Tooth Surface Loss

Question 1

what is erosion?

Answer 1

the loss of enamel and dentine primarily from attack other than those chemicals produced intraorally by bacteria.

Question 2

what is dentine hypersensitivity? 4

Answer 2

loss of enamel exposing dentine
dentine is tubular so liquids go into tubules
picked up by nerves in the pulp
hot/cold sensitivity

Question 3

what is the rim of confidence?

Answer 3

the enamel goes but there is a rim of enamel at the edge of the tooth

Question 4

what is sub-margination?

Answer 4

filling is higher up than the tooth as tooth has eroded around it but filling has not

Question 5

teeth are weaker due to erosion which causes ?

Answer 5

chipping

Question 6

tooth exposure to acids come from? 2

Answer 6

the diet (fizzy drinks)
gastrointestinal tract (GIT)

Question 7

Acid diffuses from the ? and ? upon the tooth surface. It then has to penetrate the ? or ? coating of individual ? ? that make up the enamel tooth substance

Answer 7

plaque
pellicle
protein
lipid
hydroxyapatite crystals

Question 8

how is hydroxyapatite not perfect?

Answer 8

it has substitutions
which make it more acid soluble than pure

Question 9

why is dentine more acid soluble than enamel? 3

Answer 9

smaller crystals
higher surface area per gram
more carbonate

Question 10

mode of attack of an acid is to? 2

Answer 10

dissolve by combining with carbonate/phosphate ion (direct surface etching)

Form a complex with calcium to remove calcium from the lattice (surface softening)

Question 11

how does acid come up into the mouth?

Answer 11

vomiting
regurgitation
gastroesophageal reflux
rumination

Question 12

how does saliva modify the erosion process? 4

Answer 12

dilutes and clears fluid

neutralisation and buffer

assists in acquired pellicle formation

provision of Ca, phosphate and fluoride for remineralisation

Question 13

how does dental anatomy and occlusion modify the erosion process? 2

Answer 13

tooth prominence in relation to drinking

occlusion causing abfraction -> more susceptible tooth surface

Question 14

what is abfraction?

Answer 14

when teeth together, flexural forces at the gum margin cause chipping of tooth substance

Question 15

how does soft tissue anatomy and physiological function modify the erosion process?

Answer 15

influence areas acid contacts
influence how acid moves through the mouth

Question 16

where is the most sever erosion normally found in the mouth?

Answer 16

palatal surface of teeth as the tongue has an abrasive action on softened surface

Question 17

where is it rare to find erosion in the mouth?

Answer 17

lingual surfaces of lower incisors

Question 18

why is noticing erosion as a dentist important?

Answer 18

may be the first sign to a healthcare professional that the patient is not well

Question 19

what is anorexia nervosa?

Answer 19

aversion to food leading to severe weight loss

Question 20

what is Bulimia nervosa?

Answer 20

recurrent episodes of binge eating followed by inappropriate behaviours to avoid weight gain

Question 21

what are binge eating disorders?

Answer 21

binge eat to excess but demonstrate no compensatory behaviour to avoid weight gain

Question 22

GORD (gastro oesophageal reflux disease) causes? 4

Answer 22

Oesophagitis
Barretts epithelium
Oesophageal adenocarcinoma
Aspirational pneumonitis