Toothwear 1

Question 1

why is aetiology important

Answer 1

attempt to reduce further wear
plan for problems
allow to be realistic
identifies wider medical issues
prognostic indicators
enhances consent process
aids clinical diagnoses and treatment planning

Question 2

what are the modifying factors of attrition

Answer 2

lack of posterior teeth
occlusion
restorations
erosion and abrasion
stress and anxiety

Question 3

what are the common features of a bruxist

Answer 3

significant wear throughout dentition
repeated restoration failure
root fractures
often onset in early adulthood
progressive

Question 4

what are the features of physiological tooth wear

Answer 4

canine tips flat
cupping on incisal edge

Question 5

how is lack of posterior teeth a modifying factor of attrition and what can we do to avoid this

Answer 5

as it will wear away the anterior teeth quicker as they are primarily using these teeth to eat
advise on denture use to protect anterior dentition

Question 6

what types of occlusion can have an affect on attrition

Answer 6

dep overbite can have effect on lower incisors
edge to edge can cause localised wear

Question 7

what type of restoration can cause attrition and why

Answer 7

porcelain as it is abrasive

Question 8

what are the early signs of wear

Answer 8

multiple cracks around restorations
multiple cusp fracture
root fractures in unrestored teeth

Question 9

what are the modifying factors of erosion

Answer 9

lifestyle
multiple factors
amount and frequency
level of control
psychosocial

Question 10

what are the extrinsic causes of erosion

Answer 10

carbonated drinks
sports drinks
alcoholic drinks
citrus drinks
acidic food
drugs

Question 11

what are the intrinsic causes of erosion

Answer 11

eating disorders
GROD
other medical conditions

Question 12

what features can be seen on someone who drinks a lot of carbonated drinks

Answer 12

incisal erosion on upper centrals
cupping on lower molars
palatal erosion on upper incisors
sensitivity
interproximal caries and buccal white spots

Question 13

what are the tooth features of an eating disorder

Answer 13

palatal erosion on upper teeth
polished restorations
erosion around restorations
sensitivity
caries
altered taste
halitosis
soft tissue changes sometimes

Question 14

what type of behaviours cause abrasion

Answer 14

toothbrushing
oral self harm
tongue studs
occupational
unusual habits

Question 15

what are the important questions to ask when you suspect toothbrushing abrasion

Answer 15

localised or generalised
frequency and duration
bristle and toothpaste abrasiveness
brushing technique instruction
electric v manual
part of a combination wear problem
part of stress/anxiety

Question 16

what could be the aetiology of someone with erosion (intrinsic and extrinsic), attrition and abrasion altogether

Answer 16

alcoholism and drug abuse
eating disorder

Question 17

what could be the aetiology of someone why extrinsic erosion and attrition

Answer 17

bruxist with poor diet

Question 18

what could be the aetiology of someone with intrinsic and extrinsic erosion and attrition

Answer 18

bruxist with poor diet and GORD

Question 19

what should your attitude be like when you are trying to find out the aetiology

Answer 19

comprehensive
compassionate
patient
unconditional positive regard - not blaming them

Question 20

what should your treatment plan include for wear

Answer 20

individualise preventive plan
reinforcement
signposting/referral

Question 21

what common preventive advice is given to people with wear

Answer 21

fluoride toothpaste/mouthwash
dietary modification
remineralisation
sugar free gum

Question 22

what interventions can be useful to control aetiology

Answer 22

toothbrushing instruction
splint therapy
CBT/hypnotherapy
refer to GMP

Question 23

why might people have lack of posterior support

Answer 23

denture intolerance
denture refusal
supervised neglect

Question 24

what are the consequences of lack of posterior support

Answer 24

modifying factor of tooth wear
increases severity of wear
increases rate of progression of wear
leads to occlusal collapse
function and aesthetic problems

Question 25

why do we avoid complete dentures in bruxist patients

Answer 25

bruxism will continue so causes fractured dentures, ridge resorption, pain and ulceration under complete denture

Question 26

what removable prosthodontic solutions can be used in tooth wear

Answer 26

overdentures
transitional dentures
metal based dentures
simplifying small saddles

Question 27

what is an overdenture

Answer 27

any removable prosthesis that rests on one or more remaining natural teeth, the roots of natural teeth and/or dental implants

Question 28

what are the advantages of an overdenture

Answer 28

correction of occlusion and aesthetics
support
tooth wear management
preservation of ridge form
proprioception
denture retention
used with precision attachments
MRONJ and radiotherapy patients
psychological benefits
useful in elderly patients
eases transition to edentulism

Question 29

what are the disadvantages of overdentures

Answer 29

need for good oral health
increased caries/periodontal problems
care homes
denture fracture
discomfort/infection
medical history
potentially more traumatic extractions

Question 30

what care advice is given with overdentures

Answer 30

good OH
fluoride toothpaste to roots
regular examination and radiographs
denture hygiene

Question 31

when are transitional dentures used

Answer 31

to increase the OVD in cases where poor posterior support to create space for restorations

Question 32

what do you do after you have used transitional dentures

Answer 32

get rid of impossible teeth
crowns with rest seats and undercuts
definitive dentures

Question 33

how can metal be used to modify a denture for bruxists

Answer 33

CoCr backing on teeth to avoid fracturing the teeth

Question 34

how do you simplify small saddle areas

Answer 34

use bridgework

Question 35

what do you need to do when you are planning rehabilitation for wear cases (replacing teeth)

Answer 35

impressions and facebow
mounted articulated casts on semi-adjustable articulator
high quality interocclusal record
diagnostic wax ups
stents
temporary dentures
clinical photographs
radiographs