Clinical Guidelines for Dental Erosion
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Questions and Answers

What does gastro-oesophageal reflux disease (GORD) commonly lead to?

  • Esophageal cancer
  • Increased appetite
  • Enhanced taste sensation
  • Pathological dental erosion (correct)
  • Which of the following is NOT a principal cause of gastro-oesophageal reflux?

  • Oesophagitis
  • Alcohol
  • High blood pressure (correct)
  • Sphincter incompetence
  • Which symptom is most commonly associated with GORD?

  • Retro sternum discomfort (correct)
  • Nausea during exercise
  • Chronic fatigue
  • Increased salivation
  • What percentage of adults in Europe were reported to be affected by GORD according to a 2014 systematic review?

    <p>8.8% to 25.9% (A)</p> Signup and view all the answers

    What characterizes 'silent refluxers'?

    <p>They show no signs of reflux symptomatically. (A)</p> Signup and view all the answers

    Which factor is considered to increase gastric pressure, contributing to GORD?

    <p>Obesity (B)</p> Signup and view all the answers

    In patients with GORD, what correlating factor is linked to increased prevalence of dental erosion?

    <p>Frequent respiratory symptoms (D)</p> Signup and view all the answers

    What is a major consequence of prolonged gastro-oesophageal reflux?

    <p>Palatal erosion (D)</p> Signup and view all the answers

    What is the primary aim of the guideline discussed?

    <p>To outline evidence-based discussions regarding dental erosion (C)</p> Signup and view all the answers

    What methodology was used to develop the guideline?

    <p>Modified Delphi methodology (B)</p> Signup and view all the answers

    What percentage approval was required from the working group for a recommendation to be included in the guideline?

    <p>90% (C)</p> Signup and view all the answers

    What has epidemiological studies indicated about the prevalence of dental erosion in children?

    <p>It ranges from 30% to 50% in deciduous teeth (C)</p> Signup and view all the answers

    Which groups were involved in the final approval of the guideline?

    <p>British Society of Paediatric Dentistry and British Society of Restorative Dentistry (A)</p> Signup and view all the answers

    What is suggested by the wide variation in global prevalence rates for dental erosion?

    <p>It reflects the diversity of erosive toothwear studies (D)</p> Signup and view all the answers

    What funding model supports the Faculty of Dental Surgery?

    <p>Contributions from its fellows and members (B)</p> Signup and view all the answers

    What aspect does the guideline aim to address for both children and adults?

    <p>The diagnosis, prevention, and management of dental erosion (C)</p> Signup and view all the answers

    Which group of workers is considered to have an increased risk for dental erosion due to exposure to acids?

    <p>Battery manufacture workers (B)</p> Signup and view all the answers

    Which of the following factors is considered a rare cause of erosive toothwear?

    <p>Work-related acid exposure (D)</p> Signup and view all the answers

    What is a common characteristic of erosive toothwear on the occlusal surface?

    <p>Cupped cusp tips (C)</p> Signup and view all the answers

    Which area is primarily affected by extrinsic acids contributing to dental erosion?

    <p>Buccal cervical surfaces of maxillary teeth (D)</p> Signup and view all the answers

    What should be done to facilitate the diagnosis of erosive wear?

    <p>Conduct careful examination under good lighting with dry teeth (A)</p> Signup and view all the answers

    What happens to the dentine as dental erosion progresses?

    <p>Exposure of dentine increases (B)</p> Signup and view all the answers

    What visual change may be observed at the incisal edges due to erosive wear?

    <p>Grooved or chipped edges (D)</p> Signup and view all the answers

    How may the occlusal morphology be affected in advanced stages of dental erosion?

    <p>Complete disappearance of occlusal morphology (C)</p> Signup and view all the answers

    What is important to ensure when adopting a new clinical approach for dental erosion?

    <p>Maintaining a comfortable and aesthetic dentition in the long term (D)</p> Signup and view all the answers

    What function do patient information leaflets serve?

    <p>To allow patients to consider risk factors at their own pace (A)</p> Signup and view all the answers

    What is a recommended practice for monitoring dental erosion?

    <p>Regularly assessing dental erosion on an individual basis (C)</p> Signup and view all the answers

    What is the primary use of good quality study casts in the context of dental erosion?

    <p>To aid in the monitoring of dental erosion (A)</p> Signup and view all the answers

    What is a challenge in monitoring dental erosion in children?

    <p>Growth and dentoalveolar development complicate accurate evaluations (A)</p> Signup and view all the answers

    What does a silicone putty impression help assess in adults?

    <p>Progression of dental erosion and potential compliance issues (C)</p> Signup and view all the answers

    What grading system is referred to in the Basic Erosive Wear Examination?

    <p>0 = no erosion; 1 = initial loss of enamel texture (A)</p> Signup and view all the answers

    What issue may arise from utilizing a putty index at follow-up appointments?

    <p>Gaps in the putty index can indicate progression of erosion (D)</p> Signup and view all the answers

    What types of drinks are generally considered to be non-acidic?

    <p>Sparkling water (B)</p> Signup and view all the answers

    Which of these beverages is specifically mentioned as having a high erosive potential?

    <p>Sports drinks (A)</p> Signup and view all the answers

    What is a behavior that significantly increases the risk of erosive tooth wear?

    <p>Constantly sipping acidic beverages (B)</p> Signup and view all the answers

    Which type of food is NOT mentioned as having erosive potential?

    <p>Pasta (D)</p> Signup and view all the answers

    How do warming beverages affect their erosive potential?

    <p>They may increase their erosive potential. (D)</p> Signup and view all the answers

    What type of beverages did in vitro studies show promise in reducing erosive potential?

    <p>Fruit-flavored drinks with calcium and phosphate (C)</p> Signup and view all the answers

    Which of the following is considered an intrinsic agent of erosion related to alcohol consumption?

    <p>Dry wine (D)</p> Signup and view all the answers

    Which of the following foods is indicated as having erosive potential as well?

    <p>Chillies (D)</p> Signup and view all the answers

    What is the primary risk factor for erosive toothwear progression?

    <p>Frequency of dietary acid intake (D)</p> Signup and view all the answers

    How does the consumption of dietary acids between meals affect tooth erosion risk?

    <p>It represents a further increased risk for erosion. (C)</p> Signup and view all the answers

    Which of the following beverages is noted for its high erosive potential?

    <p>Carbonated soft drinks (B)</p> Signup and view all the answers

    What demographic is particularly at risk from the erosion effects of soft drinks and fruit juices?

    <p>Infants using feeding bottles (B)</p> Signup and view all the answers

    Which dietary pattern is crucial for preventing erosive toothwear during formative years?

    <p>Reduced intake of dietary extrinsic acids (A)</p> Signup and view all the answers

    What factor is NOT considered a co-factor influencing the relationship between dietary acids and erosion?

    <p>Dietary fiber intake (A)</p> Signup and view all the answers

    How much of the added sugars in the diet of 11-12-year-old children are provided by soft drinks?

    <p>One-fifth (B)</p> Signup and view all the answers

    What characteristic of fruit juices contributes to their potential for dental erosion?

    <p>Natural fruit and additives (D)</p> Signup and view all the answers

    Flashcards

    Dental Erosion Guidelines

    Guidelines describing the diagnosis, prevention, and management of dental erosion.

    Conflict of Interest

    Disclosure stating no funded contributors to the guidelines.

    Evidenced-Based Literature

    Research-backed content used to inform dental erosion management.

    Modified Delphi Methodology

    A group consensus process used for guideline development.

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    Prevalence in Deciduous Teeth

    30% to 50% of children experience dental erosion in primary teeth.

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    Prevalence in Permanent Teeth

    20% to 45% of adults experience dental erosion in permanent teeth.

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    Global Prevalence Variation

    Erosive tooth wear varies widely depending on geography and study.

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    Stakeholders in Guidelines

    Groups involved in the approval of dental erosion guidelines, like dental faculties and societies.

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    Gastro-oesophageal reflux disease (GORD)

    A chronic condition where stomach acid frequently flows back into the esophagus, potentially leading to dental erosion.

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    Signs of GORD

    Common signs include heartburn, epigastric pain, retrosternal discomfort, and hoarseness.

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    Silent refluxers

    Patients who experience reflux symptoms without typical signs like heartburn, remaining undiagnosed.

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    Causes of GORD

    Factors leading to GORD include sphincter incompetence, obesity, and dietary choices.

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    Dental erosion

    Tooth wear caused by acid, significant in patients with GORD.

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    Extra-oesophageal symptoms

    Symptoms like chronic cough and asthma that are linked to GORD, not just heartburn.

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    GORD prevalence

    GORD affects approximately 8.8% to 25.9% of adults in Europe, suggesting commonality.

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    Pathological GORD diagnosis

    Presence of reflux condition diagnosed by standard criteria, even in the absence of symptoms.

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    Acidic Beverages

    Drinks containing fruit flavors or additives that lower pH.

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    Dietary acid intake

    The consumption of acidic foods and drinks that can erode tooth enamel.

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    Erosive Potential

    The ability of a beverage to erode tooth enamel.

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    Fruit Flavoured Teas

    Teas that contain added fruits, increasing acidity.

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    Erosive toothwear progression

    The increasing damage to tooth enamel caused by acidic consumption over time.

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    Constant Sipping

    The habit of frequently sipping acidic drinks, increasing erosion risk.

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    Risk factors for dental erosion

    Factors that increase the likelihood of tooth erosion, such as acidic intake and low saliva buffering.

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    Hard bristled toothbrush

    A toothbrush with stiff bristles that can contribute to enamel wear when used incorrectly.

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    Citrus Fruits

    Fruits like oranges and lemons known for their erosive potential.

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    Alcoholic Drinks

    Beverages like wine and cider that are also considered acidic.

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    Soft drinks and dental erosion

    Carbonated beverages, especially sugary ones, are linked to increased risk of tooth erosion.

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    Intrinsic vs Extrinsic Agents

    Internal (gastric) and external (dietary) factors causing erosion.

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    Fruit juices and dental erosion

    Juices have high acidity that can lead to tooth enamel damage, particularly in children.

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    Covert Acids

    Hidden acids in foods, like sauces and snacks, that can cause erosion.

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    Infant dental health risks

    Children using bottles with acidic drinks may suffer severe tooth damage.

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    Preventative measures for toothwear

    Strategies to reduce risk factors for dental erosion, especially in children and young adults.

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    Dental erosion risk factors

    Factors that predispose individuals to dental erosion, including exposure to acids and drugs.

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    Occupational exposure

    Work-related exposure to acidic substances that can lead to dental erosion, e.g., in factories.

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    Common affected areas

    Specific tooth areas prone to erosion, like maxillary palatal regions and mandibular occlusal surfaces.

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    Intrinsic acids

    Acids originating from within the body that contribute to dental erosion, affecting specific tooth surfaces.

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    Extrinsic acids

    Acids from external sources, such as foods and drinks, that contribute to dental erosion.

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    Signs of dental erosion

    Physical indicators of erosive wear, such as loss of contours and translucency of teeth.

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    Erosive toothwear diagnosis

    Diagnosing tooth erosion through careful examination under good lighting.

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    Preventive strategies

    Actions taken to prevent the progression of dental erosion once diagnosed.

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    Restoration Necessity

    Ensuring remaining tooth structure allows for future restoration without complications.

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    Patient Information Leaflets

    Documents helping patients understand risks related to dental erosion.

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    Erosion Monitoring

    Regular assessment of dental erosion progression or arrest.

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    Quality Study Casts

    3D models that aid in monitoring dental erosion in patients.

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    Silicone Putty Impression

    A method to capture and monitor wear on affected tooth areas.

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    Putty Index

    Tool used to assess erosion compare to tooth surface.

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    Basic Erosive Wear Examination

    Clinical index recommended for assessing dental erosion severity.

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    Erosion Grading System

    System assigning grades to tooth erosion from no erosion to hard tissue loss.

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    Study Notes

    Clinical Guidelines for Dental Erosion

    • Purpose: This document provides clinical guidelines for diagnosing, preventing, and managing dental erosion.
    • Target Audience: The entire dental team, and other healthcare providers involved in patient care.
    • Conflict of Interest: No contributors or reviewers were paid for their work on the guidelines.
    • Aim & Objectives: To describe and explain the diagnosis, prevention and management of dental erosion in children and adults, providing evidenced-based information for patients and caregivers.

    Prevalence

    • Global Prevalence: Dental erosion is a common problem in developed countries, with an average prevalence of deciduous teeth between 30-50% and permanent teeth between 20-45%.
    • Variations: Differences in prevalence are due to variations in study methodologies, sample sizes, and study populations.
    • Age & Sex Differences: Prevalence of dental wear tends to increase with age, particularly in younger adults. Sex differences aren't consistently confirmed, though some studies suggest a higher prevalence in males.
    • Primary Teeth: Children's primary teeth are more prone to faster erosive tooth wear than permanent teeth.
    • Preschool Children: Prevalence and severity of erosive toothwear increases in preschool populations.

    Aetiology

    • Definition: Dental erosion is the irreversible loss of tooth structure caused by acid dissolution.
    • Intrinsic Sources: Gastric acid, from gastroesophageal reflux disease (GERD), vomiting, or rumination, is a significant source of intrinsic acids.
    • Extrinsic Sources: Dietary (acidic foods and beverages, including carbonated drinks, fruit juices, certain fruits, and alcoholic beverages), and lifestyle factors.

    Presentation and Diagnosis

    • Characterised Loss: Loss of tooth structure, shape, and morphology.
    • Clinical Features: May involve enamel loss, often beginning at the cervical margin, and can reveal dentine (leading to hypersensitivity) and further erosion progresses; may include concavities, hollows, and other morphological changes.
    • Radiographic Evaluation: Radiographs can reveal thickness loss in affected areas.

    Management: Preventative Treatment

    • Early Intervention: Prevention and early intervention are key to reducing the need for extensive treatment later.
    • Reducing Modifiable Factors: Identify and reduce extrinsic acid exposure.
    • Monitoring and Recording: Track erosion progression or arrest.
    • Dietary Analysis: Conduct a thorough assessment of 3-day eating habits, including beverages.
    • Dietary Counselling Discuss dietary changes with patients and encourage the health benefits of a balanced diet, including fruit and vegetables.
    • Oral Hygiene: Recommend appropriate oral hygiene practices to remove plaque and encourage remineralization.

    Management: Restorative Treatment

    • Primary Dentition: Focus on symptomatic relief and minor restorative interventions where necessary.
    • Mixed Dentition: Emphasise conservative management, using bonding agents and composite resins to restore affected areas.
    • Permanent Dentition: Consider more extensive restorations if indicated. Assess for space creation strategies, if needed.

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    Description

    This quiz explores clinical guidelines for diagnosing, preventing, and managing dental erosion, aimed at dental professionals and healthcare providers. It outlines the prevalence of dental erosion globally and discusses variations based on age and sex differences. Perfect for anyone involved in patient care and dental health.

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