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tooth wear Flashcards

the aetiology and clinical presentations of toothwear/ non carious tooth tissue loss the diagnosis of early management of patient with toothwear with a focus on prevention and management

1
Q

what is tooth loss also known as

A

non carious tooth tissue loss( NCTTL)

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2
Q

what does NCTTL stand for

A

no carious tooth tissue loss

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3
Q

is tooth loss normal

A

occurs in life normally

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4
Q

when is tooth loss pathological

A

when rate of loss or degree of destruction is excessive

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5
Q

what can tooth loss lead to

A

aesthetics
sensitivity
function

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6
Q

what is toothwear due to

A

a non carious process

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7
Q

which processes are included in toothwear

A

attrition
abrasion
erosion

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8
Q

what is toothwear described by

A

aetiology
distribution localised or generalised
severity

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9
Q

which population is erosion increased in

A

youths

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10
Q

which material used for crowns could cause tooth surface loss

A

porcelain

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11
Q

what percentage of 5 year olds have TSL

A

33%

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12
Q

which surfaces do 5 year olds have TSL ON

A

buccal surfaces of primary incisors

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13
Q

what percentage of 5 year old children have TSL which extends into the dentine or pulp

A

4%

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14
Q

what percentage of 5 year olds have TSL on the lingual surfaces

A

57%

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15
Q

how much percentage of 5 year olds have TSL loss in the dentine and pulp

A

16%

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16
Q

what is the pathological loss of tooth tissue

A

erosion
attrition
abrasion

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17
Q

what is erosion

A

irreversible progressive loss of dental hard tissue caused by an acidic chemical process not caused by bacteria

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18
Q

what is attrition

A

the loss of tooth surface or a restoration caused by tooth-tooth contact
remember by the two tt in attrition

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19
Q

what was the percentage of moderate tooth wear in 1998

A

11%

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20
Q

what was the percentage of moderate tooth wear in 2009

A

15%

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21
Q

what is the definition of abrasion

A

the abnormal wearing away of a tooth surface substance or a restoration by a mechanical process other than tooth contact

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22
Q

what do teeth clinically look like when suffering from erosion

A

shiny
cupping in the teeth- eg post teeth or palatally
proud restorations

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23
Q

how is erosion classified

A

by source of acid extrinsic or intrinsic

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24
Q

what is intrinsic acid

A

acid coming up
bulimia
stomach acid-GORD( gastro oesophageal reflux disease)

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25
Q

what is extrinsic acid

A

acid going in
ef citrus fruit
juices
white wine worse than red

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26
Q

what do we need to ask in regard to bulimia

A

past or present history of being bulimic

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27
Q

what are the four things needed for erosion

A

tooth surface
time
extrinsic
host

28
Q

what might delay erosion

A

fluoride

29
Q

why might GORD occur

A

sphincter incompetence
increased gastric pressure
increased gastric volume

30
Q

why might vomiting occur

A 
psychosomatic 
metabolic/endocrine
drug induced
alcoholism 
GI disorders
31
Q

what is ruminant eating

A

chew and then bring it up and chew it more

32
Q

what are the symptoms of GORD

A 
HEARTBURN 
retostenral discomfort 
epigastric pain
dysphagia 
chronic cough
sore throat 
hoarseness 
sour taste at the back of the throat
33
Q

describe anorexia nervosa

A

aversion to food

restricting and purging types

34
Q

what is the incidence if anorexia nervosa

A

7/100000

35
Q

how many new cases of anorexia are found per year

A

4000

36
Q

what is the prevalence of anorexia

A

0.5-1%

37
Q

what is the F:M ratio of anorexia

A

10:1

38
Q

what is the average age presentation

A

16

39
Q

what is bulimia

A

overeating followed by purging

40
Q

what is the insidence rate of bulimia

A

8.6-14 per 100000

41
Q

what percentage of people got bulimia in USA in 18-30 years

A

1-4%

42
Q

what is the female to male ratio of bulimia

A

10:1

43
Q

what weight are bulimics usually

A

10% normal body weight to very obese

44
Q

what affects dietary erosion

A

amount
frequency
method of consumption
timing of consumption

45
Q

what are predisposing factors

A 
saliva flow
ph
buffering
presence of salivary mucins 
clearance rates from from different oral sites
46
Q

what is the clinical presentation of erosion

A 
anterior teeth-
loss of surface anatomy
smooth enamel surface
chipping of incisor edges 
palatal hollows
areas where enamel is absent
exposure of pulp
if intrinsic- palatal surface 
if extrinsic- labial
47
Q

what does erosion look like on posterior teeth

A 
loss of surface anatomy
cusp cupping
proud restorations
darkening of colour
pupal exposure
48
Q

how does caries and erosion differ

A

loss of the organic matrix in erosion

49
Q

what is the clinical presentation of attrition

A

enamel and dentine wearing away at the same rate
localised facets, flattened cups and incisal edges
worn surfaces
shiny amalgam in areas of contact
possibly massetric hypertrophy
possibly fractured cusps or restorations
increased risk of tooth motility
slow process as secondary dentine is laid down

50
Q

what is bruxism

A

common parafunctional activity in response to stress
associated tongue scalloping and cheek ridging
masseteric hypertrophy

51
Q

what is abfraction

A

supposes that occlusal forces cause compressive and tensile strength which are concentrated on the cervical regions of the tooth and cause micro-fracture of cervical enamel rods

52
Q

what is the clinical look of abfraction

A

deep v shaped notch
may be single tooth affected
toothbrush unable to contact base of defects
defects may be sub gingival

53
Q

clinical consequences of NCTTL

A

change in appearance
apin or sensitivity
loss of OVD
functional difficulties

54
Q

what is OVD

A

occlusal vertical dimension

55
Q

what is the initial management of tooth wear

A

identify presence and severity
identify aetiology
monitoring
prevention

56
Q

what is the issues with the severely worn dentition difficulties

A 
lack of tooth tissue 
plural problems 
aesthetic compromise 
soft tissue changes 
occlusal changes 
lack of space for restoration 
habitual/ aetiological factors
57
Q

what might aetiological factors cause

A

damage to restoration

further wear of teeth

58
Q

how do we see if the toothwear is progressing

A

sensitivity and staining

monitoring

59
Q

what can we use for monitoring

A 
study models 
silicone index 
clinical photographs 
description 
measurement:
crown indicies
ginigval margin
60
Q

what is the management of NCTTL

A

identify cause and assess long term prognosis
institute preventative measures to reduce TSL
monitor
operative treatment
Review

61
Q

prevention of alcohol

A

don’t get them to brush after they’ve eaten
diet advice
control of GORD- liase with the GP
water and sodium bicarb mouthwash

62
Q

what can we use to desensitise and strengthen the teeth

A 
fluoride mouthwash and varnish 
fluoride paste-Gelkam
low abrasive toothpaste 
sugar free gum 
dentine bonding agent
tooth mousse 
anti erosion toothpaste
63
Q

what can splints be used for

A 
bruxism 
hard or soft splints 
prevention of wear 
creating of space 
assessing tolerance of raising OVD
mandibular dysfunctions 
protection of new restorations
64
Q

where is a soft splint used

A

on lower teeth

65
Q

how do we prevent abrasion

A 
low abrasive toothpaste 
brushing technique 
patient habits 
brushing force 
bristle stiffness 
frequency 
abrasive restorations

CSA (51 decks)

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