Non carious loss of mineralised dental tissue Flashcards

1
Q

What are the 7 causes of tooth tissue loss?

A
  • Trauma
  • Caries
  • Attrition
  • Abrasion
  • Erosion
  • Abfraction
  • Resoption
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2
Q

What is attrition?

A

Tooth to tooth frictional wear

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3
Q

What is abrasion?

A

Physical wear other than by tooth e.g. hair grips etc.

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4
Q

What is erosion?

A

Chemical non-bacterial dissolution

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5
Q

What is abfraction?

A

Flexing of the tooth = tensile or shear stresses weakening enamel prisms (microfractures)

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6
Q

What % of the population is affected by tooth wear?

A

97%

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7
Q

What % of the population have pathological degrees of tooth wear requiring treatment?

A

7%

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8
Q

What does the tooth wear index suggest?

A

The normal level of wear for each decade of life from 25 y/o

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9
Q

When does tooth wear become of significance?

A

When it becomes excessive, causing problems in function, aesthetics or sensitivity

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10
Q

What is the pH at which enamel prisms become looser?

A

pH 5.5 and below

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11
Q

Why should we brush teeth before breakfast or wait 30 mins after breakfast to brush?

A

Because acid in breakfast loosens enamel prisms = can knock off if brush after

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12
Q

What is extrinsic erosion?

A

Erosion from exogenous acids (related to occupation/diet) -> contributed to by: frequency, pH, saliva buffering capacity, method of consumption (e.g. swishing), time (night-time drinking) and temp

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13
Q

N.b…

A

Babies do not develop a taste for sweet or sour until they are given sweet or sour foods = if you can persuade parents to only give water and milk children will be happy with it

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14
Q

What is intrinsic erosion?

A

Erosion from endogenous acids (e.g. stomach acid) -> often seen in GORD, eating disorders, diabetes (reflux), GI ulcers, hiatus hernia etc.

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15
Q

Why are primary teeth more susceptible to caries/erosion?

A

Enamel and dentine is thinner, enamel is more porous (less mineralised) and lower phosphate

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16
Q

What is the clinical picture of attrition?

A
  • Faceting of occlusal surface
  • Wear similar between arches
  • Pathology less frequent than erosion
  • Dentine and enamel worn away equally
  • Upper and lower teeth fit exactly perfectly
  • Dentine and enamel equally worn away
  • Depends on occlusal traits (if group function = multiple occlusal contact points)
17
Q

What makes attrition worse?

A

Bruxism

18
Q

Tell me more about bruxism:

A
  • Greatest cause associated with anxiety
  • Tooth faceting
  • Up to 96% of population affected
  • Cusp/restoration fracture
  • Occlusal forces 39-60% normal biting (75kg)
  • Associated with ecstasy and metamphetamine = posterior wear (jaw m. activity, bruxism, trismus, especially when associated w/ dry mouth)
19
Q

What professions may your be more likely to see abrasion in?

A

Carpet layers, seamstresses and hairdressers (hold things between teeth)

20
Q

What is the clinical presentation of toothbrush abrasion?

A
  • Cervical (can be elsewhere too depending on site and hand used i.e.j if right handed scrub better on the left)
  • Depends on the force of brushing, type of brush (electric or manual), bristle type and method of brushing
  • Worse if brush just after acid insult (and quicker)
21
Q

What is the clinical presentation of abrasion by restorative materials?

A

Wear on teeth opposing the restoration

22
Q

Which restorative materials cause abrasion of enamel?

A

Porcelain, Nickel/chromium (although insult to enamel from clasps most likely due to caries due to plaque retention)

23
Q

What is normal enamel/enamel wear?

A

20-40 micrometers per year

24
Q

What other dental material can cause abrasion of enamel?

A

Dental floss if used wrong = v cut at cervical margin

25
Q

What is the clinical presentation of abfraction?

A

v-shaped notches especially at the gingival margin (deeper than abrasion)

26
Q

How do we treat abfraction?

A

Fill with GIC or composite

27
Q

What are the different types of root resorption (3)?

A
  • Developmental (deciduous teeth as permanent erupt)
  • Pathological
  • Idiopathic e.g. following trauma or infection
28
Q

What are the different causes of pathological resorption?

A
  • Dentigerous cyst
  • Space occupying lesions (benign and pushes roots apart, tooth more likely to be vital)
    n. b. both can be seen on radiographs
29
Q

What are the clinical signs for external inflammatory resorption?

A

TTP, discolouration, mobility

30
Q

What causes external surface resorption?

A

Usually apical after trauma, ortho or re-implantation

31
Q

What are the clinical signs of internal resorption?

A

Pink spot and clinical symptoms (from pulp outwards), unusual and often the cervical 1/3 -> can try endo