Tooth Surface loss

Question 1

Most common cause of tooth surface loos in children?

Answer 1

Erosion

Question 2

Describe erosion clinically?

Answer 2

Silky/glassy appearance
Bucco-lingual/palatal flattening
Dished out occlusal appearance
Dentine exposure and high enamel ridges

Question 3

What is erosion?

Answer 3

Chemical dissolution of tooth substance without presence of dental plaque

Question 4

What is intrinsic erosion?

Answer 4

Gastric acid - vomiting, reflux, burping

Question 5

What is extrinsic erosion?

Answer 5

Dietary

Question 6

What is attrition?

Answer 6

Tooth to tooth contact without presence of food - teeth grinding

Question 7

What is abrasion?

Answer 7

Friction of exogenous material forced over surface of tooth

Question 8

Risk factors for tooth wear

Answer 8

Fizzy drinks frequently
Chronic medical conditios - taking oral medications with erosive potential
Xerostomia, head and neck radiation
Alcoholics
GI and eating disorder

Question 9

How is tooth surface loss menagaed?

Answer 9

Genrally ‘wait and see’ especially if no pain/sensitivity, aesthetic or functionality concerns
Record –> study casts, photographs, dietary analysis, OHI

Question 10

How can you reduce sensitisation of eroded teeth?

Answer 10

Fluoride varnish, toothpastes
ACP (amorphous clacium phsophate) - chewing gum, mousse
Sensodyne

Question 11

Treatment objectives for TSL?

Answer 11

Resolve sensitivity
Restore missing tooth surface
Prevent further tooth loss
Maintain a balanced occlusion

Question 12

Operative treatment of TSL (primary teeth)?

Answer 12

Cover with composite resin and/or stainless steel crowns

Extract offending teeth

Question 13

Operative treatment of TSL (permanent teeth)?

Answer 13

Treat conservatively = long term monitoring and composite resin to eroded surfaces
Dentien binding can offer short-lived dentine protection