Armed to the Teeth—The Oral Mucosa Immunity System and Microbiota

The oral cavity is inhabited by a wide spectrum of microbial species, and their colonization is mostly based on commensalism. These microbes are part of the normal oral flora, but there are also opportunistic species that can cause oral and systemic diseases. Although there is a strong exposure to various microorganisms, the oral mucosa reduces the colonization of microorganisms with high rotation and secretion of various types of cytokines and antimicrobial proteins such as defensins. In some circumstances, the imbalance between normal oral flora and pathogenic flora may lead to a change in the ratio of commensalism to parasitism. Healthy oral mucosa has many important functions. Thanks to its integrity, it is impermeable to most microorganisms and constitutes a mechanical barrier against their penetration into tissues. Our study aims to present the role and composition of the oral cavity microbiota as well as defense mechanisms within the oral mucosa which allow for maintaining a balance between such numerous species of microorganisms. We highlight the specific aspects of the oral mucosa protecting barrier and discuss up-to-date information on the immune cell system that ensures microbiota balance. This study presents the latest data on specific tissue stimuli in the regulation of the immune system with particular emphasis on the resistance of the gingival barrier. Despite advances in understanding the mechanisms regulating the balance on the microorganism/host axis, more research is still needed on how the combination of these diverse signals is involved in the regulation of immunity at the oral mucosa barrier.

Download Full-text

MODERN ASPECTS OF ETIOPATHOGENESIS, CLINICS AND TREATMENT OF PATHOLOGY MUCOUS MEMBRANE OF MOUTH IN PATIONS WITH GASTROINTESTINAL TRACT DISEASES

The actual problems in dentistry ◽

10.18481/2077-7566-20-16-2-5-10 ◽

2020 ◽

Vol 16 (2) ◽

pp. 5-10

Author(s):

Irina Galimova ◽

Irina Usmanova ◽

Zarema Hismatullina ◽

Yigal Granot ◽

Olga Guryevskaya ◽

...

Keyword(s):

Gastrointestinal Tract ◽

Oral Cavity ◽

Mucous Membrane ◽

Oral Mucosa ◽

Defense Mechanisms ◽

Local Treatment ◽

Underlying Disease ◽

Local Immunity ◽

Treatment And Prevention ◽

Somatic Status

Subject. Despite the many pathogenetic links in the lesions of the gastrointestinal tract and oral mucosa, unresolved issues related to their etiopathogenesis, diagnosis and high-quality therapeutic and preventive measures. Among the various pathological processes manifesting on the oral mucosa, recurrent aphthous stomatitis is a chronic disease characterized by the appearance of secondary pathomorphological elements (aphthae) in response to the development of acute proliferative inflammation. The goal is the analysis and systematization of literature data on the problem of damage to the oral mucosa in acid-dependent diseases of the gastrointestinal tract. Methodology. Recurrent aphthae of the oral cavity belong to the chronic pathology of the oral mucosa, are characterized by a prolonged course and periodic relapses, which are most often associated with the state of somatic status, including the presence of acid-dependent diseases of the gastrointestinal tract. Results. The main pathomorphological element inherent in this pathology is aphtha. Its localization is the mucous membrane of the vestibule of the oral cavity, cheeks, and lateral surface of the tongue, visually oval or round, covered with a dirty white fibrinous coating. Treatment of recurrent aphthae of the oral cavity includes a complex consisting of general systemic therapy of the underlying disease. Local treatment includes the use of antihistamines, immunocorrection, drugs that increase nonspecific hypersensitivity, normalization of cellular metabolism and stimulate nonspecific defense mechanisms, vitamin therapy and physiotherapy methods. Conclusions. This treatment should ultimately be aimed at eliminating not only pain, but also at increasing local immunity factors, combating pathogenic microflora and promoting the epithelization of pathological processes on the oral mucosa. Of great importance in the treatment and prevention of recurrent aphthae is a comprehensive examination of the patient in order to identify risk factors.

Download Full-text

Coexistence of Lack of Clinical Manifestation of Oral Mycosis and Systemic Diseases in Edentulous Patients Using Removable Prosthetic Restorations

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17176348 ◽

2020 ◽

Vol 17 (17) ◽

pp. 6348

Author(s):

Izabela Gacon ◽

Aneta Wieczorek

Keyword(s):

Oral Cavity ◽

Oral Mucosa ◽

Clinical Symptoms ◽

Chronic Obstructive ◽

Systemic Diseases ◽

Obstructive Pulmonary Disease ◽

Oral Infections ◽

Stomatognathic System ◽

Edentulous Patients ◽

The University

Objective: It is believed that oral infections can increase the risk of systematic diseases, such as atherosclerosis and coronary heart disease, stroke, chronic obstructive pulmonary disease, diabetes, cancer, rheumatoid arthritis, etc. It seems that oral invasive pathogens induce a systemic inflammatory response via mediators released by the cardiovascular system and liver, which increases the risk to the patient of these systematic infections, such as hypertension. On the basis of previous studies of the stomatognathic system, investigating the coexistence of systemic diseases and inflammation in the oral cavity, it can be expected that there is a connection between inflammation of the denture-bearing area in patients using acrylic removable dentures and the presence of systemic diseases, and that patients with inflammation in oral mucosa are more likely to have systemic diseases. Material and method: A retrospective study was carried out on a group of patients seeking prosthetic treatment at the Prosthetic Department of the University Dental Clinic (UKS) from March 2012 to February 2013. All data were collected using a UKS electronic database with KS-SOMED. The minimum period of use for removable prostheses was five years. Results: According to anamnesis, the most common systemic diseases in our study group were hypertension disease. In total, 58% of patients with hypertension disease had no inflammation in the oral cavity. Conclusions: The occurrence of systemic diseases in edentulous people using removable prosthetic restorations, and the subsequent use of medications for these diseases, may result in a lack of clinical symptoms of concomitant fungal infection of the oral mucosa.

Download Full-text

The condition of the oral cavity at the time of diagnosis of inflammatory bowel disease in pediatric patients

Scientific Reports ◽

10.1038/s41598-021-01370-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Małgorzata Klichowska-Palonka ◽

Aneta Komsta ◽

Elżbieta Pac-Kożuchowska

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Oral Cavity ◽

Oral Mucosa ◽

Bowel Disease ◽

Control Group ◽

Systemic Diseases ◽

Inflammatory Bowel

AbstractChanges in the oral mucosa can appear in the course of inflammatory bowel disease in both children and adults. They often precede the appearance of gastrointestinal symptoms. The aim of the study was to determine the nature of changes in the oral cavity at the time of diagnosis of inflammatory bowel disease in children compared to children without systemic diseases. 49 children diagnosed with inflammatory bowel disease and 60 children without systemic diseases were examined. The prevalence of the aphthae stomatitis and angular cheilitis was 24.5% in the examined group and 10% in the control group (p = 0.0772). Changes in the oral mucosa occurred more frequently in children with Crohn's disease 35.3% than with ulcerative colitis 18.7%. In children with Crohn's disease, the most frequently observed lesion was aphthous stomatitis 23.5%, and in ulcerative colitis, angular cheilitis 12.5%. Changes in the oral mucosa are a therapeutic problem requiring in general diseases patients both local and systemic treatment and interdisciplinary cooperation between dentists, paediatricians and gastroenterologists. The finding of repeated changes in the oral mucosa during a dental examination should be the reason for referring the patient to a paediatrician for the foreclosure or make a diagnosis of inflammatory bowel diseases.

Download Full-text

Stomatologic complications of eating disorders

Orvosi Hetilap ◽

10.1556/oh.2012.29483 ◽

2012 ◽

Vol 153 (45) ◽

pp. 1779-1786 ◽

Cited By ~ 1

Author(s):

Mária Resch ◽

Ágnes Nagy

Keyword(s):

Eating Disorders ◽

Oral Cavity ◽

Oral Hygiene ◽

Early Stage ◽

Multidisciplinary Treatment ◽

Young Generation ◽

Systemic Diseases ◽

Root Cause ◽

Multidisciplinary Nature ◽

International Experts

Since the 1990s numerous international experts have reported about the somatic complications of eating disorders including those having a dental and stomatological nature. Several reports emphasised that deformations in the oral cavity resulting from this grave nutritional disease typical of the young generation could already appear in the early stage and, therefore, dentists are among the first to diagnose them. Dentists are still often unaware of the importance of their role in multidisciplinary treatment. Even if they knew what the disease was about and recognised it on the basis of deformations in the oral cavity in time, their advice that their patients should brush their teeth more often would fail to eliminate the root cause of the problem. Not only the earliest possible treatment of the complications of the bingeing-purging mechanism and the maintenance of oral hygiene are important, but controlling and curing pathological habits with active participation of psychiatrists are also required to ensure full recovery. Due to the multidisciplinary nature of the disease, manifold communication is required. For this reason, publishing the dental ramifications of organic and systemic diseases at dental conferences and in technical journals, as well as providing information about oral complications of eating disorders for general practitioners and specialists are particularly important. Orv. Hetil., 2012, 153, 1779–1786.

Download Full-text

Oral and Maxillo-Facial Manifestations of Systemic Diseases: An Overview

Medicina ◽

10.3390/medicina57030271 ◽

2021 ◽

Vol 57 (3) ◽

pp. 271

Author(s):

Saverio Capodiferro ◽

Luisa Limongelli ◽

Gianfranco Favia

Keyword(s):

Early Diagnosis ◽

Oral Cavity ◽

Head And Neck ◽

Clinical Outcomes ◽

Systemic Disease ◽

Clinical Manifestations ◽

Systemic Diseases ◽

Special Issue ◽

Hard Tissues ◽

Current Special Issue

Many systemic (infective, genetic, autoimmune, neoplastic) diseases may involve the oral cavity and, more generally, the soft and hard tissues of the head and neck as primary or secondary localization. Primary onset in the oral cavity of both pediatric and adult diseases usually represents a true challenge for clinicians; their precocious detection is often difficult and requires a wide knowledge but surely results in the early diagnosis and therapy onset with an overall better prognosis and clinical outcomes. In the current paper, as for the topic of the current Special Issue, the authors present an overview on the most frequent clinical manifestations at the oral and maxillo-facial district of systemic disease.

Download Full-text

Special Issue “Oral Health and Systemic Diseases”

Journal of Clinical Medicine ◽

10.3390/jcm9103156 ◽

2020 ◽

Vol 9 (10) ◽

pp. 3156

Author(s):

Gerhard Schmalz ◽

Dirk Ziebolz

Keyword(s):

Oral Health ◽

Global Health ◽

Oral Cavity ◽

Health Issue ◽

Systemic Diseases ◽

Special Issue ◽

Global Health Issue

With an enormous prevalence worldwide, diseases of the oral cavity and respective tissues are a highly relevant global health issue [...]

Download Full-text

Oral Colonization ofStaphylococcusSpecies in a Peritoneal Dialysis Population: A Possible Reservoir for PD-Related Infections?

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2018/5789094 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Liliana Simões-Silva ◽

Susana Ferreira ◽

Carla Santos-Araujo ◽

Margarida Tabaio ◽

Manuel Pestana ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Oral Cavity ◽

Staphylococcus Epidermidis ◽

Gene Sequencing ◽

Systemic Diseases ◽

Sample Collection ◽

Starting Point ◽

Oral Colonization ◽

Mortality Causes ◽

Infectious Potential

Peritoneal dialysis-related infections are important morbidity/mortality causes, being staphylococci the most prevalent agents. SinceStaphylococcus aureusnasopharynx carriage is a known risk factor for PD infections and the oral cavity is a starting point for systemic diseases development, we aimed at comparing the oral staphylococci colonization between PD patients and controls and studying the association with PD-related infections. Saliva samples were plated in Mannitol salt, and isolates were identified byDnaJgene sequencing. Staphylococci PD-related infections were recorded throughout the 4-year period following sample collection.Staphylococcuscolonization was present in >90% of the samples from both groups (a total of nine species identified). PD patients presented less diversity and less prevalence of multispeciesStaphylococcuscolonization. Although all patients presentingStaphylococcus epidermidisPD-related infections were also colonized in the oral cavity by the same agent,only 1 out of 7 patients with ESI caused byS.aureuspresentedS. aureusoral colonization. Staphylococci are highly prevalent in the oral cavity of both groups, although PD patients presented less species diversity. The association between oralStaphylococcuscarriage and PD-related infections was present forS. epidermidisbut was almost inexistent forS. aureus, so, further studies are still necessary to evaluate the infectious potential of oralStaphylococcuscarriage in PD.

Download Full-text

Fibrinolysis: A Primordial System Linked to the Immune Response

International Journal of Molecular Sciences ◽

10.3390/ijms22073406 ◽

2021 ◽

Vol 22 (7) ◽

pp. 3406

Author(s):

Robert L. Medcalf ◽

Charithani B. Keragala

Keyword(s):

Binding Sites ◽

Defense Mechanisms ◽

Immune Cell ◽

Immune Defense ◽

Surface Proteins ◽

Cell Behavior ◽

Phylogenetic Studies ◽

Blood Clots ◽

Lower Vertebrates ◽

Almost All

The fibrinolytic system provides an essential means to remove fibrin deposits and blood clots. The actual protease responsible for this is plasmin, formed from its precursor, plasminogen. Fibrin is heralded as it most renowned substrate but for many years plasmin has been known to cleave many other substrates, and to also activate other proteolytic systems. Recent clinical studies have shown that the promotion of plasmin can lead to an immunosuppressed phenotype, in part via its ability to modulate cytokine expression. Almost all immune cells harbor at least one of a dozen plasminogen receptors that allows plasmin formation on the cell surface that in turn modulates immune cell behavior. Similarly, a multitude of pathogens can also express their own plasminogen activators, or contain surface proteins that provide binding sites host plasminogen. Plasmin formed under these circumstances also empowers these pathogens to modulate host immune defense mechanisms. Phylogenetic studies have revealed that the plasminogen activating system predates the appearance of fibrin, indicating that plasmin did not evolve as a fibrinolytic protease but perhaps has its roots as an immune modifying protease. While its fibrin removing capacity became apparent in lower vertebrates these primitive under-appreciated immune modifying functions still remain and are now becoming more recognised.

Download Full-text

The Basics of Microbiology

10.33442/vt202101 ◽

2021 ◽

Author(s):

Werner Solbach

Keyword(s):

Infectious Diseases ◽

Defense Mechanisms ◽

Wide Spectrum ◽

Severe Disease ◽

Laboratory Diagnosis ◽

Asymptomatic Infection ◽

The Body ◽

Sufficient Evidence ◽

Effective Measure ◽

Hygiene Measures

Microorganisms constitute 70 percent of the biomass on Planet Earth. Comparatively few species are adapted to colonize human surfaces and form a complex Meta-Organism with manyfold mutual benefits. Occasionally, microorganisms may overcome the barriers of the skin and mucosal surfaces and may multiply locally or in multiple sites inside the body. This process is called infection. Infections can be caused by bacteria, viruses, parasites, helminths, and fungi. Immediately after infection, numerous defense mechanisms of the immune system are activated to combat replication of the microbes. There is a balance between microorganism and human defense mechanisms, which may lead to either asymptomatic infection or result in a wide spectrum of symptoms from mild to severe disease and even death. The most important factors in the diagnosis of infectious diseases are a careful history, physical examination and the appropriate collection of body fluids and tissues. Laboratory diagnosis requires between 2 and 72 hours. Wherever possible, antibiotics should only be used when sufficient evidence of efficacy is available. Then, however, they should be used as early as possible and in high doses. In addition to everyday hygiene measures, vaccination is the most effective measure to prevent infectious diseases.

Download Full-text

CLINICAL MANIFESTATIONS OF SARCOIDOSIS ON THE PROLABIUM AND ORAL MUCOSA: MANAGEMENT

Ukrainian Dental Almanac ◽

10.31718/2409-0255.2.2018.08 ◽

2018 ◽

pp. 34-36

Author(s):

P.M. Skrypnikov ◽

T.P. Skrypnikova ◽

Yu.M. Vitko

Keyword(s):

Oral Cavity ◽

Oral Mucosa ◽

Correct Diagnosis ◽

Clinical Signs ◽

Clinical Manifestations ◽

Morbidity Rate ◽

Unknown Etiology ◽

Toxic Substances ◽

Male Population ◽

Female Population

The statistics indicates on the tendency of morbidity rate of sarcoidosis to increase. The pathology affects young and older people notably. Sarcoidosis becomes a common chronic disease, which is often difficult to diagnose. Insufficient experience in recognition of this disease leads to misdiagnosis and ineffective treatment. All mentioned above highlights the extreme relevance of this issue. Sarcoidosis is a multisystem inflammatory nature disease of unknown etiology. The hereditary predisposition is taken to be but the whole family cases are also known. An abnormal immune response is also considered among the theories of the development of the disease. The infectious factor is also regarded as the cause of the disease. The increasing activity of lymphocytes, which start to produce substances promoting the formation of the granulomas, which are considered to be the basis for the pathological process, can initiate the onset of the disease. The maximum morbidity rate of sarcoidosis is observed between the ages of 35 to 55 years. Two age periods of the peak in male population are 35-40 years and about 55 years. The rate of sarcoidosis morbidity among female population is 65%. Up to 700 new cases of sarcoidosis are registered in Ukraine annually. The clinical signs of sarcoidosis vary. This pathology is more often manifested by the bilateral lymphadenopathy of lung roots, eyes and skin lesions. The liver, spleen, lymph nodes, heart, nervous system, muscles, bones and other organs can also be affected. In dental practice sarcoidosis can be manifested on the prolabium, oral mucosa and salivary glands. Blood laboratory indices (the increased level of calcium) are changed in sarcoidosis. Chest X-ray, MRI and CT also demonstrate changes in the lungs. The test for detection of granulomas shows positive Kveim reaction (the formation of purple-red nodules due to administration of antigen). Biopsy and bronchoscopy facilitate detection of both direct and indirect signs of sarcoidosis of the lungs. A general treatment of sarcoidosis is provided by a pulmonologist, who can assess the severity of the lesion and provide appropriate treatment. The core of treatment is based on corticosteroids. In severe cases immunosuppressors, anti-inflammatory drugs, antioxidants are prescribed. A dentist performs oral cavity sanation, professional hygiene. Mouth rinses with Dekasan solution, sublingual Lisobakt pills are prescribed to prevent inflammatory lesions. Patients with sarcoidosis are recommended to avoid solar radiation and contact with chemical and toxic substances harmful to the liver, reduction of the consumption of foods rich in calcium. Healthy life-style is crucial in prevention of exacerbations of sarcoidosis. In the remission period regular medical check-ups and oral cavity sanation are recommended. The correct diagnosis in rare diseases requires highly qualified dental professionals, the interdisciplinary approach in the diagnosing and management of patients with this pathology.

Download Full-text