- LEE PHEY CHUIN

MICROBES IN ORAL DISEASE

Pathogenic Microorganism
Microorganism which is capable of causing disease.

Opportunistic Microorganism
Microorganism which is only to cause disease in compromised individuals
when their
defenses are weak, as the microbes will take opportunity by the reduced
host defense.
These opportunists are frequently members of the bodys normal flora.

Virulence
Is a quantitative measure of pathogenicity.
Is related to an organisms toxigenic potential & invasiveness.

Bacterial Virulence Factors what the bacteria has to cause it to be

pathogenic.

Bacterial Pathogenic Properties how the bacteria use virulence

factors to cause disease.

Bacterial Virulence Factors

Bacterial Pathogenic
Properties

1. Pili / Frimbriae
2. Glycocalyx
(Slim Layer/Extracellular
Polysaccharide)
3. Capsules
4. Enzymes
5. Toxins
6. Haemolysins

1. Adherence
2. Antiphagocyte Factor

3. Tissue Damage

BACTERIAL VIRULENCE FACTORS

1. Pili / Frimbriae

Pili/ Frimbriae are fine, hair like filaments, extended from the cell
surface.
Pili, found mainly on G/-ve bacteria.

2. Glycocalyx (Slim Layer/Extracellular Polysaccharide)

Surrounds and covers the outer surfaces of many bacteria.

Allows the bacteria to adhere firmly to various structures,
eg. Oral mucosa, teeth.
Made up of glycoprotein, water.

- LEE PHEY CHUIN

Protect from dehydration and loss of nutrients.

3. Capsules

A gelatinous layer.
Surrounds the entire bacterial cell wall.
Importance:
Protect the cell from the hazards of the environment.
Hinders & inhibits phagocytosis (anti-phagocytic factor).
Can be used an antigens in certain vaccines because they elicit
protective antibodies.
Mediates the adhesion of bacteria to human tissues.
(a prerequisite for colonization & infection).

4. Enzymes

Several enzymes are produced by various bacteria that extracellularly &

are associated with invasiveness.
3 types:
i.
Collagenase
An enzyme that hydrolyses collagen & destroys collages fibres,
thus allowing bacteria to spread through the tissue more easily.
Is produced by bacteria associated with periodontal disease (
Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans)
ii.
Hyaluronidase
Act as a spreading factor by breaking down hyaluronic acid, a
polysaccharide in the ground substance of connective tissue.
Is formed by many organisms including Streptococci.
iii.
Streptokinase
Causes the breakdown of the fibrin clots and thus aid the bacteria
in the spread of infection.
Is formed by Streptococci.

5. Toxins
i.

ii.

Endotoxin (only produced by G/-ve bacteria)

Stable at high temperature.
Is responsible for many features of disease.
Eg. Porphynumonas gingivalis produces endotoxin that could cause
tissue
destruction.
Exotoxin (produced by both G/+ve & G/-ve bacteria)
Toxins released extracellularly as the organism grows are called
exotoxin.
These toxins may travel from a focus of infection to distant parts of
the body.
Hence, it causes damage in region far away from the site of
microbial growth.

- LEE PHEY CHUIN

* G/-ve bacteria Lipopolysaccharide is embedded in the outer

membrane.
Lipopolysaccharide detaches from outer membrane
and become
endotoxin.
*G/+ve bacteria no outer membrane.

6. Haemolysins

Proteins that are able to act on the animal / host cell membrane, causing
cell lysis.
i Lecithinases or Phospholipases:
Attack the membrane phospholipids of the host cell membrane and
thus destroy the cell membrane.
ii

Streptolysin O:
Produced by Streptococci.
Affects the sterols of the host cell membrane.

iii

Leukocidins:
Produced by A. actinomycetemcomitans (periodontopathic
bacterium) and various G/-ve bacteria.
Lyse white blood cells, hence decrease host resistance.

Bacterial Pathogenic Properties

1. Adherence

The initial adherence is specific, involving adhesion on the bacterial

surfaces having matching receptors on the host tissue.
The major adherence contributing factors:
a) Pili/Fimbriae
b) Glycocalyx ( slim layer)
c) Capsules

2. Antiphagocyte Factor

In bacteria the major antiphagocytic factor is the bacterial capsule.

Bacterial capsule can prevent in some ways the adherence of the
phagocytes to the bacterial cell surface.
The major antiphagocytic contributing factors:
a) Capsule
b) Pili/Fimbriae

3. Tissue Damage

The major tissue damage contributing factors:

a) Enzymes
b) Bacterial toxins
c) Haemolysins

- LEE PHEY CHUIN

* For essay question, each factor should be elaborated.*

Microorganisms in Oral Disease

1. Dental caries
The main cariogenic bacteria : Streptococcus mutans ( Acidogenic &
Aciduric )
* Acidogenic able to produce acid *
* Aciduric able to live in acidic environment *

2. Periodontal disease
The main periodontopathic (periodontopathogenic) bacteria :
Porphyromonas gingivalis ( Asaccharolytic)