Dental Infection and Resistance

in Primary Health Care

Ludhang Pradipta Rizki
ludhang@ugm.ac.id
Learning Objectives

Basic concepts:
 Microbes, colonization and infection
 Basic diagnostic methods to detect dental infections
 Antimicrobial medicines, how they act, and how their overuse has
contributed to the rapid emergence of resistance in Primary Health
Care

Dentistry is a comprehensive specialties devoted to resolving dental

infections or restoring and rehabilitating tooth structure lost to such
bacterial processes

Antibiotics are routinely prescribed in dental practice for either

prophylactic or therapeutic use
Rationale for Antibiotic Usage in Dental Practice

Normal Flora in Oral Cavity

Host factors influence the oral microbiome
 Biofilm : complex community of microbes attached to a surface
 Ecological balance : dynamic equilibrium of organisms and their
environment
 Dysbiosis : condition in which the balanced state of the
ecosystem is disturbed
 Homeostasis : dynamic equilibrium of a biological system
understood as its ability to maintain its essential variables
constant through the mutual interaction of its components
Normal Flora in Oral Cavity
Evolution of microbiological methods over time
Positive effects of host-microbiome symbiosis
Host factors influence the oral microbiome
host–microbe interactions in the pathogenesis of caries
A model of periodontitis pathogenesis
Rationale for Antibiotic Usage in Dental Practice

What are microbes and how do they cause infection?

Microbes are small living organisms that multiplay rapidly
 Rationale for Antibiotic Usage in Dental Practice

Bacteria: infection and colonization

Sometimes, colonizing bacteria can cause When bacteria are found in our bodies but do
infection if they gain access to body sites that not cause any symptoms or disease, it is
are usually sterile. These infections should be referred to as colonization.
treated with antibiotics No treatment is required.
 The Role of Diagnostics in Detection of Infection

What are diagnostics?

“A diagnostic test for an infectious disease can be

used to demonstrate the presence or absence of
infection, or to detect evidence of a previous
infection” (the presence of antibodies)

Demonstration of the presence of the infecting organism

or a surrogate marker of infection is often vital for
effective management and for guiding treatment of
infectious diseases
 Basic Diagnostics Methods for Detection of Infection

Pathogen Detection Host Biomarker Detection

Microscopy

Culture
(solid or liquid media) Antibody detection
(IgG or IgM)
Molecular (detection of DNA, RNA, protein)

Biomarkers of infection
Antigen detection assays (C Reactive Protein)
(detection of protein)
The Role of the Microbiology Laboratory
The Role of the Microbiology Laboratory

Patient
6 1
Post analytical Pre analytical
(Dentist) (Dentist)

5 2

Post analytical Pre analytical

(Paper or Computer) (Sample Colection)

4 3
analytical
(Laboratory)
Considerations for antimicrobial therapy
Bactericidal and Bacteriostatic antibiotic

In vitro effects of bactericidal and bacteriostatic drugs

 Antibiotics useful in Dental Practice

Antibiotic used Cidal/Static Important characteristic

Clindamycin Static