management of tooth wear

Question 1

what is attrition?

Answer 1

loss of tooth substance/restoration as a result of mastication
or of occlusal or proximal contact between the teeth

Question 2

with what does physiological attrition occur?

Answer 2

age

Question 3

what areas are most affected by physiological attrition?

Answer 3

affects proximal surfaces b/c mastication, occlusals and incisal edges

Question 4

permanent or deciduous more affected by physiological attrition?

Answer 4

deciduous b/c softer enamel

Question 5

is the rate of physiological attrition more in men or women?

Answer 5

men

Question 6

what are the signs of physiological attrition

Answer 6

flattening of cusps, disappearence of mammelons, exposed dentine - brown, cup shaped lesions

Question 7

what is pathological attrition?

Answer 7

confined to local areas, caused by a parafunction or misalignment

Question 8

what is bruxism?

Answer 8

clenching or grinding of teeth

Question 9

causes of bruxism?

Answer 9

stress/occlusal forces interferences

Question 10

signs of bruxism?

Answer 10

visible wear facets, abnormal rate of attrition, hypertrophy or masticatory muscles, muscle tenderness, TMJ pain, tooth mobility, pulpal sensitivity to cold

Question 11

treatment of bruxism?

Answer 11

remove occlusal interferences, acrylic splint to protect tooth

Question 12

what is the rate of dentine attrition?

Answer 12

higher rate because its softer

Question 13

why is there no sensitivity in attrition?

Answer 13

slow process, secondary dentine formed so prevents sensitivity

Question 14

what is abrasion?

Answer 14

the pathological wearing away of tooth surface/ structure b/c of repetitive mechanical forces or habit

Question 15

where is abrasion most commonly seen?

Answer 15

most commonly seen in exposed root surfaces

Question 16

what is dentine abrasion like?

Answer 16

faster

Question 17

how is pulpal exposure prevented?

Answer 17

secondary dentine forms

Question 18

what is cervical abrasion?

Answer 18

v shaped groove caused by horizontal brushing etc

Question 19

side effects of cervical abrasion - abfraction is?

Answer 19

tooth flexure from occlusal loading, microfractures in enamel, cavitation

Question 20

what is habitual abrasion?

Answer 20

abrasion bc pipe smoking, holding pins, instruments etc

Question 21

where is habitual abrasion localised to?

Answer 21

area of habit

Question 22

what is iatrogenic abrasion?

Answer 22

opposing teeth gridning to accommodate restorations

Question 23

what is industrial abrasion?

Answer 23

uncommon now, b/c of abrasive particles present in atmospheres

Question 24

how to treat abrasion?

Answer 24

prevention

enough damage = restore

Question 25

what is erosion?

Answer 25

progressive loss of hard dental tissue by an acidic chemical process without bacterial ation

Question 26

signs of erosion?

Answer 26

any smooth surface, appears smooth and polished, shallow depressions, proud restorations, cupping of lower molar cusps, palatal chipping of incisal edge

Question 27

where is extrinsic erosion?

Answer 27

labial surfaces of anterior teeth, occlusals of lower perm molars

Question 28

where is intrinsic erosion?

Answer 28

palatal uppers, occlusal lower molars

Question 29

what causes extrinsic erosion?

Answer 29

frequent consumption of acid | carbonated drinks, teas, swimming in heavily chlorinated water

Question 30

what causes intrinsic erosion?

Answer 30

reflux, hiatus hernia, gastric ulcer. alcohol absuse, bullimia, pregnancy

Question 31

clinical signs of bullimia?

Answer 31

normal body weight, erosion of palatal surfaces of upper teeth lesions of palate, fingers, oral mucosa,lips signs of malnutrition

Question 32

dental management of erosion?

Answer 32

remove cause, seek help, dont brush after acid, F therapy, possible restoration, maintain OH

Question 33

intervene when?

Answer 33

poor aesthetics, loss of vitality b/c NCTSL, loss of function, sensitivity lesion compromising pulp

Question 34

how to treat the sensitivity

Answer 34

Flouride and chx

Question 35

when to restore?

Answer 35

v sensitive, pt concerned about appearance, pulp is compromised

Question 36

tx options for tooth wear?

Answer 36

prevention F/chx therapy night guard restoration

Question 37

F/Chx therapy?

Answer 37

duraphat cervitec resin - seal and protect