ORAL MICROBIAL FLORA & ITS RELATION TO DENTAL CARIES

Guided by Dr.Sophia Dr.Padmini Mrs.Kanchanadevi

IMPORTANCE :
Several microorganisms are normally present in our oral cavity. But these microorganisms are responsible for various diseases like DENTAL CARIES , Gingivitis & some forms of Periodontitis. Some microbes produce diseases in IMMUNO COMPROMISED state like Candida albicans.

ORAL MICROBIAL FLORA

Normal oral cavity contains a mixture of organisms which include bacteria , fungi , protozoa and occasionally viruses.

CLASSIFICATION: Oral Microbial Flora

Resident Flora Transient Flora
Limited period

Always present

Alpha haemolytic streptococci & lactobacilli

Streptococcus pneumoniae & Neisseria meningitidis

NORMAL MICROBIAL FLORA OF MOUTH COCCI

Streptococcus Lactobacillus sp. mutans Actinomyces sp. Propionibacterium Strept. sanguis sp. salivarius Strept. Arachnia sp. Strept. mitior Bifidobacterium Strept. milleri sp. Enterococcus sp. Bacterionema sp. Peptostreptococus Eubacterium sp. Micrococcus sp. Staphylococcus sp.

GRAM +ve

GRAM -ve

Veillonella sp. Neisseria sp. Branhamella sp.

BACILLI
GRAM +ve
Lactobacillus sp. Actinomyces sp. Propionibacterium sp. Arachnia sp. Bifidobacterium sp. Bacterionema sp. Eubacterium sp.

GRAM -ve
Actinobacillus sp. Fusobacterium sp. Bacteroides sp. Capnocytophaga sp. Leptotrichia sp. Treponema sp. Haemophilus sp. Selenomonas sp. Eikenella sp. Wollinella sp.

SPECIAL FEATURES OF CERTAIN NORMAL FLORA

Streptococcus mutans
Lactobacilli

Initiate dental caries

Promote progress of Dental caries

Veillonella species

Most numerous among Gram-ve bacteria

Anaerobic bacteria

Bacteroides,Fusobacterium,Leptotrichia,Selenomonas Fusobacterium nucleatum

Treponema vincentii,T.denticola,T.orale

problematic:

FUNGI

CAUSE DISEASE IN IMMUNOCOMPROMISED STATE

Candida albicans Candida tropicalis Candida pseudotropicalis Candida stellatoidea Cryptococcus species PROTOZOA
PATHOGENIC Vs Non Pathogenic

Entamoeba gingivalis Trichomonas tenax

Acquisition Of Normal Flora Of MOUTH Newborn at birth

After few hours First year of life With eruption of teeth

DENTAL

CARIES

Dental caries is a disease in which the calcified tissue of the tooth undergoes modification by the endogenous commensal bacterial flora of the oral cavity.

RELATION TO ORAL MICROBIAL FLORA:

Streptococcus mutans & Lactobacilli
Sticks to carbohydrates on tooth surface Metabolises sugar & other energy sources

Produces acid so cause CAVITIES

ETIOLOGY
TIME

HOST

CARIES

DIET

FLORA

HOST:

DIET:

DENTAL PLAQUE
Soft non-mineralised deposit of bacteria on the tooth surface or other hard surfaces of the oral cavity , including oral prosthesis.
DEMINERALISATION
WEAKENING OF TOOTH STRUCTURE CAVITY FORMATION EVENTUAL LOSS OF TOOTH

Food+Mucus+Dead cells+Bacteria=SOFT PLAQUE Soft plaque+Calcium+Phosphates+Other compounds =HARD PLAQUE LEFT UNTREATED
LAC TIC ACID ERODES ENAMEL & DENTIN
DENTAL CARIES IRRITATION OF NERVE

TOOTHACHE

MICROBIAL FLORA IN PLAQUE:

Strep. mutans

Glycosyl
Strep. sobrinus
Other members

TRANSFERASE

PATHOPHYSIOLOGY OF DENTAL CARIES :

THEORIES OF ETIOLOGY OF DENTAL CARIES:

* ACIDOGENIC THEORY * PROTEOLYTIC THEORY * CHELATION THEORY

HISTOPATHOLOGY OF CARIES: ZONES OF:

INCIPIENT LESION TRANSLUCENT ZONE DARK ZONE BODY OF THE LESION DENTINAL CARIES NORMAL DENTIN SUBTRANSPARENT DENTIN TRANSPARENT DENTIN

SURFACE ZONE

TURBID DENTIN
INFECTED DENTIN

STAGES OF TOOTH DECAY

SYMPTOMS: # Dark spots on tooth # Tenderness # Halitosis # Swelling # Bleeding # TOOTHACHE # Jaw pain

DIAGNOSIS:
$ Dental probe to detect sensitivity $ Dental X-Ray $ CULTURE-Salivary counts of S.mutans & lactobacilli-Antibiotic Susceptibility $ Assessment of environmental conditions Ph , salivary flow , salivary buffering

$ Visual Evidence -cavitation -surface roughness -opacification -discolouration $ Tactile Evidence Roughnes & Softness by sharp explorer

PREVENTION: * Maintenance of microbial flora * Regular brushing & flossing * Control of dietary carbohydrate * Fluoride

TREATMENT: # Scaling

# Temporary Restoration-Filling

# Direct Pulp Capping :

# Indirect Pulp Capping :

REFERENCE:
Textbook Of Microbiology For Dental Students C.P.Baveja Wikipedia

Thank You