Lecture 2: Oral bacteria and systemic disease

Question 1

paradigm shift in microbiology: chronic diseases caused are caused by _______

Answer 1

microbial community disruptions

Question 2

paradigm shift: therapies to encourage healthy communities focus on?

Answer 2

• probiotics
• prebiotics
• targeting antimicrobial

Question 3

What defines all microbes, their genomes, and interactions in a defined environment

Answer 3

microbiome

Question 4

how many species are in oral microbiome?

Answer 4

1000

Question 5

how many genes are in human dna? base pair sequences?

Answer 5

20,000-25,000, 3 billion base pairs

Question 6

T/F there are more bacterial cells than human cells

Answer 6

true

Question 7

T/F bacteria colonize differently at different sites

Answer 7

true

Question 8

what type of bacteria predominates the oral cavity?

Answer 8

streptococcus

Question 9

what is the theory that removing the oral focus of infection could cure systemic disease?

Answer 9

theory of focal infection

Question 10

T/F epidemiologic studies show association and causation

Answer 10

false, cannot show causation

Question 11

what are the 3 mechanisms for oral bacteria causing systemic diseases?

Answer 11

1. distant site infection seeded by oral bacteria
2. distant site injury from toxin produced by bacteria in oral cavity
3. host genetic hyper-susceptibility to inflammation is common pathway to disease

Question 12

what are examples of distant site infections seeded by oral bacteria ?

Answer 12

• oral bacteria gaining entry to circulatory system (bacteremia) or airway (aspiration)

Question 13

T/F infective endocarditis can be caused by oral bacteria traveling through the bloodstream to the heart

Answer 13

true

Question 14

T/F endotoixns from gram positive bacteria in perio pockets may gain entry to blood and cause cardiovascular disease

Answer 14

false, gram negative

Question 15

What are some examples of host hyper-susceptibility to inflammation causing disease?

Answer 15

• periodontitis
• cardiovascular disease
• obesity
• diabetes
• insulin resistance
• pancreatic cancer

Question 16

What is nonbacterial thrombotic endocarditis (NBTE) formed from?

Answer 16

platelets and fibrin adhering to exposed CT

Question 17

What binds to NBTE?

Answer 17

bacteria from distant sites (oral cavity)

Question 18

What types of oral bacteria are involved in infective endocarditis?

Answer 18

• streptococci (60%+) (sanguis, mutans, mitis)
• aggregatibacter actinomycetemcomitans
• gemella

Question 19

what type of skin bacteria are involve in infective endocarditis?

Answer 19

• staphylococci (25%)

Question 20

T/F dental procedures are associated with infective endocarditis

Answer 20

false, no evidence

Question 21

antibiotics carry risk of ___ and ____

Answer 21

allergy and resistance

Question 22

T/F poor oral hygiene and gingival disease are associated with increased risk for bacteremia in IE

Answer 22

true

Question 23

T/F dental procedures are more likely to causeIE than random bacteremia from daily activities (brushing and chewing food)

Answer 23

false

Question 24

indications for antibiotic prophylaxis

Answer 24

• invasiveness of procedure

- high risk IE

Question 25

what is used for antibiotic prophylaxis

Answer 25

single high dose of amoxicillin

Question 26

what is the most common cause of oral bacteria leading to pneumonia?

Answer 26

- compromised airway protective reflexes in elderly

Question 27

T/F aspiration of oral secretions can cause pneumonia

Answer 27

true

Question 28

T/F improving oral hygiene in elderly can reduce pneumonia by 40% and 1/10 deaths

Answer 28

true

Question 29

_____ in mother is associated with preterm birth

Answer 29

periodontitis

Question 30

T/F there is a strong relationship between periodontitis and preterm birth

Answer 30

false, causual relationship

Question 31

During immunosuppression, there is a high risk for ______ or ______ of oral origin

Answer 31

disseminated strep or candida

Question 32

T/F there is strong evidence for relationship of systemic diseases during immunosuppression caused by dental treatment or efficacy of antibiotics

Answer 32

false

Question 33

What are cardiovascular implantable electronic device infections (CIED) infections likely caused by?

Answer 33

staph from skin of hospital worker

Question 34

When implanted CIED, is AP recommended for dental treatment?

Answer 34

no

Question 35

Most infections (90%) of vascular graft infections are caused by bacteria native to ____ or ____

Answer 35

skin or bowels

Question 36

Is AP recommended during dental treatment if patient presents with a vascular graft/stent?

Answer 36

- not recommended | - surgeon may ask for AP because there is a high mortality rate with vascular graft infection

Question 37

T/F patients with intravascular access devices require AP for dental treatment

Answer 37

false, infections caused by staph

Question 38

what percentage of bacteria in a joint infection is oral bacteria?

Answer 38

5%, mostly caused by skin staph

Question 39

T/F AP is not needed for dental treatment in patient with prosthetic joint

Answer 39

true, but patient preference should be considered

Question 40

There is evidence for ______ at the time of joint prostheses placement, but there is lack of evidence for _______ to reduce bacteremia from distant site infections

Answer 40

- primary antibiotic prophylaxis | - secondary prophylaxis

Question 41

T/F bone pins, plates, and screw infections are caused by staph or skin bacteria and AP is not indicated for dental treatment

Answer 41

true

Question 42

T/F cerebrospinal fluid shunts have a high rate of infection to oral bacteria

Answer 42

false - do not involve vascular structure (low bacteremia) - mostly skin infections (high rate of infection)

Question 43

T/F there is increased prevalence of periodontitis in diabetics

Answer 43

true

Question 44

T/F there is a common pathway between periodontitis and diabetes

Answer 44

true, hyperactive innate immune response

Question 45

Coronary heart disease, stroke, and peripheral vascular disease all associated with ______

Answer 45

periodontitis, no causative relationship though

Question 46

T/F studies show increased risk of pancreatic cancer in patients with periodontitis

Answer 46

true

Question 47

T/F systemic lupus is associated with oral bacteria

Answer 47

false | - most patients have mitral valve insufficiency

Question 48

4 diseases with direct oral connection

Answer 48

1) infective endocarditis 2) pneumona in a compromised airway 3) immunosuppression 4) preterm birth

Question 49

3 diseases with possible transfer of oral infectious agent, but common pathway most likely

Answer 49

1) type 2 diabetes 2) cardiovascular disease 3) pancreatic cancer

Question 50

T/F oral bacteria have limited range and limited ability to cause systemic disease

Answer 50

true