Erosion Flashcards
What are the causes of non carious TSL?
Attrition
erosion
abrasion
abfraction
What is dental erosion?
this is the progressive loss of dental tissue causd by the chemical processes without bacterial involvement
T/F the prevalence of erosion is increasing?
T
esp in adolescents
WHat did the CDH survery show fo TSL affecting palatal of incisors?
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
What is the critical pH ?
the pH at which a soluton is just saturated with respect to a particular solid eg enamel mineral
What happens below the critical pH?
the solutuon is under saturated and this it can dossolve the solid
What happens above the critcal pH?
the solid can be precipitated out, the solution is super saturated
WHat is the critical pH dependant on?
the solubility of the solid
the concentrations of the mineral in the soluton
WHat is more soluble, HAP or FAP?
HAP
WHat is the critical pH for HAP in caries and how does this compare for FAP?
HAP: 5.5
FAP: 3.5
WHat is the critical pH for HAP in erosion?
there is none
since it is dependant on the saturation of the solution
What happens to the tooth as it is eroded?
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
WHat is titratable acidity and how does this relate to erosion?
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
what is the pH of saliva?
7.0
what does saliva contain to aid its buffering capacity?
it contains calcium and phosphate ions
WHat is the histopath behin erosion?
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
What is the aetology behind erosion?
extrinsic acids and intrinsic
What are the intrinic sources of acid?
reflux
eating dirosers
rimination
What is gastric reflux?
the back flow of acid into the mouth
WHat are the risk factors forr relfux?
preganancy
obesity
high fat diet
alcohol
What are the features associated with relfux?
heartburn
bad taste
dysphagia
dental erosion
WHat are the signs of eating disorder?
change in beahviour weight loss withdrawl signs of bomiting enlatged salivary galnds loss of mestrualcycle delayed puberty dizziness
WHat is anorexia nervosa?
dailure to eat in the abscence of any phyisical cause and they are more than 15% below expcted bpdy weight
what is the incidence rate for anorexia?
1/250 females
1/2000 males
t/f anorexics have a distorted body image?
t
t/f anorexics have an intense fear of gaining weight?
t
WHat may anorexia be associated with?
excess exerice
use of laxatives
appetite supression and vomiting
what is bulimia nervosa?
recurrent episodes of binge eating followed by self indeuced vimiting
which is more common buimia or anorexia?
bulimia
5x
WHat is rumination syndrome?
rare condition where there is effortless and repeitive regurgiation of recelt ingested food into the mouth and not associated with nausea
t.f the reapeated chewing and swallong may occur many times in an hour in ruminatuon syndrome?
t
WHat is rthe aetoligy behind rumination syndrome?
unknown
likely to be learnt and voluntary
Where does erosion usually affect?
anterior teeth and manbid molars with paltal and occlusal surfaces usually involved
T.F erosion can affect any surface?
t
What are the early signs of erosion?
loss of surface features and rounding of the incisal edges and cusps and teeth become chiny and incisal edge becomes more translucent
What are the later signs of erosion?
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
WHat are the later signs of erosion?
cupping of the occlusal surfaces and dentine xposre and proud restpratiuons
WHat are the signs of advanced erosion?
teeth become shorter
shine through of pulp and pulpal exposre
pulpal inflammation and peripical patho and abscesses
What is they key thing with regards to erosion in the primary dentition>
The enamel is much thinner so it progresses quickly
what are the aims of management of erosion?
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
WHat are the treatment objectives?
resolve sensitivity
restore mssing tooth surfaces
prevent further tooth loss
maintain balanced occlusaion
what would you do to treat defects in the primary dentiton?
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
WHhat are the treatment options in perm teeth?
composte venners and paltal CoCr venners
poeteriot teeth: cast gold onlays composte onlays
Dahl effect
