toothwear

Question 1

what is attrition?

Answer 1

loss of tooth substance/restoration as a result of mastication or of occlusal or proximal contact between teeth

Question 2

define physiological

Answer 2

occurs with age

Question 3

what areas are commonly affected by physiological attrition?

Answer 3

proximal surfaces, occlusal and incisal edges

Question 4

signs of physiological attrition

Answer 4

flattening of cusps, disappearance of mamelons, exposed dentine may be brown or cup shaped lesions.

Question 5

what is pathological attriton?

Answer 5

confined to local areas caused by a parafunction or malalignment

Question 6

what is bruxism

Answer 6

clenching or grinding of teeth

Question 7

what causes bruxism

Answer 7

stress, occlusal forces r interferences

Question 8

what are signs and symptoms of bruxism?

Answer 8

o	Visible wear 
o	Abnormal rate of attrition 
o	Hypertrophy of masticatory muscles 
o	Muscle weaknesses 
o	TMJ pain 
o	Tooth mobility 
o	Pulp sensitive to cold

Question 9

how would you treat bruxism?

Answer 9

remove occlusal interferences, acrylic splint

Question 10

why is there no sensitivity with attrition?

Answer 10

slow process allows formation of secondary dentine

Question 11

what is abrasion?

Answer 11

pathological wearing away of tooth surface structure due to repetitive mechanical forces or habits

Question 12

what is cervical abrasion?

Answer 12

V shaped groove caused by horizontal brushing

Question 13

what is abfraction?

Answer 13

tooth flexure from occlusal loading, microfractures in enamel, cavitation

Question 14

what is habitual abrasion?

Answer 14

abrasion due to habit i,e pipe smoking or instruments localised to the area of habit

Question 15

what is iatrogenic abrasion?

Answer 15

opposing teeth grinding to accomodate restorations

Question 16

what is industrial abrasion?

Answer 16

uncommon now, due to abrasive particles present in atmosphere

Question 17

what is erosion?

Answer 17

progressive loss of hard dental tissue by an acidic chemical process without bacterial action

Question 18

what are the signs and symptoms of erosion?

Answer 18

♣	Any surface
♣	Smooth polished appearance 
♣	Shallow depressions 
♣	Palatal chipping of incisal edges 
♣	Criss cross appearance 
♣	Hollows have no relation to occlusion 
♣	Cupping of lower molars

Question 19

what is extrinsic erosion?

Answer 19

Labial surfaces of anterior teeth, occlusal surfaces of lower molars
Caused by outside source i.e food/drink, habitual hazards, heavily chlorinated water.

Question 20

what is intrinsic erosion?

Answer 20

Reflux- hiatus hernia, gastric ulcer, gastro oesophagus, perimyolysis, stress reflux syndrome.
Vomiting- pregnancy/bulimia

Question 21

what are clinical signs of bulimia

Answer 21

normal body weight, erosion of palatal surfaces of upper teeth, lesions on palate, fingers, oral mucosa and lips. signs of malnutrition

Question 22

what is the dental management of erosion?

Answer 22

Find and remove cause 
Fluoride therapy 
Maintain OH 
Spit don’t rinse 	Restore if necessary 
Don’t brush after acid attack

Question 23

when would you intervene with NCTTL?

Answer 23

o	poor aesthetics 
o	Loss of vitality 
o	Loss of function 
o	Sensitivity 
o	Lesion progressing 
o	Pulp compromised

Question 24

treatment options for NCTTL?

Answer 24

o	Prevention 
o	Fluoride 
o	CHX-crevitec
o	Resin- seal and protect 
o	Night guard 
o	Restoration