Public healt

1. Bacterial Infections Of
Oral cavity
By : Ahmed Jawad
Group A1

2. Introduction
Bacteria constitute a large domain of
prokaryotic microorganisms.
Few micrometres in length .
Different shapes, ranging from
spheres to rods and spirals .
They lack true nucleus .

3.  Can be classified to Gram +ve & Gram –ve
Bacteria
 Many of the bacteria have Flagellae & Pili
 Healthy people may carry:
• 1012 bacteria on skin.
• 1010 in mouth.
• 1014 in GIT.

4. Tuberculosis
Infects about 1/3 of world’s
population
Kills approximately 3 million people
per year
Most important cause of death in
the world

5. caused by aerobic, non-spore
forming bacillus Mycobacterium
Tuberculosis
It has :
 Thick , Waxy coat
 Doesn’t react with Gram Stains

6. It can be spread through small airborne droplets
The organism will be carried to the Pulmonary air
spaces.

7.  Primary Tuberculosis
•Occurs in previously unexposed people.
•Almost always involves the lungs.
•Most infections are the result of direct person -
to – person spread.
•Results only in a localized , fibrocalcified nodule .

8. Secondary Tuberculosis ( Active Disease )
•Develops later in life from a reactivation of
organisms.
•This reactivation is typically associated with
compromised host defenses
Immunosuppressive medication Or HIV Patients
Diabetes
Old age

9. Clinical Signs And Symptoms :
1. Primary T.B : Usually asymptomatic.
2. Secondary T.B :
 Low grade fever
 Malaise
 Night sweats and weight loss
 With progression , hemoptysis and chest pain.

11.  Oral Tuberculosis
If oral cavity is involved , it is presented either as :
1. Primary infections
Effects
 Gingiva
 Mucobuccal fold
 Areas of inflammation

12. 2. Secondary infection ( more common )
Effects:
 The tongue
 Palate due to infected sputum

13.  Typical lesion
Indurate Chronic
Nonhealing Ulcer
That Is Usually Painful
Bony involvement of maxilla and mandible produces
tuberculosis osteomyelitis

20.  Diagnosis
•Tuberculin skin test.
•Biopsy (with special stains)
•Polymerase chain reaction (PCR) for
bacterial DNA detects the disease.

21.  Treatment
First line drugs likely to used fro treatment of TB include
• ISONIAZID
• RIFAMPIN
• PYRAZINAMIDE
• EXAMBUTHOL

22.  Drug combinations are often used in 6, 9, or 12
month treatment regimens.
Bacille Calmette Guerin (BCG) vaccine is effective
in controlling childhood TB.

23. Syphilis
 STD Disease
 Caused by Treponema Pallidum
 Two Types:
 Acquired
 Congenital

24. Acquired Syphilis
 Acquired syphilis is subdivided into:
1. Primary Syphilis:
Characterized by the appearance of “Chancre”
A firm nodule in which the surface breaks up in a few
days leaving a round hard ulcer
Chancre is typically painless and heals spontaneously
in weeks

26. 2. Secondary Syphilis :
• Develops in 1 to 4 months of initial infection.
• It Causes:
 Mild Fever - Malaise
 Sore Throat
 Headache
 Muscle Pain
 Generalized lymphadenopathy
 Rash and Stomatisis

27.  Numerous red macules and papules
occur in the mouth & palate as ulcers
White grey plaque on the tongue ,
gingiva , palate and buccal mucosa
The Ulcer Discharge contains many
spirochetes

29. 3. Tertiary syphilis
Latent period of 1-30 years between secondary
and tertiary stage
 Presented as
 Neurological defects
 Cardiovascular defects

30. Oral findings in tertiary
syphilis
 Atrophic Glossitis :
smooth shiny tongue

31.  Gumma : At the tongue ,
palate , tonsils , begins as
swelling that ulcerate and
destroy the underlying
tissue that may cause
perforation of the palate

32. Congenital syphilis
 Passing syphilis from the mother to the child
 Results in classical symptoms called triad of
Hutchinson:
 Corneal Keratitis
 Deafness ( involvement of the 8th cranial nerve)
 under development of the maxilla , palate and
saddle nose

33. Hutchinson’s notched incisors, mulberry-shaped molar teeth .

35. Actinomycosis
Chronic bacterial disease
Caused by Gr +ve anaerobic Actinomyces Israeli
About 55% occur in cervicofacial region
Not regarded as contagious because infection cannot be
transmitted from one individual to another
 Usually appears after Trauma , Surgery and previous infection

36. When occurs in the Head and Neck it
appears as:
• Swelling of Mandible.
• Skin lesion are indurated.
• Having woody hard consistency.
• Results in Osteomyelitis that may drain
through gingiva.

37. Treatment
Drainage of abscess
surgical excison of sinus tracts
Long-term, high-dose
penicillin
For severe cases, IV penicillin
followed by oral penicillin

38. Gonorrhea
Most common sexually transmitted
bacterial infections
Caused by gram -ve diplococcus Neisseria
gonorrhea

39. Short incubation period of less than 7 days
Absence of symptoms in many individuals,
especially females
Transmission from an infected patient to
dental personnel is regarded as highly
unlikely
Requires break in skin or mucosa to establish
an infection

40. Oral Findings
I. No specific clinical signs have been
consistently associated with oral gonorrhea.
II. Multiple ulcerations
III. Generalized erythema
IV. Cervical lymphadenopathy
V. Chief complaint may be sore throat

41. Treatment
Uncomplicated gonorrhea responds to single dose of
appropriately selected antibiotic.