Tooth wear Flashcards
(42 cards)
what Is tooth wear and what can I be referred to?
Referred to as Non- Carious tooth, Tissue loss or Non-carious tooth surface loss
-Normal process that Occurs throughout life
- Pathological when rate of loss or degree of destruction is excessive
- May lead to problems with function, aesthetics or sensitivity
how does tooth wear occur?
Due to a non carious process
- erosion, abrasion , attrition
defined by aetiology, severity , distribution
describe the 2009 dental health survey
- Moderate tooth wear has increased from 11% in 1998 to 15% in 2009
although severe wear remains rare, Increase in moderate toothier in younger adults
Describe the Dental health in the UK relating to tooth wear
- ageing dentate population with increasing evidence of cumulative effects of toothier
- Erosion on the increase in younger population
-NCTTL increasing in prevalence and occupying large amounts of practitioner time - Can be complex to manage in later stages but early treatment simple and effective
what is the definition of attrition
- the loss of tooth substance or a restoration caused by tooth to tooth contact
attrition = tooth to tooth
Describe the UK child dental health survey 2013
33% of 5yd have evidence of TSL on one or more buccal surfaces of the primary upper incisors
4% involving dentine or pulp
57% of 5 old had TSL of the lingual surfaces,16% progressing to dentine or pulp
what is the definition of abrasion
- the abnormal wearing away of tooth substance or a restoration by a mechanical process other than tooth contact
what is the definition of erosion?
- the irreversible, progressive loss of dental hard tissue by an acidic chemical process not involving bacteria
what are the clinical presentations of attrition?
- enamel and dentine wearing at the same rate
- localised facets, flattened cusps/incisal edges
- worn surfaces ‘mate’ in closed eccentric movements
- shiny amalgam in areas of contact
- slow process so secondary dentine forms and usually not sensate
- possible massetric hypertrophy
- Possible fractured cusps and/or restorations
-increased risk of tooth mobility
what is bruxism
- common parafunctional activity on response tor stress
- associated tongue scalping /or cheek pidgin in active cases
- masseteric hypertrophy in sever cases
what factors can increase risk of abrasion
- tooth brushing
- abrasive dentirfices
- abrasive food particles
- peicrings
- habits
nail biting
tobacco chewing
pipe smoking
wire stripping - Iatrogenic
unglazed porcelain
What are clinical presentaion of abrasion
general
- mainly cervical
-sharply defined margins
- smooth hard surface
- more rounded and shallow if associated with erosion
what is the theory of abfraction
Theory of abstraction supposes that occlusal forces cause compressive and tensile stresses, which are concentrated at the cervicla region of the tooth and cause miucrofractor of cervical enamel rods
describe abfrsction
- deep V shaped notch
- may be a single tooth affected
- toothbrush unable to contact base of defect
- defects may be sub gingival
how is erosion classified?
classified according to the source of the acid
- Intrinsic (acid coming up)
- Extrinsic (acid going in)
what is the clinical presentation of erosion?
Anterior teeth
- loss of surface anatomy, smooth enamel surface
- increased incise translucency
- chipping of incised edges
- palatal hollows
- areas where the enamel is absent
- exposure of the pulp
- intrinsic often affects the palatal surfaces, extrinsic the labial
Posterior teeth
- loss of surface anatomy
- cusp cupping
- proud restorations
- darkening of colour
- plural exposure rare in permanent teeth
General
- Worn surfaces not in contact in closed eccentric movements
How does erosion differ from caires?
In CARIES- plaque acid leads to demineralisations but the organic matrix is not affected
In EROSION- Extrinsic/Intrinsic acid leads to demineralisation and loss of the organic matrix
List some intrinsic acids that can lead to regurgitations erosion
- Gastro oesophageal reflux (GOR)
- Vominting (voluntary/involuntary)
- eating disorders
-pregnancu - Metabolic/endocrin
-GI disorders - Drug induced
- Alcoholism
List some GOR - symptoms
- heart burn
- retrosternal discomfort
-epigastric pain - Dysphagia
- Chronic cough
-Sore throat - Hoarseness
- Sour taste at back of throat
however in many cases may be silent reflux
how many in the UK have and eating disorder
over 700,000
90% females
- underestimate
-risk of onset higher for adolescents and young adults
most ocmmon
- Atypical eaten disorders
- binge eating disorders
- Bullimia nervosa
-Anorexia nervosa
Describe anorexia nervosa
- ’ aversion to food’
- restricting and binge/prufing types
- overall incidence of 6 per 100,000 population with highest incidence age 15-19 years
- Prevalence in young women of 0.5-1%
- Female to male ration 10;1
-More than 15% below ideal body weight
Describe Bulimia nervosa
- over eating followed by inappropriate compensatory behaviour e.g purging
- prevalence in Europe less than 1-2 %
- peak age of onset 15-25 years
Email to male ratio 10;1 - within 10% of ideal body weight or grossly overweight
List some dietary acid sources
- acid drinks and food
- soft drinks - fruit juice, carbonated and still
- alcoholic drinks
- fresh fruit, fruit pulp, dared fruit
- pickles, vinegar, acetic acid added to crisps
- Yoghurts and sauces
- Fruit and herbal teas
- Energy/sports supplements
what are the important factors to consider with dietary erosion
amount
frequency
method of consumption
timing of consumption
