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BDS4 Exam Perp > Tooth wear tutorial > Flashcards

Tooth wear tutorial Flashcards

1
Q

What are the 5 aetiologies of tooth wear?

A
  • Attrition
  • Erosion
  • Abrasion
  • Combination
  • Unknown
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2
Q

Why is it important to take a history to gather information of the aetiology of toothwear?

A
  • Attempt to reduce further wear
  • Allow signposting if any medical or wellbeing issues are encountered
  • Determine prognosis
  • Enhance consent
  • Diagnosis and treatment planning
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3
Q

Define attrition

A

The physiological wearing away of tooth structure as a result of tooth to tooth contact

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4
Q

What are the ends of attrition spectrum?

A

Physiological wear <—> Bruxist

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5
Q

What are 5 modifying factors of attrittion?

A
  • Lack of posterior teeth
  • Erosion and abrasion
  • Occlusion
  • Restorations
  • Stress and anxiety
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6
Q

Give 5 common features of bruxism ?

A
  • Significant wear throughout the dentition
  • Repeated restoration failure
  • Root fractures
  • Often onset in early adulthood
  • Progressive
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7
Q

Common features of physiological toothwear

A
  • Wear that you would expect to see given the age of the patient
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8
Q

What are the common features of attrition due to lack of posterior support?

A
  • More extensive tooth-wear
  • Rapid progression
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9
Q

What kind of toothwear would you see in a patient with a deep overbite?

A
  • Lower incisors toothwear
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10
Q

What kind of toothwear would you see in a patient with edge to edge occlusion?

A

Localised anterior toothwear

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11
Q

What may make toothwear due occlusion worse?

A

Parafunctional habits

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12
Q

What is the cause of this ?

A

Upper restorations (porcelain)

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13
Q

Other than toothwear, give 3 other indicators in the patient mouth for parafunction?

A
  • Multiple cusp fracture
  • Root fractures in unrestored teeth
  • Multiple cracks around restorations
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14
Q

Define erosion

A

The loss of tooth surface due to a chemical process that does not involve bacterial action

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15
Q

What are the modifying factors of erosion?

A
  • Lifestyle
  • Level of control
  • Psychosocial
  • Amount and frequency of acid attacks
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16
Q

5 extrinsic causes of Erosion?

A
  • Carbonated drinks
  • Sports drinks
  • Alcoholic acidic drinks
  • Citrus drinks
  • Pickles
17
Q

4 intrinsic causes of erosion?

A
  • Eating disorders
  • GORD
  • Hiatus hernia
18
Q

What are the common features of someone who drinks carbonated drinks?

A
  • Incisal erosion on upper centrals
  • Cupping on lower molars
  • Palatal erosion on upper incisors
  • Sensitivity
  • Inter-proximal caries and buccal white spot/brown spot caries
19
Q

What are 5 common features of eating disorders erosion?

A
  • Palatal erosion on upper teeth
  • Polished restorations
  • Erosion around restorations
  • Sensitivity
  • Caries
  • Halitosis
  • Altered taste
20
Q

What is abrasion?

A

The physical wearing away of tooth substance through an abnormal mechanical process independent of the occlusion

21
Q

4 examples of abrasive behaviour other than tooth brush abrasion?

A
  • Oral self-harm
  • Tongue studs
  • Occupational
  • Unusual habits
22
Q

4 questions you would ask a patient presenting with abrasive toothwear?

A
  • Ask about toothbrushing habits?
  • Do you use manual or electric toothbrush?
  • Investigate eating disorders
  • Are you stressed? ask about occupation?
23
Q

Patient present with erosion, attrition and abrasion , give 3 things that may contribute to the aetiology?

A
  • Alcoholism and drug abuse
  • Eating disorders
24
Q

Patient present with erosion and attrition , what might be the cause ?

A

Bruxist with poor diet

25
Q

A patient present with erosion and attrition, what might be the cause?

A
  • Bruxism, poor diet and GORD
26
Q

Define 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

27
Q

What are the two theories involved in abfraction?

A
  • Abfraction is the basic cause is the basic cause of all non-carious cervical
  • Abfraction has a multifactorial aetiology (combination of occlusal stress, attrition, erosion)
28
Q

5 things you may uncover in the history of toothwear?

A
  • eating disorders
  • undiagnosed diabetes
  • Mental health issues
  • GI issues
  • Abuse and harm
29
Q

How would your preventive advice include for a tooth-wear patient?

A
  • Fluoride - high dose toothpaste, alcohol free mouthwash
  • Dietary modification - Frequency and quantity, method of delivery, elimination and addition
  • Remineralisation - tooth mousse
  • Sugar free gum
30
Q

4 interventions you can do to control the aetiology of toothwear?

A
  • Toothbrushing instructions
  • Splint therapy
  • Signposting to CBT and hypnotherapy
  • Referral to GMP , psychiatrist and social services
31
Q

Which technique is the technique of choice for managing anterior toothwear?

A
  • composite additions using the DAHL technique
32
Q

Why is the DAHL technique the technique for choice for managing anterior toothwear?

A
  • They are effective over a 10 year period with some maintenance. But this cannot be confirmed for full mouth reconstruction
33
Q

Define the Dahl technique?

A
  • It is a method of gaining space in cases of localised tooth wear
  • Originally a CoCr anterior bite plane but now use composite additions to incisors and canines
  • This results in disclusion on posterior teeth and increase in OVD of 2-3mm (need at least 2mm for composite thickness)
  • Over a period of 3-6 months posteriors erupt into occlusion and anteriors intrude
34
Q

What are 2 advantages of DAHL technique?

A
  • Better aesthetics
  • Immediate result
35
Q

What are 2 disadvantages of DAHL technique?

A
  • Technically demanding
  • Time comsuming
36
Q

4 contraindications of DAHL technique?

A
  • Active periodontal disease
  • Post orthodontics
  • TMD
  • Bisphosphonate patients
  • Implants
  • Fixed bridges
37
Q

What are 6 things you need for DAHL technique?

A
  • Impressions and facebow
  • Mounted articulated casts on semi-adjustable articulator
  • Interocclusal record
  • Diagnostic wax ups
  • Stents and mock up
  • Temporary denture
  • clinical photographs
  • Radiographs
38
Q

Which material would you use for interocclusal record for casts of DAHL technique?

A

Alminax

BDS4 Exam Perp (72 decks)

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