management of tooth wear Flashcards
what is attrition?
loss of tooth substance/restoration as a result of mastication
or of occlusal or proximal contact between the teeth
with what does physiological attrition occur?
age
what areas are most affected by physiological attrition?
affects proximal surfaces b/c mastication, occlusals and incisal edges
permanent or deciduous more affected by physiological attrition?
deciduous b/c softer enamel
is the rate of physiological attrition more in men or women?
men
what are the signs of physiological attrition
flattening of cusps, disappearence of mammelons, exposed dentine - brown, cup shaped lesions
what is pathological attrition?
confined to local areas, caused by a parafunction or misalignment
what is bruxism?
clenching or grinding of teeth
causes of bruxism?
stress/occlusal forces interferences
signs of bruxism?
visible wear facets, abnormal rate of attrition, hypertrophy or masticatory muscles, muscle tenderness, TMJ pain, tooth mobility, pulpal sensitivity to cold
treatment of bruxism?
remove occlusal interferences, acrylic splint to protect tooth
what is the rate of dentine attrition?
higher rate because its softer
why is there no sensitivity in attrition?
slow process, secondary dentine formed so prevents sensitivity
what is abrasion?
the pathological wearing away of tooth surface/ structure b/c of repetitive mechanical forces or habit
where is abrasion most commonly seen?
most commonly seen in exposed root surfaces
what is dentine abrasion like?
faster
how is pulpal exposure prevented?
secondary dentine forms
what is cervical abrasion?
v shaped groove caused by horizontal brushing etc
side effects of cervical abrasion - abfraction is?
tooth flexure from occlusal loading, microfractures in enamel, cavitation
what is habitual abrasion?
abrasion bc pipe smoking, holding pins, instruments etc
where is habitual abrasion localised to?
area of habit
what is iatrogenic abrasion?
opposing teeth gridning to accommodate restorations
what is industrial abrasion?
uncommon now, b/c of abrasive particles present in atmospheres
how to treat abrasion?
prevention
enough damage = restore
what is erosion?
progressive loss of hard dental tissue by an acidic chemical process without bacterial ation
signs of erosion?
any smooth surface, appears smooth and polished, shallow depressions, proud restorations, cupping of lower molar cusps, palatal chipping of incisal edge
where is extrinsic erosion?
labial surfaces of anterior teeth, occlusals of lower perm molars
where is intrinsic erosion?
palatal uppers, occlusal lower molars
what causes extrinsic erosion?
frequent consumption of acid
carbonated drinks, teas, swimming in heavily chlorinated water
what causes intrinsic erosion?
reflux, hiatus hernia, gastric ulcer. alcohol absuse, bullimia, pregnancy
clinical signs of bullimia?
normal body weight, erosion of palatal surfaces of upper teeth
lesions of palate, fingers, oral mucosa,lips
signs of malnutrition
dental management of erosion?
remove cause, seek help, dont brush after acid, F therapy, possible restoration, maintain OH
intervene when?
poor aesthetics, loss of vitality b/c NCTSL, loss of function, sensitivity
lesion compromising pulp
how to treat the sensitivity
Flouride and chx
when to restore?
v sensitive, pt concerned about appearance, pulp is compromised
tx options for tooth wear?
prevention
F/chx therapy
night guard
restoration
F/Chx therapy?
duraphat
cervitec
resin - seal and protect
