Toothwear Part 1 Flashcards
1
Q
Aetiology of toothwear
A
- attrition: tooth to tooth
- erosion: acid attack
- abrasion: toothbrush abrasion
- combination
** older pt is likely to have more wear than a younger pt
2
Q
Why aetiology is important?
A
- allow us to reduce further wear
- plan for problems, contingencies and failure
- allow you to be realistic with yourself and patients
- identifies wider medical & wellbeing issues
- allows signposting to medical services
- prognostic indicator, ie: bruxism
- enhances consent process
- aids clinical diagnosis & Tx planning
3
Q
Attrition
A
- one spectrum is physiological wear, one is when pt is a bruxist
4
Q
Modifying factors for attrition
A
- lack of posterior teeth
- occlusion
- restorations; ie: porcelain
- erosion and abrasion
- stress and anxiety
5
Q
Common features of bruxist
A
- significant wear throughout dentition
- repeated restoration failure, ie: crown splitting
- root fractures
- often onset in early adulthood
- progressive
6
Q
Physiological Toothwear
A
wear is expected given the pt age
7
Q
Lack of posterior support
A
- wear is more extensive as no posterior support
- more rapidly progressive as no posterior support
- advise pt to wear dentures to protect anterior dentition
8
Q
Occlusion
A
- caused by nature of occlusion often linked by parafunction
- deep overbite, affecting lower incisors
- edge to edge occlusion- localised wear
9
Q
Restorations
A
- wear is normally worse than expected
- natural teeth opposed by restorations
- porcelain main cause normally
10
Q
Evidence of parafunction without obvious wear
A
11
Q
Extrinsic factors of Erosion
A
- carbonated drinks
- sport drinks
- alcoholic acidic drinks
- citrus drinks
- acidic fruits
- acidic sweets
- pickles
- drugs
12
Q
Intrinsic factors of erosion
A
- eating disorders
- GORD
- other medical conditions
13
Q
Modifying factors of erosion
A
- lifestyle
- multiple factors
- amount and frequency
- level of control
- psychosocial
14
Q
Common features of carbonated drink intake
A
- incisal erosion on upper centrals
- cupping on lower molars
- palatal erosion on upper incisors
- sensitivity
- interproximal caries and buccal white spot/ brown spot caries
15
Q
Common features of eating disorders
A
- palatal erosion on upper teeth
- polished restorations
- erosion around restorations
- sensitivity
- caries
- altered taste
- halitosis
- soft tissue changes (bulimia)
17
Q
Issues to consider for toothbrush abrasion
A
- localised/ generalized
- frequency and duration
- bristle and toothpaste abrasiveness
- brushing technique instruction
- electric vs manual
- part of a combination wear problem, ie: eating disorder
- part of a stress/ anxiety related problem
18
Q
Less common abrasion
A
- oral self harm
- tongue studs
- occupational
- various habits
