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Introduction to Oral Pathogens

There are some bacteria that cause a disease, but there are some diseases that bring about a condition that is ideal for the growth of some bacteria. -Pasteur

Reasons for Uncertainty/Confusion in Defining Microbial Periopathogens

Periodontal disease may be periodontal diseases Mixed infections Large number of species present Many species are difficult to grow Time of sampling may be wrong Different sites in same patient may have different bacteria Opportunistic species grow as result of disease rather than as cause.

Carrier states

Association studies

Phenotypically normal, but infected with pathogen Strains of putative pathogens may vary in virulence. Some may harbor phage or plasmids.

Bacteroides Group

fragilis Porphyromonas Prevotella

Porphyromonas & Prevotella

Both gram-negative rods, black colonies on blood agar After Bf, most common cause of human infection by anaerobic gram-negative bacilli Habitat: oral cavity, upper alimentary, respiratory tracts, colon unusual endotoxin Infections: dental, sinus, pulmonary, human bite Susceptible to penicillins

General Characteristics of

Bacteroides forsythus

Renamed in 1986 for fusiform Bacteroides Gram-negative, anaerobic, pleomorphic often fusiform Cells are nonmotile and have no flagella This species demonstrates a distinctive surface layer Requires exogenous N-acetyl-muramic acid for growth One of a few oral species demonstrating strong trypsinlike activity Periodontopathogen; associated with progressive attachment loss in subjects before therapy (RPP) and in refractory periodontitis

Peptostreptococcus and Microaerophilic Streptococci

Confusing taxonomy Some peptostrep reassigned to genus Streptococcus Gram-positive cocci; chains; slow growers in O2 or CO2 Habitat: normal oral flora; colon; female genital tract Penicillin sensitive; aminoglycoside resistant


Opportunists, often associated with other organisms Present in cerebral abscess, pelvic peritonitis, anaerobic cellulitis, septic thrombophlebitis Gas production; can be smelly

Treponema denticola

Treponema; Greek, turning thread General Characteristics:

Gram-negative, anaerobic, chemoorganotroph, very motile in highly viscous environment, rifampin resistant Growth conditions: peptone-yeast extractserum medium + fatty acids, cocarboxylase


Mounting evidence implicating T. denticola in the etiology of human periodontitis. T. denticola overgrowth is synonymous with the presence of clinical inflammation.

Armamentarium of proteolytic, cytolytic, and adherence properties

Meager and confusing information about which T. denticola antigen(s) are recognized by the humoral immune system or the characteristics of the antibodies produced.