Podcast
Questions and Answers
What is the primary goal when the presence of GORD is identified in a patient?
What is the primary goal when the presence of GORD is identified in a patient?
- Immediately referring the patient to a specialist
- Prescribing medication to reduce stomach acid
- Performing a BEWE examination
- Eliminating any contributing factors to the condition (correct)
Which of the following actions would NOT be included in the management strategy for a patient with a summed BEWE score between 3 and 8?
Which of the following actions would NOT be included in the management strategy for a patient with a summed BEWE score between 3 and 8?
- Dietary assessment and recommendations
- Using a scalpel to score the affected tooth surface (correct)
- Reviewing the patient at two-year intervals
- Routine dental maintenance
What is the significance of a BEWE score of 0?
What is the significance of a BEWE score of 0?
- It necessitates a dietary assessment and oral hygiene recommendations
- It indicates the presence of significant tooth wear
- It suggests a need for immediate referral to a specialist
- It implies no signs of erosive tooth wear (correct)
What is the clinical management recommendation for a patient with a summed BEWE score of 2?
What is the clinical management recommendation for a patient with a summed BEWE score of 2?
What does the term 'aetiological agent' refer to in the context of tooth erosion?
What does the term 'aetiological agent' refer to in the context of tooth erosion?
What is defined as the wear that occurs from tooth-to-tooth contact?
What is defined as the wear that occurs from tooth-to-tooth contact?
Which factor is increasingly significant for the long-term health of the dentition?
Which factor is increasingly significant for the long-term health of the dentition?
What describes wear occurring due to the friction of exogenous material?
What describes wear occurring due to the friction of exogenous material?
What is a common consequence of non-carious tooth surface loss?
What is a common consequence of non-carious tooth surface loss?
Which option is not a type of non-carious tooth wear?
Which option is not a type of non-carious tooth wear?
What external factor can contribute to abrasion on teeth?
What external factor can contribute to abrasion on teeth?
Which of the following is least likely to cause tooth surface loss?
Which of the following is least likely to cause tooth surface loss?
In terms of tooth wear, what is the main distinction between attrition and abrasion?
In terms of tooth wear, what is the main distinction between attrition and abrasion?
What is the main difference between intrinsic and extrinsic erosion?
What is the main difference between intrinsic and extrinsic erosion?
Which of the following factors is NOT mentioned as influencing the severity of erosive damage?
Which of the following factors is NOT mentioned as influencing the severity of erosive damage?
How do liquids of low pH affect dental tissues?
How do liquids of low pH affect dental tissues?
What is a common property of solid acidic foods mentioned in the content?
What is a common property of solid acidic foods mentioned in the content?
Which sour food product is noted for having a very low pH level?
Which sour food product is noted for having a very low pH level?
What is the role of the tongue during the swallowing process regarding acidic liquids?
What is the role of the tongue during the swallowing process regarding acidic liquids?
What effect does gastric acid have as compared to dietary acids?
What effect does gastric acid have as compared to dietary acids?
Which of the following is an example of a factor that may NOT influence erosive patterns in oral health?
Which of the following is an example of a factor that may NOT influence erosive patterns in oral health?
What is abfraction mainly associated with?
What is abfraction mainly associated with?
Which factor is considered a co-factor contributing to cervical lesions?
Which factor is considered a co-factor contributing to cervical lesions?
What might indicate that enamel surfaces are 'mildly active'?
What might indicate that enamel surfaces are 'mildly active'?
What is the purpose of the 'scratch test' used for determining enamel activity?
What is the purpose of the 'scratch test' used for determining enamel activity?
What pH level is generally associated with moderate acids affecting tooth surfaces?
What pH level is generally associated with moderate acids affecting tooth surfaces?
Which condition is more likely to cause erosion of the mandibular teeth rather than the maxillary teeth?
Which condition is more likely to cause erosion of the mandibular teeth rather than the maxillary teeth?
What type of tooth damage is characterized by subsurface demineralization?
What type of tooth damage is characterized by subsurface demineralization?
How quickly do erosive acids act on tooth surfaces compared to moderate acids?
How quickly do erosive acids act on tooth surfaces compared to moderate acids?
What is the primary philosophy that must be applied in managing tooth wear?
What is the primary philosophy that must be applied in managing tooth wear?
Which mechanism is NOT typically associated with non-carious tooth surface loss?
Which mechanism is NOT typically associated with non-carious tooth surface loss?
What co-factors may exacerbate the effects of tooth wear?
What co-factors may exacerbate the effects of tooth wear?
How should tooth wear mechanisms be assessed by the clinician?
How should tooth wear mechanisms be assessed by the clinician?
Flashcards
Non-carious tooth surface loss
Non-carious tooth surface loss
Loss of tooth structure not caused by decay, affecting long-term dental health.
Tooth wear
Tooth wear
The gradual loss of tooth structure from mechanisms like attrition, abrasion, and erosion.
Attrition
Attrition
Wear of teeth caused by tooth-to-tooth contact without food being involved.
Abrasion
Abrasion
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Risk assessment
Risk assessment
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Long-term dental health
Long-term dental health
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Exogenous materials
Exogenous materials
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Dental function
Dental function
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GORD
GORD
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BEWE Score 0
BEWE Score 0
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BEWE Score 1
BEWE Score 1
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BEWE Score 2
BEWE Score 2
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Management for Erosion Risk Level <2
Management for Erosion Risk Level <2
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Abfraction
Abfraction
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Cervical lesions
Cervical lesions
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Aetiological co-factors
Aetiological co-factors
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Scratch test
Scratch test
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Activity determination
Activity determination
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Serial colour photographs
Serial colour photographs
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Tooth morphology changes
Tooth morphology changes
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Dietary acid sources
Dietary acid sources
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Minimum Intervention Dentistry
Minimum Intervention Dentistry
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Erosion
Erosion
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Hyposalivation
Hyposalivation
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Hypomineralisation
Hypomineralisation
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Tooth Erosion
Tooth Erosion
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Demineralization
Demineralization
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White Spot Lesion
White Spot Lesion
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pH Level
pH Level
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Subsurface Damage
Subsurface Damage
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Mandibular Teeth
Mandibular Teeth
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Erosive Demineralization
Erosive Demineralization
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Plaque Acids
Plaque Acids
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Intrinsic erosion
Intrinsic erosion
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Extrinsic erosion
Extrinsic erosion
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pH/buffering titration
pH/buffering titration
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Frequency of acid exposure
Frequency of acid exposure
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Palatal surfaces
Palatal surfaces
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Erosive patterns
Erosive patterns
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Critical pH
Critical pH
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Solid acidic food
Solid acidic food
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Study Notes
Non-Carious Tooth Surface Loss (Tooth Wear)
- Tooth wear is a significant factor affecting long-term dental health, impacting both young and older adults.
- This necessitates better preventive and restorative approaches by dental professionals.
- The main mechanisms of tooth surface loss are erosion, attrition, and abrasion.
Mechanisms of Tooth Surface Loss
- Erosion: Chemical dissolution of tooth substance without plaque.
- Factors impacting erosion include:
- Acids (intrinsic, exogenous): Gastric acid, dietary, environmental, and occupational acids.
- Frequency of exposure.
- pH/buffering.
- Common erosive patterns:
- Vomiting (palatal surfaces most affected).
- Gastroesophageal reflux disease (GORD).
- Rumination.
- Eructation (burping).
- Dietary intake (acids).
- Drinking acidic beverages (labial surfaces).
- Acidic sour candies.
- Attrition: Tooth-to-tooth contact without food.
- Factors impacting attrition:
- Stress (chronic stress, "highly strung" individuals).
- Distress.
- Sleep disturbances.
- Occlusal interferences (generally, not a direct significant factor).
- This grinding action can lead to pathological damage (enamel flaking, cusp fractures) and tooth damage, particularly on anterior teeth.
- Abrasion: Wear due to exogenous material friction.
- Abrasive sources: food, toothbrushes, dentifrices, foreign objects.
- Abrasion can be from hard foods, occupations, etc.
- Food abrasion is less of a problem now due to food processing.
Identifying Erosion
- Micro-anatomical enamel features are lost leading to a "glazed" or "silky" appearance.
- The teeth lose contours with curved enamel areas flattening.
- Scooped dentine.
- The presence of wedge-shaped non-carious cervical lesions suggests erosion.
Identifying Attrition
- Presence of facets (flattened areas).
- Enamel flaking/cusp fractures.
- Craniomandibular disorders.
Identifying Abrasion
- Asymmetric wear ("notch").
- Scooped dentine (incisal/occlusal surfaces).
- Lack of sensitivity.
- Impacted by associated erosion.
Minimum Intervention for Tooth Surface Loss Treatment
- Identify the mechanism(s).
- Assess if the mechanism(s) are active.
- Determine why the patient has this problem (lifestyle, medications, etc.).
- Develop a preventive/monitoring program tailored to the patient.
- Perform minimum intervention where needed, preserving tooth structure.
- Ensure patient assumes responsibility for preventive treatment success.
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