Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CASE PRES > Toothwear > Flashcards

Toothwear Flashcards

1
Q

What is attrition?

A

it is the physiological wearing away of tooth structures as a result of tooth to tooth contact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How does attrition appear?

A
  • reduction in cusp height
  • flattening of occlusal inclined planes
  • can be related to parafunctional habits such as bruxism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is erosion?

A
  • it is the loss of tooth surface by a chemical process that does not involve bacterial action
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does erosion appear?

A
  • exposed dentine
  • cupping of the occlusal surfaces of the molars and incisor edges of the anteriors
  • base of lesion is not in contact with opposing arch
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does affect the severity and location of erosive toothwear?

A
  • depends on the source, type and frequency of exposure to the acid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the aetiology of toothwear?

A
  • increase with the increase of age
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the causes of erosion?

A
  • medications with low PH
  • medications that cause dry mouth
  • alcoholism
  • heartburn
  • GORD
  • Rumination
  • pregnancy
  • Diet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What would you tell the patient about erosion?

A

-it is a term used to describe the wearing away of teeth by chemical means
- it can be due to an acidic diet, or can be associated with some medical conditions such as eating disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How would you manage your patient if you suspect they have acid reflux?

A

Refer them to general dental practitioner

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are you looking for when examining the TMJ?

A
  • restriction of movement
  • clicking
  • crepitus
  • Examine musculature hypertrophy
  • Check lip line
  • check smile line
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How would you record the OVD ?

A
  • using dividers of willis bite gauge
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What also would you check in the patient occlusion?

A
  • freeway space
  • record the OVD and resting face height
  • has there been any dentoalveolar compensation
  • Record the overbite and the overjet
  • look for contacts in centric relation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is smith and knight?

A
  • it is a tooth wear index
  • that has scores for rating the extent of tooth wear , the scores vary from 0 to 4
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is score 0 of smith and knight index?

A
  • no loss of enamel surface
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is score 1 of SKI

A

loss of surface enamel characteristics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is score 2 of SKI?

A

buccal, lingual and occlusal loss of enamel exposing dentine for less than one third of the surface
- minimal dentine exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is score 3 of SKI?

A

buccal, lingual and occlusal loss of enamel exposing dentine for more than one third of the surface
- substancial dentine exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is score 4 of SKI?

A

buccal, lingual and occlusal complete loss of enamel exposing dentine or exposure of secondary dentine

19
Q

What other indices can you use for erosion ?

A

BEWE index (basic erosive wear index)
0 - no erosive wear
1- initial loss of surface texture
2- distinct defect (less than 50% of surface)
3- hard tissue loss for more than 50% of the surface area

20
Q

What special investigations would you carry out for toothwear?

A
  • sensibility testing
  • radiographs
  • study models
  • intraoral photographs
  • diagnostic wax ups
  • dietary analysis
21
Q

How would you prevent further toothwear?

A
  • by monitoring the patient toothwear
  • taking baseline records
22
Q

How can you address attrition?

A
  • related to parafunctional habits
  • related to stress
23
Q

How can you manage attrition?

A
  • CBT
  • Hypnosis
    Splints can be used
24
Q

How do splints work in attrition?

A
  • all work by being softer than teeth
  • they cause no damage to the opposing teeeth
  • may be a habit breaker
25
Q

What type of splint would you use

A
  • Soft splint can be used as a diagnostic device - as it wears away if wear is present
  • hard splint - more robust and can be used over long term
26
Q

Give example of a splint?

A
  • michigan splint
  • provides ideal occlusion with centric stops
27
Q

How to prevent erosion?

A
  • fluoride use
  • desensitising agents can aid in symptomatic relieve
28
Q

What habit changes might you address with the patient to prevent further erosion?

A
  • swilling drinks around in the mouth
  • drinking from cans ( use a straw)
  • rumination
  • drink healthy
  • Ask if they drink any sport drinks
29
Q

What medical conditions might contribute to erosion?

A
  • GORD , acid reflux
  • Hiatus hernia (when part of the stomach moves up in the chest)
  • Xerostomia
  • anorexia and bulimia
30
Q

What are the factors contributing to active management of toothwear?

A
  • the pattern of anterior maxillary toothwear
  • the interocclusal space
  • Space required for restorations to be planned
  • Quality and quantitiy of remaining tooth tissue, particularly the enamel
  • the aesthetic demand of the patient
31
Q

What are the contraindication for restoring toothwear?

A
  • short roots
  • reduced periodontal support
  • lack of remaining enamel reduces the success rate
32
Q

What difficulties you might face when building up incisal toothwear?

A
  • small bonding area
33
Q

How would you do the vacuum formed stent?

A
  • taking impressions
  • Asking the lab for diagnostic wax ups
  • and then a vacuum formed clear plastic matrix is formed on this
  • then this is cut to size and used as a mould for buildup
34
Q

What are your long term prognosis of toothwear after restoring it with composite?

A
  • maxillary restorations last better than mandibular (due to increased bonding area)
  • require repair and maintenance
  • 70% over 10 years
35
Q

Why is maxillary wear more common than lowers?

A
  • tongue and saliva protect the lowers
36
Q

What information would you give to the patient regarding the treatment?

A
  • Your bite will feel strange for a few days and you may have difficulty chewing - this will get better with time
  • your teeth might feel a bit tender to bite
  • you might have some speech difficulty such as lisping but this should get better with time
37
Q

What are the extrinsic factors of erosion?

A
  • carbonated drinks
  • sports drinks
  • alcoholic acidic drinks
  • citrus drinks
  • acidic fruits
  • acidic sweets
  • pickles
  • drugs
38
Q

Intrinsic factors of erosion?

A
  • eating disorders
  • GORD
  • other medical conditions
39
Q

What are the common features of carbonated drink in erosion in this patient?

A

palatal erosion on upper incisors

40
Q

What are the common features of eating disorders?

A
  • polished restorations
  • erosion around restorations
  • caries
  • altered taste
  • halitosis
  • palatal erosion on upper teeth
41
Q

How would you take the history?

A
  • be comapassionate
  • be comprehensive
  • show patience
42
Q

What would you look for in the patient history?

A

-eating disorders
- undiagnosed diabetes
- mental health conditions
- GI issues
- Abuse, harm or adddiction

43
Q

What preventative advice would you give patient regarding fluoride?

A
  • use high dose toothpaste
  • alcohol free mouthwash
44
Q

What dietary modification would you give to the patient?

A
  • frequency and quantity
  • method of delivery
  • elimination and addition
  • advise the use of sugar free gums

CASE PRES (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions