Prevention Of Tooth Wear Flashcards
What are causes of abrasion?
• Oral hygiene habits
o Excessive brushing/flossing
o Abrasives in dentifrices/toothpastes
• Personal habits
o Putting foreign objects in the mouth
- It is not just the abrasive content of the toothpaste that is important; the abrasive type, particle size and surface, and the chemical effects of the other constituents will also affect the amount of abrasion.
- other factors such as brushing force, bristle stiffness and particularly the frequency of and time spent on tooth brushing are very important in encouraging dental abrasion.
There is strong evidence to show that abrasion increases enormously if the teeth are first exposed to an acidic erosive challenge, and then tooth brushing is undertaken shortly afterwards.
What’s clinical appearance of a brasion?
- The enamel and dentine is worn away to produce a ‘V’ shaped notch at the neck of the tooth.
- Worn, shiny often yellow/brown areas at the cervical margin.
- Worn ‘notches’ on the incisal surfaces of the anterior teeth
What’s the cause of attrition?
parafunctional activities, such as bruxism, are probably the most significant factors in the development of pathological tooth wear in contact areas.
What are Clinical appearance of Attrition?
- Polished facets on enamel surfaces
- Cupping – dentine is exposed
- Occasional full loss of enamel, dentine is exposed and stains heavily
What’s domestication?
Demastication: loss of tooth substance during mastication, influenced by the abrasivity of the food. This should be regarded as a combination of abrasion and attrition.
What’s Clinical Appearance Of Erosion?
- Occurs most frequently on the palatal and labial surfaces of the incisor teeth.
- The effected surfaces appear smooth and highly polished with a scooped out depression.
- The lesion primarily occurs in the enamel,in more severe cases the dentine becomes exposed.
- As enamel loss progresses sensitivity to thermal changes are noticed
- More persistent pain occurs in severe cases
What are Principal causes of gastro-oesophageal reflux?
- Increased gastric pressure: Obesity.
- Increased gastric volume: After heavy meals , Obstruction, Spasm.
- Sphincter incompetence: Hiatus hernia, Diet, Drugs, e.g. diazepam, Neuromuscular, e.g. cerebral palsy ,Oesophagitis-alcohol
- is the first sign that reflux is occurring, General associated symptoms are heartburn, retrosternal discomfort and dysphagia.
- rumination-deliberately bringing food back into the mouth to re-chew-which has led to extensive erosion.
What are Principal causes of vomiting:
• Psychesomatic
Stress-induced psychogenic vomiting
o Eating disorders.
o Bulimia nervosa.
o Anorexia nervosa.
- Pregnancy/Hormones
- Motion sickmess
What are Extrinsic acid sources
- There are many sources of acid from outside the body which may affect the dental tissues
- Dietary, drinks etc.
- Lifestyle influences
Dietary, drinks
- A significant association has been shown between soft drink consumption and dental erosion, particularly, the bed-time consumption of fruit-based drinks.
- There are also acidic foods and practices that may be implicated such as high consumption of fruit, pickles, and sauces.
Lifestyle influences:
Encouragement to take regular exercise may also lead to increased consumption of acidic drinks; some of the sports drinks are not only acidic, but also contain a considerable amount of simple sugars.
Both competitive swimmers and cyclists have been reported as having higher levels of dental erosion. • Industrial atmospheric pollution.
- Chemical workers, battery manufacturers.
- Chlorine, from gas chlorinated swimming pools
- Professional swimmers.
What medicine cause abrasion?
- Ascorbic acid tablets, Aspirin tablets, Iron.
* Medication that reduce salivary flow such as tricyclic antidepressants and antihypertensive
What are Clinical Problems associated with tooth wear?
- Aesthetics.
- loss of tooth structure.
- Sensitivity and pain.
- Inter-occlusal space.
- Patient compliance and expectations.
HOW CAN WE PREVENT TOOTH WEAR?
- Abrasion: good oral hygiene instruction relating to tooth brushing procedures and use of toothpaste with minimal abrasivity.
- Attrition: it is impossible to prevent parafunctional activity, but the consequent damage may be minimized by providingocclusal protection
- Erosion: The most important step in prevention is the determination of primary aetiological factors.
o Any reflux activity o Dietary assessment and counseling o dentition is stable or not.
Talk about Treatment of tooth wear
- Address the aetiological factors first
- If diagnosis is made early and prevention is effective, then treatment will not be necessary
- If the tooth wear is not under control, attempts at restorative treatment will fail
Restorative treatment may be necessary for:
- aesthetics
- tooth sensitivity (dentine hypersensitivity)
- prevention of pulp exposure
- loss of structural integrity
- fractured teeth
- fractured/failing restorations
