Tooth tissue loss

Question 1

Attrition

Answer 1

Wear due to tooth-tooth contact

Question 2

Attrition - aetiology

Answer 2

Habit, bruxism
Malocclusion (class III incisors, or cross bite)
Loss of posterior teeth

Question 3

Bruxism

Answer 3

Parafunctional activity of muscles of mastication
Often whilst sleeping
Stress-related

Question 4

Erosion

Answer 4

Tissue loss due to non-carious acid dissolution

May see ‘raised’ margins of restorations

Question 5

Erosion - aetiology

Answer 5

Extrinsic factors - diet
-soft drinks
-alcohol
-citrus fruit
-pickles/ vinegar
Intrinsic factors
-bulaemia
-pregnancy or illness involving recurrent vomiting or reflux

Question 6

Tooth wear - aetiology

Answer 6

Usually a combination of factors

Erosion and attrition rarely indipendent

Question 7

Abrasion

Answer 7

Tooth wear due to contact with food or other object(s)
Toothbrush
Nails
Cotton
Wind instrument

Question 8

Trauma aetiology

Answer 8

Falls/ messing around
Contact sports
Non-accidental injury
> overjet is risk factor
Most common in 8-10 year old boys

Question 9

Enamel or dentine defects aetiology

Answer 9

Genetic conditions: amelogenesis imperfecta and dentinogenesis imperfecta
Trauma or infection to developing tooth germ
Systemic illness or malnutrition
Chemotherapy/ radiotherapy

Question 10

Diagnosis of tooth tissue loss

Answer 10

History
-PCO
-HPC
-medical history
-social factors/ dental history
-diet
-any family history of similar problem
Examination
-which surfaces?
-condition of restorations

Question 11

Principles of management

Answer 11

Thorough history and examination
-may include clinical photos, study models, radiographs, vitality testing
Treatment objectives (prevention vs intervention)
-prevention (e.g. mouthguard, dietary advice, fluoride)
-pain releif
-protection of pulp
-improve/ restore dental and facial aesthetics (restorations)
-improve function
Monitoring
-clinical photos, study models, radiographs, vitality testing