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FINALS - Tooth Wear > Tooth Wear 1 > Flashcards

Tooth Wear 1 Flashcards

1
Q

What are some examples of tooth surface loss?

A
  • Everything that can cause it
  • Caries
  • Trauma
  • Developmental problems
  • Tooth wear
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2
Q

What are some examples of non-carious tooth surface loss?

A
  • Trauma
  • Developmental problems
  • Tooth wear
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3
Q

What are the two types of Tooth wear?

A
  • Pathological
  • Physiological
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4
Q

What is Physiological tooth wear?

A
  • The normal wear associated with normal function for that individual
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5
Q

What is the Normal estimate of Physiological tooth wear per annum?

A
  • 20-38um per year
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6
Q

What is pathological tooth wear?

A
  • Occurs if the remaining tooth structure or pulpal health is compromised
  • The rate of tooth wear is in excess of what is expected for that age
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7
Q

What are the 4 main causes of tooth wear?

A
  • Attrition
  • Abrasion
  • Erosion
  • Abfraction
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8
Q

What is the definition of Attrition?

A
  • The physiological wearing away of tooth structure as a result of tooth to tooth contact
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9
Q

Where are Attritive lesions most commonly found?

A
  • Found on occlusal and incisal contacting surfaces
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10
Q

What is the early appearance of an attritive lesion?

A
  • Polished facet on a cusp
  • or a Slight flattening of an incisal edge
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11
Q

What does progression of an attritive lesion cause?

A
  • Lead to reduction in cusp height
  • Lead to flattening of occlusal inclined planes
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12
Q

What are some other findings for attritive lesions?

A
  • Shortening of clinical crown of incisor and canine teeth
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13
Q

What is Attrition almost always related to?

A
  • Parafunctional habit ( Bruxism)
  • Flat facets are also present and related to functional and often parafunctional movements
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14
Q

When talking about Attrition what occurs to the restorations as well as tooth structure?

A
  • Show the same wear as the tooth structure
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15
Q

What is the definition of Abrasion?

A
  • The physical wear of tooth substance through an abnormal mechanical process independent of occlusion.
  • It involves a foreign object or substance repeatedly contacting the tooth.
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16
Q

What is the most common area that is affected by Abrasion?

A
  • Labial/ buccal and cervical on canine and premolar teeth
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17
Q

What do abrasion lesions look like clinically?

A
  • V shaped or rounded lesions
  • Have sharp margin at enamel edge where dentine is worn away preferentially
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18
Q

What is the commonest cause of Abrasion?

A
  • Tooth brushing
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19
Q

Abrasion can manifest as notching of incisal edges. What can this be related to?

A
  • Habits/lifestyle/occupation
  • Pins, nails, electrical wire stripping, fishing line, thread, pipe smoking
20
Q

Slide 18 **

A
21
Q

What is the definition of Erosion?

A
  • The loss of tooth surface by a chemical process that does not involve bacterial action
22
Q

What is the most common cause of pathological tooth wear?

A
  • Erosion
  • INcreasing in prevalence
23
Q

What is Erosion caused by?

A
  • Chronic exposure of dental hard tissues to acidic substances
  • Acidic substances can be extrinsic or intrinsic
24
Q

What is the appearance of an erosion lesion?

A
  • Typically bilateral
  • Concave lesions
  • Do not have chalky appearance of bacterial acid decalcification
25
Q

What occurs in early stage erosion lesion?

A
  • Enamel surface affected
  • Loss of surface detail
  • Surfaces become flat and smooth
  • Later dentine becomes exposed
26
Q

What does preferential wear of dentine lead to?

A
  • Leads to ‘cupping’ of occlusal surfaces of molars and incisal edges of anteriors
27
Q

What are the factors which determine the severity of erosive wear?

A
  • Source
  • Type
  • Frequency of exposure to acid
28
Q

In Erosion cases how would amalgam and composite restorations appear?

A
  • Stand proud of tooth
29
Q

What are some other presentation of erosive wear?

A
  • Increased translucency of incisal edges ( can appear dark)
  • Base of lesion not in contact with opposing tooth
  • No tooth staining present
30
Q

What is the definition of Abfraction?

A
  • The loss of hard tissue from eccentric occlusal forces leading to compressive and tensile stresses at the cervical fulcrum areas of the tooth
31
Q

What are the theories in regard to Abfraction?

A
  1. Abfraction if the basic cause of all non-carious cervical lesions
  2. Multifactorial aetiology. A combination of occlusal stress, abrasion and erosion
32
Q

Slide 28, 29,30-37

A
33
Q

During assessment of a pt what are the stages you must complete?

A
  • Recognise the problem is present
  • Grade its’ severity
  • Diagnose the likely cause or causes
  • Monitor the progression of the disease
    • Is it active or historic
    • Are preventative measures working or is active restorative treatment required
34
Q

What Medical History is relevant to tooth wear cases ( particularly erosion cases)?

A
  • Medications with low pH
  • Medications which dry the mouth
  • Eating Disorders
  • Alcoholism
  • Heartburn
  • GORD
  • Hiatus Hernia
  • Rumination
  • Pregnancy
  • Patients are not always aware of reflux

(Pt may require referral to GMP - require consent to do this)

35
Q

What is the relevant past dental history?

A
  • Regular attender previously (tooth wear require a lot of visits so need good attendance)
  • Previous experience of txt (simple, complex)
  • OH habits
    • Poor OH
    • Toothbrushing so ask frequency, Intensity, Duration, type of toothpaste
36
Q

What is relevant for Social history?

A
  • Lifestyle stresses (Bruxism)
  • Occupational details
  • Alcohol consumption
  • Dietary analysis
  • Habits
  • Sports
37
Q

What are some main things you need to look for when examining the pt?

A
  • Extra Oral
  • Must examine TMJ for restriction of movement, clicking, crepitus
  • Examine musculature for hypertrophy
  • Examine mouth opening for restriction (<4cm) and deviation during movement
  • ? Parotid hypertrophy
  • Overclosure ?
  • Lip Line
  • Smile line
38
Q

What is Overclosure?

A
39
Q

When examining the occlusion of a pt what are the main things that should be recorded?

A
  • Freeway space
  • OVD and resting face height
  • If there is any dento-alveolar compensation
  • Overbite and overjet
  • Are there stable contacts in centric relation
  • What are tooth contacts like in excursive movements
40
Q

What is recorded when performing a Wear examination?

A
  • Location (Anterior/Posterior , Generalised)
  • Severity (Enamel only, into dentine, Severe)
41
Q

What is the most common location of wear?

A
  • Generalised anterior
42
Q

What is the BEWE wear index ? (More used than Smith and Knight)

A

0 - No erosive wear
1 - Initial loss of surface texture
2 - Distinct defect, hard tissue loss <50% of surface
3 - Hard tissue >50% of surface area

43
Q

What are the risk levels for BEWE? (add up all sextants)

A

None - Less than or equal to 2
Low - Between 3 and 8
Medium - Between 9 and 13
High - 14 and over

44
Q

What special tests can be used in tooth wear cases?

A
  • Sensibility testing
  • Radiographs (useful for sever tooth wear 1/3-1/2 loss of tooth)
  • Articulated study models
  • Intra-oral photographs
  • ? Salivary analysis
  • Diagnostic Wax-up
  • Dietary analysis
45
Q
A

FINALS - Tooth Wear (8 decks)

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