Tooth Development, Caries, Tooth Wear Flashcards
Can Erosion wear facets be remineralised?
No, as there is an absence of enamel matrix
What is Erosive Tooth Wear (ETW)?
Erosive tooth wear is erosion in combination with mechanical wear (Attrition and/or Abrasion)
Erosive tooth wear can have 2 different aetiologies. What are they and give 2 examples of each
Extrinsic: soft drinks, sour candies, vinegar (phosphoric, citric, acetic acids)
Intrinsic: stomach acid (HCl) either via GORD or induced vomiting (eg bulimia)
What are the main risk factors for Oesophageal Adenocarcinoma?
Obesity
Having Barrett’s Oesphagus
Being a male over 60
In what pH range are Fluoride and CPP-ACP effective treatments for oral symptoms of GORD?
pH 4-5
Why is Sleep GORD more dangerous for teeth?
Regurgitation leaves more stomach acids in the oesophagus and mouth for longer periods, resulting in critically low pH (1-2) for hours at a time. This has a rapid effect on eroding teeth.
What methods can help minimise damage during GORD?
1) Preserving biofilm overnight
2) Increasing saliva
3) Nightguard to protect teeth from other forms of wear
4) Use of remineralisation agents (F, CPP-ACP)
5) Avoiding restorative treatment until erosion is inactive
How does Barrett’s Oesophagus manifest histologically?
Transition from respiratory epithelium to intestinal epithelium with deep invaginations with goblet cells and glands.
What can Reflux Esophagitis progress to?
Reflux Esophagitis > Barrett’s Oesophagus > Oesophageal Adenocarcinom
What is the prognosis for Oesophageal Adenocarcinoma?
High Morbidity
How are host defense mechanisms affected during sleep reflux?
Decreased Salivary Flow during sleep
Decreased heartburn (conscious warning sign)
Decreased Swallowing Reflex
Decreased Esophageal Peristalsis response
How does Normal Reflux (Heartburn) manifest with regard to pH?
Predominantly neutral pH but with spikes of pH 2-4 based on reflux episodes
How does GORD manifest orally?
Dentinal Hypersensitivity
Dental Erosion
