Toothwear Flashcards
List types of toothwear
Attrition - tooth to tooth (grinding)
Abrasion - rubbing (brushing/nails/pens)
Erosion - acids in diet
List intrinsic sources of erosion
Indigestion, heartburn, reflux, vomiting
List extrinsic sources of erosion
Drinks - fizzy, sports, alcohol
Food - fruit
Medication - Vit C,iron tablets or aspirin
MH influences of toothwear (4)
Meds with low pH
Eating disorders/heartburn/GORD
Diet + alcoholism
Pregnancy
SH influences of toothwear
Grinding/stress/sports gels/alcohol
E/O + I/O signs of toothwear
TMJ - restricted opening/click
MOM-hypertrophy
Mouth opening <4mm
Linea alba
Scalloped tongue
Frictional keratosis
Mandibular tori
Wear facets/cupping/short teeth
SIs for toothwear
Sensibility
Xrays
Diag study models + wax ups
Diet diary
Photos
BEWE
BEWE Scores 0-3
0 - no wear
1 - initial loss of surface
2 - HT loss <50% of SA
3 - HT loss >50% of SA
Only note the tooth in the sextant with the highest score
Management of tooth-wear
Pain/sensitivity
- DBA/cover exposed dentine
- Smooth sharp edges
- TMD advice if required
Initial tx
- Stabilise dentition
- Identify cause of wear
- BEW,models,photos
Management of abrasion
Change toothpaste
Alter TB habits/biting
Apply RMGIC on areas
Management of attrition
Stress management
Splint
Management of erosion
NO SPLINT
F, Diet management
Use straw, dont swirl drinks
MEDICAL
Discuss with GMP
Describe the Dahl Technique
Method of gaining space in cases of localised tooth wear over period of 3-6mths
Mechanism of Dahl Technique
Restorations placed high in occlusion
Anteriors intrude, posteriors OE and this creates space
Contraindications of Dahl Technique (5)
Active perio
TMJ issues
Post ortho
On bisphosphonates
Bridges/implants present
Lab sheet for Dahl Technique
Please pour U+L imps and mount as per jaw registration provbided
Please increase OVD by 2-3mm
Create canine guidance in R+L lateral excursions
