Oral hygiene Flashcards
what is oral health
A state of the oral and related tissues and structures that contributes positively to physical, mental and social well-being and to the enjoyment of life’s possibilities, by allowing the individual to speak, eat and socialize unhindered by pain, discomfort or embarrassment
current state of oral health
- 74.5% canadian go to annual dental visit
- most have access to dental care and report good oral health
- 95.9% of adult over 20 have had a cavity
what are the 4 structural components of the tooth
Enamel: hard outer coating protecting the crown
Dentin: hard substance beneath enamel: makes up the bulk of tooth, microscopic tubules that transfer nutrients
Pulp: soft tissue in middle of tooth: lots of nerve endings, if decay reaches it can get infraction, lots of pain -> need root canal
Cementum: hard itssue covering root and attaches it to jaw bone
what is a biofilm
• Sticky, mat-like microbial communities
- > Organisms cooperate (synergistic)
- >Teamwork ensures their mutual survival
- 700 oral microbila special contribute to dental plaque biofilm
- > types: supragingival and subgingival
- > buildup is direcctly related to incidence of oral disease
how does a biofilm form
- initial adherance
- tooth surface covered by acquired pellicle
- primary colonizing bacterial (primarily gram pos cocci and rods) ahdere to pellicle
- Lag phase
- attachment to pellicle leads to shift in genetic expression that causes lag in bacterial growth\
- Rapid growth
- other types of bacteria ahdere to primary colonizers: forms mature dental biofilm
- primaru colonizers: gram pos cocci
- secondary colonizers: fusobacterium
- final biofilm: mostly pathogenic gram neg
- other types of bacteria ahdere to primary colonizers: forms mature dental biofilm
- Steady statte/detachent
- some surface bacteria disperse to colonize other areas of mouth
How does a biofilm cause oral disease
- accumulation on tooth surfaces leads to caries
Accumulation along & under the gingival margin often leads to gingivitis
• Chronic gingivitis -> periodontitis
how are systemic and oral health connected
- systemic conditions have oral manifestations
- treatments for systemic condiions have oral health effects
- oral diseases have impacts on treatments for systemic conditions
*inflammation is pathway that links
what are the main microbial players in oral health
A. actinomycetemcomitans, T. forsynthia, T. denticola, P. gingivalis ( highest risk pathogen)
*P.gingivalis is considered a keystone pathogen in development of many systemic diseases
- > translocated dueing normal oral hygiene activites
- > deposits in tissues of heart, liver and placenta
- systemic spread happens quickly and gradually -> chornic & pathologic inflammation repsonse
- > highest proteolytic activity; induced dysbiosis; produces endotoxins (LPS) -> proinflammatory cytokine release
what systemic diseases are associated with oral pathogens
- alzheimer disease
- cardiovascular disease
- oral colorectal carcinomas and GI diseases
- respiratory tract infection and bacteria pneumonia
- adverse pregnancy outcomes
- diabetes and insulin resistance
link between cardiovascular health and oral health
- oral microbes can enter general circulation
- > people with periodontal disease have 2x higher LDL
- > endotoxins released make BV more permeable & more inner layer of arterial walls stickier (makes it easier to deposit)
*studies support an association between PD and atherosclerotic vascular disease but does not support a causative relationship
connection between PD and diabetes mellitus
- inflammation in oral cavity impairs bodies ability to control blood sugar and utilize insulin
- high blood sugar makes one more prone to infection like PD
- patients with diabetes have higher prevalence of PD as diabetes is a risk factor
- poor blood glucose control is associated with PD
- PD increases systemic inflammation and contrinutes to problems with glycemic control
*PD treatment -> 10-20% improvement in glycemic control
connection between PD and GI health
- GI is a highway from oral cavity to rectum
- > leaky gut syndrome: oral microbes associated with periodontal disease, can impact gut lining
- pancreatic cancer: H. pylori and P. gingivalis are heavily involved (believed to trigger tumour formation on pancreas)
connection between PD and pulmonary health
- abundant evidence that PD affect lung health
- pulmonary disease characterized by:
- > inflammatory mediators found in saliva & gingival crevicular fluid
- > oralpharyngeal structures serve as resevoirs that harbour bacteria (can become pathogenic)
- if fluids are aspirated: triggers inflammatory response -> build up of fluid & lung exudate
*associations are well established does nto establish causation
what other disease are associated with PD
- Liver Disease
- intestinal bacteria of patients with cirrhosis contain large number of oral deried microbes (P. Gingivalis)
- pro-inflammatory mediators can cause cirrhosis
- Systemic Lupus Erythematosis
- characterized by persistent inflammation -> oral damage
- linked to microbial dysbiosis
- Rheumatoid Arthritis
- characterized by chronic inflammation
- linked to microbial dysbiosis
- Oral antiseptic treatment for PD has been shown to be protective against RA-induced bone loss
Associated with PD and dementia
- Research supports a strong association with PD
- bi-directional relationship
- > cytokines form oral cavity -> bloodstream/brain
- > alzheimer’s patients -> poorer oral hygiene, inability to report pain
