• Gender and race can influence disease susceptibility, and possibly also affect the
microflora.
• The reasons for this are unknown, but may reflect some variation in the local
immune response.
• IgG2 is elevated in some forms of periodontal disease, and levels of this
immunoglobulin have been related to host genetics.
• Genetic polymorphisms associated with interleukin-1 (IL-1), or other cytokines, can
increase the likelihood of detecting certain key periodontal pathogens and
predispose individuals to periodontitis.
75
74. Benefits Of Normal Oral Microflora
• Prevent the invasion of body by pathogens.
• Synthesize vitamins especially vitamin k.
• Raise the overall immune status of the host.
• Produce bacteriocins & endotoxins and thus help in defense mechanism.
• The presence of a resident microflora prevents disease by reducing the
chance of colonization by exogenous species.
76
75. • AN UNDERSTANDING OF RELATIONSHIP BETWEEN ORAL MICROFLORA
AND HOST IS NECESSARY FOR DIAGNOSING ORAL INFECTION
• ORAL INFECTION USUALLY INVOLVE THE COMMENSAL MICROFLORA
• ANTIMICROBIAL PROPHYLAXIS SHOULD BE GIVEN CAUTIOUSLY
77
CONCLUSION
76. References
• Philip D Marsh-5th edition, oral microbiology
• Anant Narayan- 5th edition, textbook of microbiology
• Shafer’s-6th edition, textbook of oral pathology
• Shobha Tandon – 2nd edition, textbook of Pedodontics
• Damle -5th edition, Text Book Of Pediatric Dentistry
78
Oral microflora
S mutans
Window of infectivity
Lactobacilli in dental caries
Harbour : that can cause disease to spread
Microrogranisms found in human oral cavity
Before 2 Oral cavity is proximal part of both alimentary & respiratory tracts. Mouth is principal portal of entry of infectious agents & allergens into human body.
Hence, it is essential to understand the interaction of human beings & their pathogen prsnt in the environment, where mouth has its own microflora.
Oppurtunstic-microorganisms that has potential to cause disease when harmonous relation with host is alter
Koch's postulates were developed in the 19th century as general guidelines to identify pathogens that could be isolated with the techniques of the day.
Associate
Isolate
Inoculate
Reisolate
AEROBIC Microorg. that require O2 for growth. eg. mycobact. Tubrculosis
ANAEROBIC Microorg. that don’t require O2 for growth. eg. actinomyces, clostridium
CAPNOPHILIC Microorg. that require CO2 for growth. eg. hemophilus influenzea
OBLIGATORY Microorg. that require a specific environment for growth. E.g. obligatory anaerobes - clostridium
FACULTATIVE Microorg. that can grow in the presence or absence of a specific environment E.g. facultative aerobes
HABITAT Site where the microorg. grow
Symbiosis : is defined as condition where two dissimilar organisms living together in an intimate associate that seems both organisms benefit .
Before Microbial colonization of all environmentally exposed surfaces of the body begins at birth.
Commensalism: Eg. Many microbes live off secretions and dead cells and do not benefit or harm host.
Mutualism: Eg. E. coli synthesizes vitamin K and some B vitamins.
Parasitism: Eg. Most disease causing bacteria.
Exo: are micorgoransims are introduced by external world .endo : infection caused by normal flora under certain condition
a. eg: EXO - antibiotic t/t or frequent intake of fermentable carbs; ENDO - alterations in integrity of host defences following drug therapy
b. eg: when oral bact. enter bld stream following tooth extraction or other traumas n are disseminated to distant organs, where they can cause abscesses or endocarditis.
Endogenous- disease dat r produced by nrml flora in their host.
1.Micro-organisms with the potential to cause disease at exceptional circumstances - ‘Oppurtunistic Pathogens’. Hiv virus
Normal flora are the microroganisms that live on another living organisms or object without causing disease
The mixture of organisms regularly found at any anatomical site
Bacteria, fungi, protozoa, and viruses - derive from their host a steady supply of: Nutrients, stable environment, protection, transport
The host obtains from normal flora : nutritional & digestive benefit, stimulation of development, activity of immune system, protection against colonization
(When the number of resident normal flora is greatly reduced, opportunistic microbes can easily cause infections in these areas e.g. Candida albicans that cause candidiasis.)
Later on the slide - 1. Enteric secrete vit k, b12; 2. compete for attachment site 3. thru production of substance which kill non indigenous species. 4. cecum of germ free animal.
Indigenous : living or growing in theplace whee it can originally origin
Transient flora Nisseria, streptococcus pnemonia 4. As these transients normally do not have mechanisms for persisting in the crowded oral environment
Foetus in the womb is normally sterile.
Passive transfer occurs from the mother.
Mouth is highly selective for microorganisms even during the first few days of life.
Bifidobacterium is a genus of gram-positive, nonmotile, often branched anaerobic bacteria. They are ubiquitous inhabitants of the gastrointestinal tract though strains have been isolated from the vagina and mouth of mammals, including humans
UBIQUTIOUS : seeming to be everywhere or in several places at a same time .
pioneer species /: The first microorganisms to colonize are termed pioneer species, and collectively they make up the pioneer microbial community.
Pioneer organisms also called as disaster taxon. Organisms that populates a region after a natural diaster ,mass extincatrion or any other events that kills most of the life of that region
An ecological niche is the role and position a species has in its environment; how it meets its needs for food and shelter, how it survives, and how it reproduces.
A species' niche includes all of its interactions with the biotic and abiotic factors of its environment.
----the progressive development of a pioneer community (containing few species) through several stages in which the number of microbial groups increases, until an equilibrium is reached; this is termed the climax community
The oral cavity of the newborn contains only epithelial surfaces for colonization. The pioneer populations consist of mainly aerobic and facultatively anaerobic species. In full-term babies, a range of streptococcal species have been recovered during the first few days of life, and S. oralis, S. mitis biovar and S. salivarius were numerically dominant.
the diversity of the streptococcal microflora increases with time; after one month, all babies were colonized by at least two species of Streptococcus, with S. salivariu.
pioneer species /: The first microorganisms to colonize are termed pioneer species, and collectively they make up the pioneer microbial community.
the progressive development of a pioneer community (containing few species) through several stages in which the number of microbial groups increases, until an equilibrium is reached; this is termed the climax community
4. Which enables the MS to colonize the oral cavity
Cfu-colony forming unit
Cfu is the measure of viable coloonogenic cell in per cfu/ml
little evidence of father infant (or father–mother) transmission of mutans streptococci was observed, although horizontal transmission between spouses, and vertical transmission within family units, can occur with some periodontal pathogens, such as Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans.
Knowledge regarding the natural history of an infectious disease facilitates a more comprehensive approach toward its prevention.
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S salivarius –birth
-S mitis -7
S mutans -
Before 1 Immediately after birth (<5 mins) - the bact. communities +nt in diff. habitats of the newborn (oral, nasopharyngeal, skin, and intestines) are very similar to each other.
After 2 Great variability appears to exist in the bacterial composition for the first few days of life. For example, one can detect several species of streptococci, pneumococci, micrococci, enterococci, staphylococci, veillonella, c . Most of these organisms are found sporadically,
Around 5 months of age, infants already show a distinct oral microbiota from the mother, due to environmental exposure that occurs in the first months of life, particularly through the ingestion of food, contact with other adults and children, contact with domestic animals, hygiene habits, (At this stage, the most frequent colonizers of the oral cavity are Gram-positive cocci, including Streptococcus and Staphylococcus)
After 1 Thus the mucous membranes of the infant oral cavity are ideal for this organism to proliferate.
After 3 but one would not expect to find them in significant proportions because conditions in the oral cavity at this time are not conducive for their maximal retention and growth.
It should be noted that "anaerobic“ genera can be found although in low numbers in the oral microbiota of the child less than one year of age. Thus, Nocardia, Actinomyces and Veillonella are found with increasing regularity in the infants mouths up to one year of age.
Summarize Oral flora in the child’s first year, consists of :
Streptococcus, staphylococcus, neisseriae & Lactobacilli.
Anaerobes such as veillonella & fusobacterium.
(Anaerobic fusiform bacilli – present in mouths younger than 2 months & infants before eruption of incisors.
Fusiform bacilli – inc. in number during the 4-8 months.
Peptostreptococcus appears in 5 months older infants)
After 1 . For example, the incidence of S. mutans increases significantly as infants grow older.
In adolescence
With the eruption of permanent teeth, there is increase in the anaerobic forms.
Like bacteriodes, leptotrichia, fusobacteria, spirocheates and vibrio
Before everything The proportions of the predominant cultivable organisms from the gingival crevice area of the preschool child appear to generally resemble that of the adult with the exception that spirochetes and Bacteroides melaninogenicus were not present in all children
The incidence of B. melaninogenicus in children about 5 years of age ranges from 18-40%, however by 13-16 years of age essentially all individuals harbour this organism.
reason for the late establishment not clear.
Possibly conditions essential not be provided
For example, heme and a 2 globulin might not be available in abundance due to a "normal" gingival sulcus. In addition, it is likely that repeated transmission is necessary for these organisms to become established particularly for the spirochetes which are uniquely sensitive to oxygen and are liable to be killed on exposure to air
Adult shall discuss it in part 2
oral MICROFLORA CHANGES WITH AGE
Four major ecosystems are present in the oral cavity
Buccal mucosa – predom. – S. mitior, with S. sanguis n salivarius.
Hard palate – (resembles buccal mucosa) predom. - streptococci.
Soft palate- Harbours resp. tract bact. - Corynebacterium, Neisseria, Haemophilus.
Tongue - Is an ideal site for retention of microorg d/t its keratinized dorsal surface. S. salivarius –50% of the total. S. mitior - also common.
Teeth and artificial hard surfaces - Fissures and deep grooves in the teeth, especially with regard to the occlusal surfaces of posterior teeth, provide ideal conditions for the formation and build-up of dental plaque. As these areas are seldom in direct contact and mechanical friction, which also removes bioflim from these surfaces.
Gingival crevice - most numerous bact. population among all sites d/t absence of dislodging forces and GCF acting as a rich nutrient medium.
The clinical significance of their presence in the oral cavity is that they are responsible for the plaque formation d/t their interaction with each other and the tooth surface. (Discussed in part 2)
1884- Christian Gram- helps in the classification and differentiations of microorganisms.
Gram positive- some of the bacteria are able to retain the voilet, blue and some are decolorized by alcohol
The cell walls of gram positive bacteria have a thick layer of protein-sugar complexes called peptidoglycan and lipid content is low. Decolorizing the cell causes this thick cell wall to dehydrate and shrink, which closes the pores in the cell wall and prevents the stain from exiting the cell.
Gram negative bacteria, cell wall also takes up the CV-Iodine complex but due to the thin layer of peptidoglycan and thick outer layer which is formed of lipids, CV-Iodine complex gets washed off. When they are exposed to alcohol, decolorizer dissolves the lipids in the cell walls, which allows the crystal violet-iodine complex to leach out of the cells. Then when again stained with safranin, they take the stain and appears red in color.
Procedure of gram staining heat fixed smear crystal violet iodine acetone/alc safranine
Hemolysis occur into 5 % horse agar
Based on their haemolytic properties: 3 types of rxns seen on bld agar medium
Alpha viridans grp of strep. N pneumococcus
Beta most pathogenic strep. Mainly s. pyogenes (majority of human infections); s. pyogenes further classified based on their surface proteins (M) into 80 Griffith serotypes
The species most frequently isolated from the oral cavity are Streptococcus salivarius, Streptococcus sanguis, Streptococus mitis, and mutans Streptococci
S. mutans polymerizes the glucose and the fructose moieties of sucrose to synthesize glucans and fructans, which are two types of extracellular polymers.
The enzymes responsible for the synthesis of extracellular glucans and fructans are called glucosyl- and fructosyl transferases, respectively.
Synthesis of glucans from sucrose has been considered for several years to be the essential glue in S. mutans attachment to enamel and subsequent plaque formation.
Primary pathogen in:
Enamel caries in children and young adults
Root surface caries in the elderly
Nursing caries in infants
After 1S. salivarius, becomes well established within 2 days of birth.
After 2 Produce large quantities of an unusual extracellular fructan from sucrose.
S.intermedius strains produce a protein toxin, intermedilysin.
Normal inhabitants of the mouth, throat and nasopharynx.
Usually an etiologic agent in odontogenic infections and endocarditis.
The prevalence and proportions of a wider range of streptococcal species were reported from a group of infants before and after tooth eruption.
Acidogenic – produces great amt of acids
Aciduric- can tolerate acidic enviornments.
LAST Some species have been associated with dental caries although these bacteria are normally symbiotic in humans and are found in the gut flora.
A strong correlation has been established between the saliva Lactobacillus count and dental caries,
More than 40 species of Bacteroides have been identified.
Before everything Actinomyces from Greek word "actis" ray, beam and "mykes" mucus, fungus.
Initially assumpted to be a fungus.
Individual bacteria are rod-shaped, morphologically Actinomyces colonies form fungus-like branched networks of hyphae.
A. viscosus and A. naeslundii have been implicated in the etiology of periodontal disease.
Fusobacterium: F. nucleatum periodontal pathogen
Extrinsic temperature
Intrinsic ph redox potentintial
The human mouth is kept at a relatively constant temperature (35–36°C) which provides stable conditions suitable for the growth of a wide range of microorganisms.
Periodontal pockets with active disease (inflammation) have a higher temperature up to 39°C) compared with healthy sites. Even such relatively small rises in temperature can significantly alter bacterial gene expression, and possibly the competitiveness of individual species.
A rise in temperature down-regulated expression of some of the major proteases as well as the gene coding for the major subunit protein of fimbriae
Enzymatic reactions are oxidation – reduction reactions in which one compound is oxidized and another compound is reduced
Eh is the measurement of the ease in which it gains or loose the electron
Oxidation reduction potential is nothing but is the ratio of total oxidizing (electron accepting) power to the total reducing power (electron donateing)power of substance.
Oxygen concentration is the main factor limiting the growth of obligately anaerobic bacteria.
after 4 line ---It is the commonest and most readily reduced electron acceptor in the majority of microbial habitats, and its presence results in the oxidation of the environment..
1. And are extremities of acid and alkali
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
the pH then recovers slowly to resting values.
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 that are associated with healthy sites can tolerate brief conditions of low pH, but are inhibited or killed by more frequent or prolonged exposures to acidic conditions.
These latter conditions are likely to occur in subjects who commonly consume sugar-containing snacks or drinks between meals
This can result in the enhanced growth of, or colonization by, acid-tolerant (aciduric) 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.
Before everything ---Exogenous nutrients are the process in substances entering the body from the enviorment .
After 2 line ----Ingested food is broken down into comparatively simple chemical compound which are absorbed and then used to build tissues and organs to regulate functions .
carbohydrates can be broken down to acids while, additionally, sucrose can be converted by bacterial enzymes (glucosyltransferases, GTF, and fructosyltransferases, FTF) into two main classes of exopolymer (glucans and fructans) which can be used to consolidate attachment or act as extracellular nutrient storage compounds.
.
The levels of acid-tolerating species, especially mutans streptococci and lactobacilli, increase while the growth of acid-sensitive species (for example, some strains of Streptococcus sanguinis and S. gordonii) is inhibited, and they decrease. The metabolism of plaque changes so that the predominant fermentation product becomes lactate. Such alterations to the microflora and its metabolism can predispose a site to dental caries.
Lastly ------Dairy products (milk, cheese) have some influence on the ecology of the mouth. The ingestion of milk or milk products can protect the teeth 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 metabolise casein
2. For eg: chemical properties of salivary mucins result in the formation of hydrophilic, viscoelastic gels function as protective barrier as well as bacterial aggregating factors.
3. they are termed as innate immunity and adaptive immunity
After 1 line ----because they are lost at an even faster rate by swallowing. Although saliva contains between approximately 10*8 viable microorganisms ml−1, these organisms are all derived from dental plaque and the oral mucosa, especially the tongue.
2.Produced by plasma cell in salivary gland.
3. by virtue of its local dispersal of environment antigens
4. but are derived from GCF it contains leukocytes