#2 Oral Microbiome and Systemic Disease Flashcards Preview

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Flashcards in #2 Oral Microbiome and Systemic Disease Deck (39)
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1
Q

2 aims of the Human micro biome project

A

-characterize microbial communities form multiple human body sites-find correlations between micro biome changes and human health

2
Q

we used to think of microbes as “germs” that are pathogenic invaders but now we are switching our thinking to believe that some are _____

A

essential

3
Q

3 ways microbes are beneficial

A

-resistance against pathogens-metabolic functions-immune activation (if kids are too clean they will have immune problems later in life)

4
Q

old goal of bacteria vs new goal of bacteria

A

old: sterile environmentnew: manage and preserve NATIVE microbes

5
Q

old way of thinking in which it was believed that a disease is caused by a single cause

A

Koch’s postulate*now we now it is a community disruption and loss of healthy species

6
Q

what are two example of OLD therapies that focused on broad eradication

A

-antibiotics-antiseptics

7
Q

what are three examples of NEW therapies to encourage healthy communities

A

-probiotics (yogurt)-prebiotics (encourages growth of good bacteria)-targeted antimicrobials

8
Q

idea that oral “focus of infection” causes systemic disease

A

theory of focal infection*Hippocrates cured arthritis by pulling a tooth

9
Q

this was an old way thought to treat mental illness

A

therapeutic eduntulation (pulling teeth)*ended by 1930

10
Q

when did evidence for connections between oral infections and systemic diseases start?

A

25 years ago with cardiovascular disease

11
Q

oral-systemic connections

A

-infective endocarditis (infection of heart valves)-pneumonia-cardiovascular disease-type 1 diabetes-cancer-preterm birth-immunosuppression-biofilm infections on implanted devices

12
Q

what are the two direct mechanisms for oral connections to systemic diseases?

A

-translocation of bacteria (seeded by oral bacteria)-translocation of toxin (produced by oral bacteria)

13
Q

what two things constitute good evidence for oral systemic effects?

A

-epidemiologic studies (no correlation)-evidence of causality —human trials show tx prevents disease—presence of oral bacteria at disease site—effect in animal model

14
Q

spread of bacteria throughout the blood

A

bacteremia

15
Q

60% of the oral bacteria

A

streptococci (sanguis, mitis, mutans)

16
Q

in practice does antibiotic prophylaxis prevent bacteremia?

A

no

17
Q

what are the two risks to antibiotics?

A

-allergy-cost

18
Q

T/F dental procedures associated with infective endocarditis

A

False

19
Q

how do you reduce the risk of getting Infective Endocarditis?

A

-good health and hygiene-optimize regular hygiene measures to keep bacterial load low than give antibiotic prophylaxis

20
Q

aspiration pneumonia is caused by what two things?

A

-aspirations of oral secretions-oral bacteria

21
Q

when is Pneumonia seen?

A

common when airway protective refexes compromised—physically handicapped or elderly

22
Q

what prevents lung infection?

A

oral hygiene measuresreduce nosocomial pneumonia by 40%could prevent 10% of deaths in nursing homes

23
Q

how is preterm birth carried out?

A

bacteria in the amniotic fluid, some of them common oral species, associate with it

24
Q

does periodontal tx reduce the risk of pre-term birth or low birth weight?

A

no*no strong evidence for cause and effect relationship

25
Q

tx of periodontitis improves what?

A

glycemic controlshows causality btw periodontitis and diabeteshyperactive innate immune response of both*synergistic effect on inflammation

26
Q

what is the effect of treating oral bacteria to help with cardiovascular disease

A

effect is modest

27
Q

inc risk of what type of cancer with periodontitis

A

pancreas

28
Q

cardiovascular implantable electronic device infections are caused by what?

A

bacteria from skin of pts or hands of hospital workers or environment*recommend NO antibiotic prophylaxis for dental treatment

29
Q

____ rates are high when the infection is around a vascular graft/stent *90% caused by bacteria native to skin or bowel

A

mortality *recommend NO antibiotic prophylaxis for dental treatment

30
Q

what percentage of joints become infected

A

1-2%morbidity is highmost infections occur in preoperative period from wound contamination

31
Q

evidence for PRIMARY antibiotic prophylaxis relating to joints is when?

A

at the time of device placement

32
Q

is there any dental risks associated with joints?

A

no

33
Q

concerning joints, late infections occur from where?

A

hematogenous seeding

34
Q

is there an indication for antibiotics to prevent oral bacterial source for pts with pins, plates, and screws?

A

no

35
Q

is prophylaxis recommended with cerebrospinal fluid shunts?

A

nono vascular structures so low bacteremiahigh rate of infection

36
Q

do dental procedures cause infections with CSF shunts?

A

no

37
Q

what conditions involve DIRECT TRANSFER OF ORAL BACTERIA?

A

-infective endocarditis-pneumonia in compromised airway-immunosuppression-preterm birthprimary preventative strategy is to improve oral health and reduce bacterial loadantibiotic prophylaxis is indicated in specific HIGH RISK situations

38
Q

what conditions involve TRANSFER OF ORAL BACTERIA OR TOXIN, OR COMMON INFLAMMATORY PATHWAY

A

-type II diabetes-cardiovascular disease-pancreatic cancerprimary preventative strategy is to treat periodontal disease to improve microbial profileimprove overall health by improving risk factors

39
Q

what conditions involve NON ORAL CONDITIONS

A

-cardiovascular implantable electronic devices-vascular grafts/stents-intravascular access devices-prothetic joints-bone pins, plates, screws-renal dialysis shunts-CSF shunts*no specific oral precautions