Tooth Monitoring and Management

Question 1

What are the 4 extrinsic aetiological factors regarding tooth erosion?

Answer 1

1. diet
2. environment
3. lifestyle
4. medication

Question 2

What are examples of beverages containing acid?

Answer 2

fruit juices, carbonated beverages, sports drinks, wines, cider, herbal tea

Question 3

What are examples of foods containing acid?

Answer 3

fruits and berries, acidic fruit, flavoured sweets, vinegar conserves, salad dressings

Question 4

What are the 2 main acids that effect tooth erosion?

Answer 4

citric and phosphoric

Question 5

How do citric and phosphoric acid attack tooth surface?

Answer 5

attack directly and complex with the lattice by removing calcium

Question 6

What anion has greater affinity for lattice?

Answer 6

citrate anion

Question 7

What must be considered with medication?

Answer 7

frequency, duration of course, inhaled/ liquid

Question 8

What are examples of medication that can affect tooth erosion?

Answer 8

iron tonics, vitamin c, aspirin, acidic salivary flow stimulants/ substitutes, nutritional supplements

Question 9

How may diet affect tooth erosion?

Answer 9

increased consumption of acidic fruits and vegetables

Question 10

How may sporting affect tooth erosion?

Answer 10

increased fluid intake and more prone to reflux

Question 11

What are some oral hygiene practises some people partake in which may cause tooth erosion?

Answer 11

• knifes to clean teeth
• lemons to whiten teeth

Question 12

What illegal drug causes dry mouth?

Answer 12

ecstasy

Question 13

What risk does vomiting pose on tooth erosion?

Answer 13

x4 risk by weekly vomiting
x16 risk with chronic vomiting

Question 14

What is regurgitation and reflux?

Answer 14

lack of diaphragmatic muscular contraction so small amount of material is ejected. There is an increased gastric volume and pressure.

Question 15

What are 3 biological factors modifying erosion?

Answer 15

1. saliva
2. dental anatomy and occlusion
3. soft tissue anatomy and functions

Question 16

What are the main functions of saliva?

Answer 16

• dilution and clearance
• neutralisation and buffering

Question 17

What does saliva form on teeth?

Answer 17

acquired pellicle formation

Question 18

What elements does saliva control for remineralisation?

Answer 18

calcium, phosphate and fluoride

Question 19

What can dental occlusion influence?

Answer 19

abfraction and cervical area becomes more susceptible to erosion

Question 20

In relation to soft tissue anatomy, where is the most severe area of erosion found?

Answer 20

palatal surfaces of teeth that are touched by the tongue

Question 21

What does the tongue influence?

Answer 21

areas that acid contacts and clearance patterns

Question 22

Why is history taking important?

Answer 22

may find aetiology and assist in lifestyle changes, leading to prevention of further erosion

Question 23

What should be recorded in a diet diary?

Answer 23

• weekday/ weekend
• what and when

Question 24

What oral hygeine advice may be given to normal patients?

Answer 24

• soft/ medium toothbrush
• low abrasive toothpastes
• avoid brushing following acids
• sugar free gum

Question 25

What percent of fluoride rinse should be used?

Answer 25

0.025-0.5% non-acidulated fluoride

Question 26

What oral hygiene advice would be given to patients with erosion?

Answer 26

- decrease frequency of acid foods/ drinks - acid foods only at mealtimes - finish meal with neutral food e.g., cheese - drink acid beverages quickly - rinse with water after acid consumption

Question 27

What are the first 2 prevention interventions?

Answer 27

- early diagnosis and monitoring - information and instruction

Question 28

What are 3 prevention techniques of erosion?

Answer 28

- professional stain removal - fluoride application (4 yearly) - replacement of failed occlusal restorations

Question 29

What is essential before any type of operative intervention?

Answer 29

- study casts - photos - wear indices - early innovations

Question 30

What is BEWE?

Answer 30

Basic Erosive Wear Examination

Question 31

What are ways to make space for restorations?

Answer 31

The Dahl Appliance

Question 32

What does the Dahl Appliance consist of?

Answer 32

a removable Co/Cr splint with 2mm coverage of palatal surfaces of upper anteriors and buccal retention on canines and premolars

Question 33

What have studies shown about the Dahl Appliance?

Answer 33

increase face height

Question 34

What type of alloys are adhesive gold restorations?

Answer 34

Type IV gold alloy