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Up to 5-6 months
S. viridans, S. oralis, S. sanguinis, lactobacilli, diphteroids
Teeth eruption
1. Infectious window period for S. mutans, G- cocci (Veilonella,
Neisseria), anaerobic streptococci, gramm negative rods
Adolescence
G- anaerobes (Prevotella), Porphyromonas spp. , Capnocytophaga spp.,
anaerobic Vibrio spp., spirillae
100%
80%
filaments and
fusobacteria
spirili and vibrio
spp.
60%
40%
20%
0%
0
Toothbrushing
11
No oral hygiene
13
15
days
Toothbrushing
Investigating association of
microbial flora with dental caries
Taxonomy I.
(Bergeys Manual of Determinative Bacteriology 2nd Edition, 1992)
Domain (Bacteria)
Kingdom (Procaryotae /Monera/)
Phylum (Firmicutes)
Class (Bacilli)
Order (Lactobacillales)
Family (Lactobacillaceae)
Genus (Streptococcus)
Species (S.
mutans)
Oral lactobacilli
Heterofermentative
main substrate: starch (glucose,
maltose, dextrins)
slow metabolism
produce only 50% lactic acid and
considerable amounts of ethanol,
acetic acid and carbon dioxide
not so low pH
L. casei
L. fermentum
L. salivarius
L. plantarum
L. brevis
L. cellobiosus
L. buchneri
Homofermentative
main substrate: glucose,
sucrose
rapid metabolism
produce more than 85% lactic
acid from glucose
low pH
L. acidophillus
L. acidophillus sensu
stricto
L. crispatus
L. gasseri
L. rhamnosus
S. mutans ecological
requirements
Presence of solid surfaces in the oral cavity
hard dental tissues, dentures, infant obturator in cleft
children
Repeated infection
Increased frequency of sucrose intake
Ecological niche
mode of existence that a species has within an ecosystem
smaller proportion of other viridans streptococci (showing
alpha haemolysis on blood agar - S. viridans, S. oralis, S.
sanguinis)
S. mutans topography
Lactobacilli topography
Carious defects
Proportion in salivary planktonic bacteria
partially reflects the proportion in plaque
saliva as material for microbial examination
Treatment of carious defects does decrease the
proportion of SM in plaque
Actinomycetes - ecological
requirements
Presence of solid surfaces in the oral cavity
hard dental tissues, dentures, infant obturator in
cleft children
Actinomycetes topography
Interdental spaces
Subgingival plaque
Carious defects
Proportion in salivary planktonic bacteria does
not reflect the proportion in plaque
Treatment of carious defects does not decrease
the proportion of A. in plaque
Abundant in the human mouth and induce root
surface caries in hamsters and gnotobiotic
animals
Heterofermentative lactobacilli
Optimum pH for metabolism 3.5 5.5
Enzymatic set for intensive glycolysis
Amylase
Relationship of other
microorganisms to dental caries
Mixed flora of dental plaque
Microaerophilic conditions for cariogenic
microorganisms
Aciduricity (tolerance of, and growth at low pH)
Co-aggregation increased cohesion of plaque
proteases destruction of protein matrix
of
enamel/dentin
amylase hydrolysis of starch to oligosaccharides
Kochs postulates
Suspected pathogenic microorganism should be
present in all cases of the disease and absent from
healthy animals
The microorganism should be grown in pure
culture
Cells from pure culture should cause disease in a
healthy animal
The microorganism should be re-isolated and
shown to be the same as the original
Production of polysaccharides by SM
Extracellular polysaccharides ( 1-3, 1-4, 1-6
glucane) adhesion factor
glucosyltranspherase (GTF)
Extracellular polysaccharides
Microorganism
Extracellular polysaccharides
S. mutans
mutane
dextrane
lactobacilli
2-6, fructane
levane
actinomycetes
2-6, fructane
1-6, glucane
levane
dextrane
Density of plaque
Fermentable
polysaccharides
EPS
Cariogenic
plaque
Noncariogenic
plaque
Chemo-parasite theory
W.D.Miller 1892
Dental caries occurs as a result
of hard dental tissues
demineralization with organic
acids end products of sucrose
metabolism of oral
microorganisms.
S. sanguis
lactobacilli
actinomycetes
Enough of
sucrose acidic
pH
Healthy tooth
caries
Microbial
agent
Defending
mechanisms
Microbial agent
Defending
mechanisms
specific
pathogen
or virulent
genotype
Defending
mechanisms
Hypotheses integration
Non-cariogenic
spectrum of
plaque
Cariogenic
spectrum of
plaque
virulent
virulent SM
SM and
and
lactobacilli
lactobacilli
genotypes
genotypes
Selective genetic
pressure
acidophilic
acidophilic
flora
flora
(lactobacilli)
(lactobacilli)
Selective
ecological
pressure
aciduric
aciduric flora
flora
(S.
(S. mutans)
mutans)
Window of infectivity
C.W. Caulfield 1993
Beginning of the
eruption of
temporary teeth
Beginning of the
eruption of
permanent teeth
Repeated
infection
Repeated
infection
Window of
infectivity
0
6
age
12
18
24
months
Succedaneous
window of
infectivity?
30
36
6
years
Infection entry
Repeated transmission
Contributing factors
window of infectivity
Tooth
Caries
experience
S. mutans
S. sanguinis
lactobacilli
With caries
low
2.0
With caries
high
25
Caries free
intact
dentition
<1
13
Caries free
low
2.0
21
<1
Caries free
high
8.0
<1
E-learning resources
www.textbookofbacteriology.net
www.db.od.mah.se/car/carhome.html
www.uic.edu/classes/peri/peri343/
http://www.dent.ucla.edu/ce/caries/index.html
http://www.dentistry.leeds.ac.uk/OROFACE/PAGE
S/micro/micro.html
http://dentistry.ouhsc.edu/intranetweb/Courses/DSA8212/CarHomePage.html
http://hebw.cf.ac.uk/oralhealth/index.html