CDH 3.12 Non carious tooth surface loss in children Flashcards
The 3 main processes make up the contribution to the phenomenon of TSL:
- Abrasion – something external – toothbrush/ musical instruments (uncommon)
- Attrition – common - particularly in the primary dentition (more tooth-tooth contact due to unstable occlusion)
o Thinner enamel – doesn’t take as long to get into dentine - Erosion (chemical attack) – main one
- Erosive changes are more evident on ____and __surfaces
* The _________________ is the most likely tooth to be affected by TSL as it is usually _____________
- Erosive changes are more evident on lingual and buccal surfaces
- The first permanent molar is the most likely posterior tooth to be affected by TSL as it is usually the first permanent tooth to erupt in a child, typically at 6 years.
What percentage of 5 years olds have evidence of TSL?
2) What percentage have TSL involving dentine or pulp?
accoriding the the CDHS 2013
• A third (33%) of 5 year olds had evidence of TSL on one or more of the buccal surfaces of the primary upper incisors, although only 4% overall had TSL involving dentine or pulp.
• As with primary incisors, TSL on permanent incisors was more common on ___surfaces than ___surfaces, with 38% of children being so affected.
• As with primary incisors, TSL on permanent incisors was more common on lingual surfaces than buccal surfaces, with 38% of children being so affected.
• The proportion of children with any TSL at age 15 on the occlusal surface of the molar was higher than at age 12 (___% compared to ____%).
• The proportion of children with any TSL at age 15 on the occlusal surface of the molar was higher than at age 12 (31% compared to 25%).
What is the clinical features seen with erosion? (4)
silky or glassy appearance, bucco-lingual/palatal flattening, dished out occlusal appearance , dentine exposure and high enamel ridges
How does erosion occur what is it?
2) would there be subsurface damadge?
• Chemical dissolution of tooth substance without the presence of dental plaque
• Moderate to strong acids (PH 1.2-5)
• Act over short time frames (seconds)
2) Affect tooth surface with very little subsurface damage
What intrinsic things could be causing erosion?
vomiting, GORD, Rumination (refluxate enters the mouth is chewed, has been noted among bulimics and infants, erosive pattern is more genrealised and includes occlusal surfaces, eructation (moist “acidic air” enters the oral cavity)
What teeth are most likely affected by erosion in thoses with GORD or vomiting?
2) is this the same for rumination and eructation?
1) maxiallary posterior teeth as tongue covers the rest of the teeth
2) rumination (more generalised and includes occlusal surface), and in eructation more post. max teeth affected but depends on whether mouth is open or closed, other surfaces will also be affected.
Erosion extrinsicis caused by what
?
dietary, environmental or occupational acids (extrinsic or exogenous erosion)
extrinsic erosion: • If the occlusal surfaces of the mandibular teeth are affected more than the maxillary teeth, then the agent is usually a_____ that ____ the mandibular teeth.
• If the occlusal surfaces of both arches are equally affected, then the agent is usually ______acidic food that is masticated
- If the occlusal surfaces of the mandibular teeth are affected more than the maxillary teeth, then the agent is usually a liquid that floods the mandibular teeth.
- If the occlusal surfaces of both arches are equally affected, then the agent is usually solid acidic food that is masticated
What is attrition?
2) what motion of occlusion do grinding pt move in typically?
3) What pathological tooth damage can you see?
4) what are the 3 clinical features?
Occurs from tooth-to-tooth contact without the presence of food - tooth grinding either nocturnally while asleep or diurnally
2) centric occlusion to eccentric lateral position
3) enamel flaking and cusp fracture
4) • Matching wear facets, flat no scooping • Symptoms of TMD
What is abrasion?
2) how is wear pattern usually distributed?
3) does sensitivity occur why?
4) what appearance does exposed dentine usually have?
Wear that occurs by the friction of exogenous material (anything foreign to the tooth) that is forced over the surfaces of the tooth
2) general throughout arch
3) • Not sensitive due to presence of a smear layer
4) scooped out
What are the 3 main causes of TSL in children?
- Dietary
- Gastric regurgitation
- Parafunctional habit (grinding)
Recall some high risks groups of erosion (6)?
- Regular and frequent acidic drink consumption
- 4 or more acidic dietary intakes per day
- Patients suffering from chronic medical conditions and taking regular oral medication with erosive potential
- Patients suffering from xerostomia, hyposalivation and previous head & neck radiation
- Alcoholics/professional wine taster
- GI and eating disorders
