Tooth Monitoring and Management Flashcards
What are the 4 extrinsic aetiological factors regarding tooth erosion?
- diet
- environment
- lifestyle
- medication
What are examples of beverages containing acid?
fruit juices, carbonated beverages, sports drinks, wines, cider, herbal tea
What are examples of foods containing acid?
fruits and berries, acidic fruit, flavoured sweets, vinegar conserves, salad dressings
What are the 2 main acids that effect tooth erosion?
citric and phosphoric
How do citric and phosphoric acid attack tooth surface?
attack directly and complex with the lattice by removing calcium
What anion has greater affinity for lattice?
citrate anion
What must be considered with medication?
frequency, duration of course, inhaled/ liquid
What are examples of medication that can affect tooth erosion?
iron tonics, vitamin c, aspirin, acidic salivary flow stimulants/ substitutes, nutritional supplements
How may diet affect tooth erosion?
increased consumption of acidic fruits and vegetables
How may sporting affect tooth erosion?
increased fluid intake and more prone to reflux
What are some oral hygiene practises some people partake in which may cause tooth erosion?
- knifes to clean teeth
- lemons to whiten teeth
What illegal drug causes dry mouth?
ecstasy
What risk does vomiting pose on tooth erosion?
x4 risk by weekly vomiting
x16 risk with chronic vomiting
What is regurgitation and reflux?
lack of diaphragmatic muscular contraction so small amount of material is ejected. There is an increased gastric volume and pressure.
What are 3 biological factors modifying erosion?
- saliva
- dental anatomy and occlusion
- soft tissue anatomy and functions
What are the main functions of saliva?
- dilution and clearance
- neutralisation and buffering
What does saliva form on teeth?
acquired pellicle formation
What elements does saliva control for remineralisation?
calcium, phosphate and fluoride
What can dental occlusion influence?
abfraction and cervical area becomes more susceptible to erosion
In relation to soft tissue anatomy, where is the most severe area of erosion found?
palatal surfaces of teeth that are touched by the tongue
What does the tongue influence?
areas that acid contacts and clearance patterns
Why is history taking important?
may find aetiology and assist in lifestyle changes, leading to prevention of further erosion
What should be recorded in a diet diary?
- weekday/ weekend
- what and when
What oral hygeine advice may be given to normal patients?
- soft/ medium toothbrush
- low abrasive toothpastes
- avoid brushing following acids
- sugar free gum
What percent of fluoride rinse should be used?
0.025-0.5% non-acidulated fluoride
What oral hygiene advice would be given to patients with erosion?
- 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
What are the first 2 prevention interventions?
- early diagnosis and monitoring
- information and instruction
What are 3 prevention techniques of erosion?
- professional stain removal
- fluoride application (4 yearly)
- replacement of failed occlusal restorations
What is essential before any type of operative intervention?
- study casts
- photos
- wear indices
- early innovations
What is BEWE?
Basic Erosive Wear Examination
What are ways to make space for restorations?
The Dahl Appliance
What does the Dahl Appliance consist of?
a removable Co/Cr splint with 2mm coverage of palatal surfaces of upper anteriors and buccal retention on canines and premolars
What have studies shown about the Dahl Appliance?
increase face height
What type of alloys are adhesive gold restorations?
Type IV gold alloy
