Erosion

Question 1

What are the causes of non carious TSL?

Answer 1

Attrition
erosion
abrasion
abfraction

Question 2

What is dental erosion?

Answer 2

this is the progressive loss of dental tissue causd by the chemical processes without bacterial involvement

Question 3

T/F the prevalence of erosion is increasing?

Answer 3

T

esp in adolescents

Question 4

WHat did the CDH survery show fo TSL affecting palatal of incisors?

Answer 4

1993: 5 yo: 52% affected, 24% into dentine
15 yo: 27% affected, 2% into dentine

2003: 5 yo: 53% affected, 22% into dentine
15 yo: 33% affected, 5% into dentine

Question 5

What is the critical pH ?

Answer 5

the pH at which a soluton is just saturated with respect to a particular solid eg enamel mineral

Question 6

What happens below the critical pH?

Answer 6

the solutuon is under saturated and this it can dossolve the solid

Question 7

What happens above the critcal pH?

Answer 7

the solid can be precipitated out, the solution is super saturated

Question 8

WHat is the critical pH dependant on?

Answer 8

the solubility of the solid

the concentrations of the mineral in the soluton

Question 9

WHat is more soluble, HAP or FAP?

Answer 9

HAP

Question 10

WHat is the critical pH for HAP in caries and how does this compare for FAP?

Answer 10

HAP: 5.5
FAP: 3.5

Question 11

WHat is the critical pH for HAP in erosion?

Answer 11

there is none

since it is dependant on the saturation of the solution

Question 12

What happens to the tooth as it is eroded?

Answer 12

it oriduces a layer of eroded calcium and phospkahte ions which surround the tooth immediatly this then increases the saturation of the solution aound the tooth and this reduces the liklihood of dissolution ocurring

Question 13

WHat is titratable acidity and how does this relate to erosion?

Answer 13

this is the amount of strong base which is needed to neutalise a strong base and the higher the TA value the longer it can maintain its low pH when buffered or diluted

Question 14

what is the pH of saliva?

Answer 14

7.0

Question 15

what does saliva contain to aid its buffering capacity?

Answer 15

it contains calcium and phosphate ions

Question 16

WHat is the histopath behin erosion?

Answer 16

when enamel is exposed to acid it becomes softened to a depth of 0.2-3microns and increased roughness which now resembles etched enamel
continued acid attack then leads to bulk mineral loss with the reamining surface being partially demineralised
this layer is much more suscwptible to loss due to physical forces

This same process affects dentine and then los of dentine volume occurs at a faster rate than enamel since it has a lower mineral content

Question 17

What is the aetology behind erosion?

Answer 17

extrinsic acids and intrinsic

Question 18

What are the intrinic sources of acid?

Answer 18

reflux
eating dirosers
rimination

Question 19

What is gastric reflux?

Answer 19

the back flow of acid into the mouth

Question 20

WHat are the risk factors forr relfux?

Answer 20

preganancy
obesity
high fat diet
alcohol

Question 21

What are the features associated with relfux?

Answer 21

heartburn
bad taste
dysphagia
dental erosion

Question 22

WHat are the signs of eating disorder?

Answer 22

change in beahviour
weight loss
withdrawl
signs of bomiting
enlatged salivary galnds
loss of mestrualcycle
delayed puberty
dizziness

Question 23

WHat is anorexia nervosa?

Answer 23

dailure to eat in the abscence of any phyisical cause and they are more than 15% below expcted bpdy weight

Question 24

what is the incidence rate for anorexia?

Answer 24

1/250 females

1/2000 males

Question 25

t/f anorexics have a distorted body image?

Answer 25

t

Question 26

t/f anorexics have an intense fear of gaining weight?

Answer 26

t

Question 27

WHat may anorexia be associated with?

Answer 27

excess exerice use of laxatives appetite supression and vomiting

Question 28

what is bulimia nervosa?

Answer 28

recurrent episodes of binge eating followed by self indeuced vimiting

Question 29

which is more common buimia or anorexia?

Answer 29

bulimia | 5x

Question 30

WHat is rumination syndrome?

Answer 30

rare condition where there is effortless and repeitive regurgiation of recelt ingested food into the mouth and not associated with nausea

Question 31

t.f the reapeated chewing and swallong may occur many times in an hour in ruminatuon syndrome?

Answer 31

t

Question 32

WHat is rthe aetoligy behind rumination syndrome?

Answer 32

unknown | likely to be learnt and voluntary

Question 33

Where does erosion usually affect?

Answer 33

anterior teeth and manbid molars with paltal and occlusal surfaces usually involved

Question 34

T.F erosion can affect any surface?

Answer 34

t

Question 35

What are the early signs of erosion?

Answer 35

loss of surface features and rounding of the incisal edges and cusps and teeth become chiny and incisal edge becomes more translucent

Question 36

What are the later signs of erosion?

Answer 36

thinning and chipping of the incisal edge and chmafered edges at teh gingival margin teeth appear darkened as dentine begins to shine through and there is dentine sensitivitiy

Question 37

WHat are the later signs of erosion?

Answer 37

cupping of the occlusal surfaces and dentine xposre and proud restpratiuons

Question 38

WHat are the signs of advanced erosion?

Answer 38

teeth become shorter shine through of pulp and pulpal exposre pulpal inflammation and peripical patho and abscesses

Question 39

What is they key thing with regards to erosion in the primary dentition>

Answer 39

The enamel is much thinner so it progresses quickly

Question 40

what are the aims of management of erosion?

Answer 40

Early Dx: ask about diet and relevant medical history identify aetoligy: 3 day diet diary, could also be historic, refer to GMP if no cause is idnetified prevention: based on aetiology desensitiation: FLuoride moth rinse, high fluorde tooth paste, varnihs and tooth mousse monitor: study models, photos restore: inly provide defintive once aetology determined but can stablise during the monitoring ohase

Question 41

WHat are the treatment objectives?

Answer 41

resolve sensitivity restore mssing tooth surfaces prevent further tooth loss maintain balanced occlusaion

Question 42

what would you do to treat defects in the primary dentiton?

Answer 42

asym: resrotave treatmnet not indicated small areas of exposed dentine: cover with composite/GIC large areas of exposed dentine: composite for anterior and SSC posterior exposed pulp: pulp therapy or extract

Question 43

WHhat are the treatment options in perm teeth?

Answer 43

composte venners and paltal CoCr venners poeteriot teeth: cast gold onlays composte onlays Dahl effect