Management of worn teeth

Question 1

4 terms of erosive tooth wear

Answer 1

1. Dental erosion
2. Attrition
3. Abrasion
4. Abfraction

Question 2

Dental erosion is wear of teeth by

Answer 2

acids NOT from a bacterial origin

Question 3

Attrition is wear of teeth by

Answer 3

teeth

Question 4

Abrasion is wear of teeth by

Answer 4

external object

Question 5

Abfraction is wear of teeth by

Answer 5

occlusal forces

Question 6

3 clinical features should be taken into consideration when managing wear..

Answer 6

1. shape of wear facets
2. position of wear
3. corresponding wear on occluding teeth

Question 7

Dental erosion usually happens slowly over time however in rapid cases what can occur

Answer 7

dental pulp exposure

Question 8

Dental attrition clinical featues

Answer 8

affecting incisal edges - teeth are very flat

Question 9

Two main causes of dental erosion

Answer 9

dietary acids - carbonated/fizzy/citrus drinks
medical conditions - gastric juice

Question 10

What 4 things are important to consider in dietary acids

Answer 10

1. amount
2. timing
3. nature
4. method of consumption

Question 11

4 things to consider for regurgitated acid

Answer 11

1. When
2. How often
3. How much
4. How far does it travel up

Question 12

Protective mechanisms of saliva in erosive wear:

Answer 12

Ions such as calcium, phosphate, fluoride
buffering acids
reducing demineralisation and enhancing remineralisation

Question 13

4 steps of management of patients with worn teeth

Answer 13

1. Diagnosis
2. Prevention
3. Monitor
4. Treat

Question 14

Ho do we manage dental erosion?

Answer 14

• Reduce acids: dietary (amount,t timing, nature, method of consumption. Regurgitated acids (lifestyle modifications, medications, surgery).
• Strengthen defence mechanism such as fluoride, gum to increase salivary flow
• protect surfaces (dental bonding, fissure sealant, composite)
• Monitor

Question 15

Unsupported enamel can lead to fracturing what would you place to support enamel

Answer 15

Composite in the facets

Question 16

What measurements to take when monitoring wear and when do you repeat measurements?

Answer 16

measure height from restoration to the tooth surface and repeat at 6 months then yearly

Question 17

Criteria for treatment of wear? list 4

Answer 17

-patients wishes (a lot of time due appearance)
- sensitivity/pain
- chipping of incisal edges
- short clinical crown

Question 18

Criteria for treatment of wear? list 4

Answer 18

-patients wishes (a lot of time due appearance)
- sensitivity/pain
- chipping of incisal edges
- short clinical crown

Question 19

Methods of treatment for wear, list 5

Answer 19

• dentine bonding agents
• composite restorations
• composite veneers
• porcelain veneers
• crowns - more complex