Erosion Flashcards
What is erosive toothwear?
The combination of erosion plus abrasion/attrition
If the patient shows strong signs of erosive toothwear but says that they don’t experience any reflux, what are THREE potential causes?
- Acidic diet (most common cause of erosive toothwear)
- Medications (e.g. asthma puffer)
- Sleep regurgitation
What are FOUR reasons why is acid attack more dangerous during sleep?
Decreased:
- Salivary flow
- Primary peristalsis (swallowing)
- Secondary peristalsis (oesophageal)
- Heartburn (warning)
Why is the mucosa in the oral cavity not as affected by acid attack vs. oesophageal mucosa?
Acid is rapidly diluted in the oral cavity.
What are THREE oesophageal manifestations of GORD?
- Reflux oesophagitis (mucosal erosion)
- Barrett’s oesophagus
- Adenocarcinoma
What happens in Barrett’s oesophagus and what’s so bad about it?
- Metaplasia (mimics intestinal mucosa e.g. goblet cells)
- May progress to dysplasia then adenocarcinoma (poor prognosis)
NOTE: cancer risk is higher with obesity (16.5x)
What is the first-line treatment for GORD related toothwear?
Remove the cause. (Prevention is key - remineralising agents only as adjunctive treatment)
- Controlling attrition/abrasion also important (e.g. nightguard, OHI)
True or false: erosive toothwear can occur very rapidly, taking out large scoops of enamel at a time.
False, although it does occur rapidly, it occurs in very thin layers at a time (nanometres). This cycle repeats rapidly, leading to the scooped lesions.