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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
what is extrinsic acid
acid going in ef citrus fruit juices white wine worse than red
26
what do we need to ask in regard to bulimia
past or present history of being bulimic
27
what are the four things needed for erosion
tooth surface time extrinsic host
28
what might delay erosion
fluoride
29
why might GORD occur
sphincter incompetence increased gastric pressure increased gastric volume
30
why might vomiting occur
``` psychosomatic metabolic/endocrine drug induced alcoholism GI disorders ```
31
what is ruminant eating
chew and then bring it up and chew it more
32
what are the symptoms of GORD
``` HEARTBURN retostenral discomfort epigastric pain dysphagia chronic cough sore throat hoarseness sour taste at the back of the throat ```
33
describe anorexia nervosa
aversion to food | restricting and purging types
34
what is the incidence if anorexia nervosa
7/100000
35
how many new cases of anorexia are found per year
4000
36
what is the prevalence of anorexia
0.5-1%
37
what is the F:M ratio of anorexia
10:1
38
what is the average age presentation
16
39
what is bulimia
overeating followed by purging
40
what is the insidence rate of bulimia
8.6-14 per 100000
41
what percentage of people got bulimia in USA in 18-30 years
1-4%
42
what is the female to male ratio of bulimia
10:1
43
what weight are bulimics usually
10% normal body weight to very obese
44
what affects dietary erosion
amount frequency method of consumption timing of consumption
45
what are predisposing factors
``` saliva flow ph buffering presence of salivary mucins clearance rates from from different oral sites ```
46
what is the clinical presentation of erosion
``` 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
what does erosion look like on posterior teeth
``` loss of surface anatomy cusp cupping proud restorations darkening of colour pupal exposure ```
48
how does caries and erosion differ
loss of the organic matrix in erosion
49
what is the clinical presentation of attrition
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
what is bruxism
common parafunctional activity in response to stress associated tongue scalloping and cheek ridging masseteric hypertrophy
51
what is abfraction
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
what is the clinical look of abfraction
deep v shaped notch may be single tooth affected toothbrush unable to contact base of defects defects may be sub gingival
53
clinical consequences of NCTTL
change in appearance apin or sensitivity loss of OVD functional difficulties
54
what is OVD
occlusal vertical dimension
55
what is the initial management of tooth wear
identify presence and severity identify aetiology monitoring prevention
56
what is the issues with the severely worn dentition difficulties
``` lack of tooth tissue plural problems aesthetic compromise soft tissue changes occlusal changes lack of space for restoration habitual/ aetiological factors ```
57
what might aetiological factors cause
damage to restoration | further wear of teeth
58
how do we see if the toothwear is progressing
sensitivity and staining | monitoring
59
what can we use for monitoring
``` study models silicone index clinical photographs description measurement: crown indicies ginigval margin ```
60
what is the management of NCTTL
identify cause and assess long term prognosis institute preventative measures to reduce TSL monitor operative treatment Review
61
prevention of alcohol
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
what can we use to desensitise and strengthen the teeth
``` fluoride mouthwash and varnish fluoride paste-Gelkam low abrasive toothpaste sugar free gum dentine bonding agent tooth mousse anti erosion toothpaste ```
63
what can splints be used for
``` bruxism hard or soft splints prevention of wear creating of space assessing tolerance of raising OVD mandibular dysfunctions protection of new restorations ```
64
where is a soft splint used
on lower teeth
65
how do we prevent abrasion
``` low abrasive toothpaste brushing technique patient habits brushing force bristle stiffness frequency abrasive restorations ```

CSA (51 decks)

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