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2ND Year- CSA > Tooth wear > Flashcards

Tooth wear Flashcards

1
Q

What can tooth wear also be referred to as?

A

Non carious tooth tissue loss (NCTTL)

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2
Q

What can cause normal tooth wear min olde rpatient?

A

Generally using the teeth

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3
Q

What is tooth wear defined by?

A

Aetiology
Severity
Distribution

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4
Q

WHat are the 3 types of tooth wear?

A

Abrasion
Attrition
Erosion

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5
Q

With an ageing population what also increases?

A

The number of patients with tooth wear

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6
Q

What work can we do that can cause localised tooth surface loss?

A

Porcelain crowns or high restorations

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7
Q

Why are younger patients also developing tooth wear?

A

Due to a high acidic diet of fizzy drinks or fruit

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8
Q

Define erosion

A

The irreversible progressive loss of dental hard tisue by acidic chemical process not involving bacteria

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9
Q

Define attrition

A

The loss of tooth substance or restoration due to the contact of 2 teeth

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10
Q

Define abrasion

A

Abnormal wearing of tooth substance or a restoration by mechanical process other than tooth contact

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11
Q

What is erosion classified according to?

A

According to the source of the acid:
Intrinsic
Extrinsic

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12
Q

Define intrinsic acid sources

A

Acid coming up

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13
Q

Deine extrinsic acid sources

A

Acid going in

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14
Q

Give examples of extrinsic acid sources

A

Wine
Pickled onions
Vinegar
Fizzy drinks

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15
Q

Give examples of intrinsic acid sources

A

Vomiting
Gastro oesophageal reflux
Ruminant eating

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16
Q

What is GOR caused by

A

Sphincter incompetence
increase gastric pressure
increased gastric volume

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17
Q

What are the Symptoms of GOR

A 
Heartburn
Retrosternal discomfort Epigastric pain
Dysphagia 
Chronic cough 
SOre throat
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18
Q

Name an eating disorder that can lead to tooth problems

A

Bulimia nervosa

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19
Q

Patients you are being exposed to intrinsic acid sources may see erosion on which surfaces of the teeth?

A

The palatal surfaces

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20
Q

Which type of drinks have the highest erosion potential?

A

Fruit juices EG orange and apple juice

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21
Q

Name some important factors we need to consider when looking at dietary erosion

A

Amount
Frequency
Method of consumption
Timing of consumption

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22
Q

Name a predisposing factor that can make it more likely for someone to have erosion

A

Reduced saliva

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23
Q

What is the clinical presentation of erosion of anterior teeth

A
  1. Loss of surface anatomy
  2. Smooth enamel
  3. Increased incisal translucency
  4. Chipping of incisal edge
  5. Palatal hollows
  6. Areas where enamel is absent
  7. `Exposure of pup
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24
Q

What is the clinical presentation of erosion of posterior teeth

A
  1. Loss of surface anatomy
  2. Cuspal cupping
    3 Proud restorations
  3. Darkening of color
  4. Pulpal exposure is rare
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25
Q

What is the clinical presentation of attrition?

A
  1. Enamel and dentine wearing at the same rate
  2. Localised facets flattened cusps/ incisal edges
  3. Worn surfaces mate in closed eccentric movements
  4. Shiny malgam in areas of contact
  5. Slow process so secondary dentine form and not usually sensitive
  6. Possible masseteric hypertrophy
  7. Possible fractured cusps / restorations
  8. Increases risk of tooth mobility
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26
Q

What condition can cause attrition?

A

Bruxism (Grinding)

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27
Q

What can abrasion be caused by?

A
  1. Tooth brushing
  2. Abrasive dentifrices
  3. Abrasive food particles
  4. Piercings
  5. Nail biting
  6. Tobacco chewing
  7. Pipe smoking
  8. Unglazed porcelain
28
Q

What is the clinical presentation of abrasion

A
  1. Sharply defined margins
  2. Smooth hard surface
  3. More rounded and shallow if associated with erosion
29
Q

What is abfraction

A

theory of abfraction supposes that occlusal force cause compressive and tensile stresses which are concentrated at the cervical region of the tooth and cause microfracture of cervical enamel rods

30
Q

What should you do when you think a patient suffers from tooth wear

A

Identify the type and severity of tooth wear
Identify etiology
Manage and monitor

31
Q

Name some severe consequences of tooth wear

A 
Lack of tooth tissure 
Pulpal problems 
Aesthetic compromse 
Lack of space for restoration 
Occulal changed 
Soft tissue changes
32
Q

Name some severe consequences of tooth wear

A 
Lack of tooth tissue 
Pulpal problems 
Aesthetic compromise 
Lack of space for restoration 
Occlusal changed 
Soft tissue changes
33
Q

How do we manage NCTTL?

A
  1. Identify the cause if possible and assess the long term prognosis for the patients dentition
  2. Institute preventative meaures and try to control it
  3. Monitor it
  4. Operative treatment if required
  5. Review
34
Q

How do we manage NCTTL?

A
  1. Identify the cause if possible and assess the long term prognosis for the patients dentition
  2. Institute preventative measures and try to control it
  3. Monitor it
  4. Operative treatment if required
  5. Review
35
Q

Give sone intrinsic sources of acid

A
  1. Gastro oesophageal reflux (GOR)
  2. Vomiting
  3. Ruminant eating
36
Q

Give examples of some eating disorders we need to los out for

A

Anorexia nervosa

Bulimia nervosa

37
Q

What is anorexia nervosa described as?

A

Aversion to eating

38
Q

What is the prevalence of anorexia nervosa in young women

A

0.5-1%

39
Q

What is the incidence of Anorexia nervosa

A

incidence of 7 per 100,000

4000 new cases in the uk per yr

40
Q

What is the average age of presentation for anorexia nervosa?

A

16 yrs

41
Q

Wha is bulimia nervosa described as?

A

Over eating followed y inappropriate compensatory behaviour eg purging

42
Q

What is the incidence of bulimia nervosa?

A

8.6-14 per 100,000

43
Q

What is the average age of presentation of bulimia nervosa ?

A

25 yrs

44
Q

What is the difference between erosion and caries?

A

In caries plaque acid leads to demineralisation BUT organic matrix isnt affected
In erosion acid leads to demineralisation and loss of the organic matrix

45
Q

What Is bruxism sometimes a response to?

A

Commonly a parafunctional activity in response to stress

46
Q

What is bruxism associated with?

A

Tongue’s scalloping and or cheek ridging in active cases

In severe cases masseteric hypertrophy can occur

47
Q

On which tooth surface does abrasion usually occur on?

A

Mainly cervical

48
Q

Describe a tooth affected by abfraction

A
  1. Deep V shaped notch
    2.May be a. single tooth affected
    3, Toothbrush is unable to contact base of defect
  2. Defects may be sungingival
49
Q

What are some clinical consequences of NCTTL?

A
  1. Change in appearance
  2. Pain and/ or sensitivity
  3. Loss of OVD and/or lack of occlusal stability
  4. Functional difficulties
50
Q

What are some difficulties associated with severely worn dentition

A
  1. Lack of tooth tissue
  2. Pulpal
  3. Aesthetic compromise
  4. Lack of space for restoration
  5. Occlusal changes
  6. Soft tissue changes
  7. Habitual / aetiological factor
51
Q

How can we check if tooth wear is progressing in a patient?

A

By using clues such as if theres sensitivity of straining

By monitoring

52
Q

How can we monitor tooth wear?

A
  1. Study models
  2. Silicone index
  3. Clinical photographs
  4. Description
  5. Measurement: crown height and gingival margin
53
Q

Howdy we manage NCTTL?

A
  1. Identify the cause if possible and assess the long term prognosis for the patient’s dentition
  2. Institute preventive measures and try to control the TSL
  3. Monitor the TSL
  4. Operative treatment if required
  5. Review
54
Q

How can erosion be prevented?

A
  1. By giving diet advice
  2. Avoid brushing immediately after having acidic food
  3. Control of GORD/ eating disorder
  4. Water and sodium Bicarbonate mouth wash
55
Q

Name some products patients can use for Desensitisation and protection

A
  1. Fluoride mouthrinses and varnish
  2. Fluoride paste
  3. Low abrasivity toothpaste
    4 .Sugar free chewing gum
  4. Dentine bonding agents
  5. Anti erosion toothpastes
  6. Tooth mousse
56
Q

How can attrition be prevented?

A
  1. Increase patients awareness by providing education
  2. Splints
  3. Composite
57
Q

Name the 2 different types of splints

A
  1. Soft splints

2. Hard splints

58
Q

Describe soft splints

A
  1. They can be used as an upper fluoride/ sodium bicarbonate tray
59
Q

When are soft splits used?

A

Usually tried first on patients and if the patients read through them a hard splint is used
Usually lower in bruxism cases

60
Q

Give some positives of soft splints

A

They provide a full coverage

They re quick and easy to use

61
Q

Give some disadvantages of soft splits

A

Patents can bite through them

62
Q

Give some disadvantages of hard splints

A

They ar more time consuming and difficult to put on

63
Q

Give some advantages of hard splints

A

They provide an ideal occlusion ;They relax the muscles and reposition the mandible

64
Q

When are hard splints used?

A

After a patient has chewed through their soft splint

65
Q

How can abrasion be prevented?

A
  1. Patient is given OHI advice
    2, Using. softer brush and lower brushing force
  2. Using tooth paste with a lower paste abrasivity
  3. Abrasive restoration
66
Q

When do we intervene in regards to tooth wear?

A
  1. Earlier rather than later
  2. When pulp may be affected close to being affected
  3. When aesthetics are involved
  4. Functional problems occur
  5. Loss of structural integrity
  6. To prevent further complex treatment
  7. Patient wishes

2ND Year- CSA (8 decks)

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