Non-Carious Hard Tissue Loss Flashcards
6 causes of non-carious/ perio tooth loss and define
- attrition: tooth to tooth frictional wear
- abrasion: physical wear other than by tooth
- erosion: chemical non-bacterial dissolution (acid)
- abfraction: tensile/ shear stresses weakening enamel prisms (micro-fractures)
- resorption (roots)
critical pH. what happens below
5.5
below this, tooth erodes, lose enamel prisms
when does tooth wear become significant 3
when it causes problems with
- function
- aesthetics
- sensitivity
% population with
a. tooth wear
b. pathological tooth wear
a. tooth wear: 97%
b. pathological tooth wear : 7%
2 classifications of erosion
- extrinsic: exogenous acids (occupation, diet)
intrinsic: endogenous acids (GI)
examples of dietary factors that cause erosion
- drinks: smoothies, herbal tea, sports drinks, wine, juice, coke
- food: citrus fruit, pickles, yoghurt, salad dressing, vinegar, indian food
- medicaments: lemsip, vit C, iron tonics, aspiriin, mouthwash
lifestyle factors that cause erosion
- industrial: acid fumes
- wine tasters
- swimmers in chlorinated pools
- sportsment (acidic drinks)
5 factors that influence impact of extrinsic erosion
- frequency
- pH/ buffering capacity
- method of consumption (eg swishing worse than straw)
- time (night-time worse)
- temperature (worse with heat eg herbal teas, lemsip)
relationship between non-carious tooth loss factors
non-proportional: >1 factor causes a lot more damage
development of taste buds and relevance
children don’t have taste buds until they are exposed to those stimuli –> if they are never given sweets, they won’t want them
compare deciduous and permanent teeth terms of erosion/ caries susceptibility
deciduous: enamel more porous, thinner, less mineralised –> more susceptible to caries and erosion
causes of intrinsic erosion
- GORD
- pregnancy
- diabetes
- neurological, psychosomatic and CNS disorders eg bolemia
prevalence of GORD
7%
causes of GORD
chronic alcoholism, GI ulcers, hiatus hernia
prevalence of eating disorders in females
0.5%
prevalence of alcoholism in genders
M: 1/5
F: 1/8
explain voluntary regurgitation
‘chewing the cud’
vomit in to mouth, chew and swallow again
common in stress, cerebral palsy, institutionalised
effect of pregnancy on vomiting
1st trimester- morning sickness
3rd trimester: regurgitation
likely cause of erosion
a. anterior teeth external/incisal
b. posterior teeth occlusal
c. palatal surface
a. anterior teeth external/incisal: acidic fruits
b. posterior teeth occlusal: acidic drinks
c. palatal surface: intrinsic (vomiting)
common sites for attrition
- proximal contacts points during function
- supporting cusp tips during grinding
- guiding surfaces during grinding
freq of attrition needed to be noticable
heavy forces >35 mins/24 hours (remember mosst grinding occurs at night during sleep)
is pathology more freq in attrition or erosion
erosion
% population affected by bruxism
up to 96%
% of normal biting force when grinding
30-60%
causes of bruxism
- anxiety/ stress
- ecstacy, MD, meth (gurning)
do people with attrition have canine or group function and why
group function. canines worn down by attrition
attrition or erosion what causes
a. enamel and dentine wearing at equal rate
b. proud restorations
c. tooth mobility
d. cupping of molars
e. more breakdown of enamel than dentine
a. enamel and dentine wearing at equal rate: attrition
b. proud restorations: erosion
c. tooth mobility: attrition
d. cupping of molars: erosion
e. more breakdown of enamel than dentine: erosion
risk factors for abrasion
occupational eg hairdressers (hairpins in mouth) carpet layers (carpet in mouth) etc -too hard tooth brushing -flossing incorrectly -porcelain crowns
most common sites for abrasion
buccal/labial surface of incisors, canines, premolars
physiological amount of enamel wear/yr
20-40 microns/yr
impact on abrasion:
a. gold
b. amalgam
c. porcelain
d. NiCr
e. acrylic
f. composites
a. gold: least abrasion
b. amalgam: ok
c. porcelain: v bad, lots of abrasion
d. NiCr: more abrasive than enamel
e. acrylic: less abrasive than enamel
f. composites: depends on filler size (larger filler = better aesthetics but more abrasive)
explain abfraction
occlusal loads –> cusps FLEX (esp premolars) –> deform enamel at cervical margin –> enamel pings off
difference in appearance between adfraction and abrasion cavities
abfraction cavities deeper, more defined notch
3 causes of root resorption
- developmental (deciduous teeth during exfoliation)
- pathological (dentigenerous cysts, space-occupying lesions)
- idiopathic (eg following trauma/ infection)
effect on roots of
a. benign lesion
b. malignant lesion
a. benign lesion: pushes roots apart. tooth stays vital
b. malignant lesion: eats in to roots, –> non vital tooth
3 types of resorption
- external inflammatory resorption: TTP, discolouration, mobility
- external surface resorption: usually apical after trauma/ ortho/ re-implantation
- internal resorption: pink spot, starts at pulp and moves outwards. cervical 1/3. usually asymptommatic
