Toothwear - Monitoring and Management Flashcards
What is Abrasion
Physical wear by objects other than another tooth.
–e.g. Pipe stem
–e.g. Sewing thread
What is Erosion?
The loss of enamel and dentine primarily from chemical attack other than those chemicals produced intraorally by bacteria.
What is Attrition?
The physical wear of one tooth surface against another with tooth tissue loss occurring on the contacting surfaces.
What are the risk factor of toothwear?
- Dietary
- Environmental
- Medication
- Lifestyle
What are Environmental Extrinsic Aetiological Factors?
- Exposure to Inorganic Acids
–eg. Nitric, Sulphuric, Hydrochloric Acids
- Dynamite and Munitions
- Battery Acid
- Galvanising Factory workers
- Fertilizer Factory workers
- Competitive swimmers
- Printers
- Professional Wine tasters
What are Environmental Extrinsic Aetiological Factors?
All ACID containing
Citrus fruit juices and other acidic juices, carbonated beverages, uncarbonated beverages, sports drinks, wines, cider, herbal teas, fruits & berries, salad dressings, vinegar conserves, acidic fruit flavoured sweets.
What are the Two main acids in drinks?
- Two main acids
–Citric
–Phosphoric
- Both attack directly and complex with lattice by removing calcium
- Citrate anion greater affinity for lattice
–At pH 2 direct attack, at pH 7 draws lattice Ca2+
How can Medication as an Extrinsic Aetiological Factor affect toothwear?
- Consider the method of drug administration
–Frequency
–Duration of course
–Inhaled/liquid
- Consider pH of medication
- Iron Tonics
- Liquid HCl (achlorhydia]
- Vitamin C
- Aspirin
- Acidic salivary flow stimulants/substitutes
- Nutritional supplements
What are Intrinsic Aetiological Factors?
- Gastric contents reach oral cavity by
- Vomiting
- Regurgitation
- Gastroesophageal reflux
- Rumination
What are Biological factors modifying the erosion process?
- Saliva
- Tooth composition and structure
- Dental anatomy and occlusion
- Soft tissue anatomy and physiological function
Where is the most severe erosion generally found?
On the palatal surfaces of teeth that touched by the tongue.
What is the best Strategies for prevention and treatment?
Diagnosis is the key
- Intraoral exam
- History
- Medical history
- Diet history
- Occupation and Lifestyle
- Salivary tests (Flow rate, buffer capacity]
- Intraoral photographs
- Study models
- Consultation with patients physician
Why is history takin important?
- May find aetiology
- May assist in life style changes
- If successful leads to prevention of further erosion
With regards to monitoring what does BEWE stand for?
BEWE – Basic Erosive Wear Examination
- Highest score per sextant recorded and totalled
- Score used to both monitor and inform management.
How can patients help with pervention?
- Soft/medium toothbrush
- Low abrasive toothpaste’s
- Avoid brushing following acid challenge
- 0.025 - 0.05% non-acidulated Fluoride rinse x2 daily
- Sugar free gum
