Tooth Wear 1 Quiz

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Questions and Answers

What percentage of adults in the UK are estimated to have some wear on their permanent teeth?

20%

77% (correct)

50%

30.4%

Which of the following is a source of intrinsic acids that can contribute to dental erosion?

Dietary acids from fruits

Acids from fermented foods

Stomach acids from vomiting (correct)

Acids in carbonated beverages

What is the primary definition of dental erosion?

Chemical loss of tooth tissue due to non-bacterial acids (correct)

Wear caused by chewing hard foods

Physical wear from brushing too hard

Loss of tooth structure due to bacteria

Which type of tooth wear is not considered when discussing severe tooth wear clinically?

Dental caries Signup and view all the answers

What is the definition of tooth wear according to the European Federation of Conservative Dentistry?

Cumulative loss of mineralised tooth tissue due to physical or chemical-physical processes Signup and view all the answers

What is the estimated global prevalence of severe tooth wear among children and adolescents?

2% Signup and view all the answers

Which of the following is NOT a factor that contributes to tooth wear?

Caries Signup and view all the answers

Which factor contributes to the difficulty in determining the prevalence of tooth wear?

Inconsistency in recording methods and definitions Signup and view all the answers

Which of the following types of tooth wear is characterized by the mechanical wearing away of enamel and dentin?

Abrasion Signup and view all the answers

Which type of tooth wear is associated with chemical processes?

Erosive tooth wear Signup and view all the answers

What is the significance of outlining the key aetiological factors of tooth wear in oral health?

It guides in the diagnosis and treatment of tooth conditions. Signup and view all the answers

What proportion of children and adolescents are estimated to have tooth wear in the UK?

20-45% Signup and view all the answers

What term describes accelerated rates of tooth wear in relation to a patient's age?

Accelerated tooth wear Signup and view all the answers

Which component of dental erosion refers to outside sources of acid?

Extrinsic acids Signup and view all the answers

How is severe tooth wear characterized?

Significant impact on a patient's life Signup and view all the answers

What is the clinical significance of discouraging the classification of other reasons for tooth structure loss?

To ensure accurate diagnoses Signup and view all the answers

What components are included in the definition of tooth wear?

Enamel, dentine, and cementum Signup and view all the answers

Which of the following assessments is NOT part of the formative assessment for tooth wear?

E-assessment Signup and view all the answers

Which of the following best describes abrasion in terms of tooth wear?

Mechanical wear caused by external influences Signup and view all the answers

Why is it important to understand the distinction between tooth wear and caries?

Tooth wear is related to mineral loss while caries is biofilm-induced. Signup and view all the answers

Study Notes

Tooth Wear 1

Tooth wear is the cumulative loss of mineralised tooth tissue (enamel, dentine and cementum) due to physical or chemical-physical processes (Schlueter et al 2020).
Tooth wear is NOT the result of biofilm-induced diseases (e.g., caries) nor a consequence of trauma or resorption.

Lectures and Assessments

Tooth Wear 1: Pre-recorded lecture + workbook
Tooth Wear 2: Pre-recorded lecture + quiz
Tooth Wear 3: Live lecture + case studies to apply theory
Formative assessments: workbook, quiz, and case studies
Summative assessments: e-assessment and/or cases

Intended Learning Outcomes

Define tooth wear
Describe key aetiological factors of tooth wear
Outline the significance of tooth wear for oral health
GDC Learning Outcomes: 1.1.2, 1.1.4, 1.1.8, 1.7.7, 1.10.1, 1.10.2, 1.10.3, 1.10.4, 1.10.6

Alternative Terms

Erosive tooth wear (chemical-physical)
A combination of erosion (chemical), attrition (physical), and abrasion (physical)
Accelerated tooth wear
Severe tooth wear, where the rate of wear is significant for a patient's age, impacting self-esteem, chewing ability and sensitivity
Tooth surface loss - clinically discouraged as other reasons for loss of tooth structure.

Clinical Appearance of Severe Tooth Wear

Images of severe tooth wear are presented (clinical examples)

Epidemiology: Prevalence

Globally, 20-45% of permanent teeth show wear (Schlueter and Luka 2018).
In the UK, 77% of adults have some degree of tooth wear, and 2% have severe wear (Bartlett et al 2013, ADHS 2009).
30.4% of permanent teeth among children and adolescents exhibit wear (Bartlett et al 2013).
Prevalence difficult to determine due to inconsistent recording methods, varying definitions, and unsystematic monitoring.

Aetiology of Tooth Wear

Tooth wear results from three main factors: Erosion, Attrition, and Abrasion.

Erosion

Dental erosion is the chemical loss of mineralised tooth tissue caused by acids not derived from oral bacteria (Schlueter et al 2020)
Acids can be intrinsic (e.g., stomach acid) or extrinsic (e.g., acidic drinks).

Sources of Acids

Intrinsic Acids: Stomach acid (HCl, pH 1-2), Gastro-oesophageal reflux disease (GORD), eating disorders (frequent vomiting), pregnancy (severe morning sickness).
Extrinsic Acids: Acidic drinks (regardless of meal or in between meals), multiple intakes of fruit juice, alternate drinking habits (swishing, holding in mouth), high quantity acid intake.

Extrinsic Acids – Evidence

Carbonated drinks, acidic snacks/sweets, and fruit juices are associated with increased erosion occurrence, particularly in 8-19 year-olds.
Milk and yogurt consumption may reduce erosion.

Extrinsic Acids

A recent review of top 5 UK energy drinks showed acidic pH values & high sugar content.
Critical pH values and free sugar levels of these drinks are presented.

Attrition

Dental attrition is the physical loss of mineralized tooth tissue caused by tooth-to-tooth contact (Schlueter et al 2020)
Bruxism (teeth grinding) and malocclusion (misalignment) are key causes.
Images of dental attrition are shown

Abrasion

Dental abrasion is the physical loss of mineralized tooth tissue caused by physical factors other than teeth (Schlueter et al 2020).
This often co-exists with erosion
Common sources include occupational factors (e.g., construction workers), lifestyle habits (e.g., nail biting), oral hygiene routines (e.g., abrasive toothpaste) and diet (e.g., chewing bones).
Images of dental abrasion clinical examples are shown

Multifactorial Aetiology

Tooth wear typically occurs gradually and naturally with living and using teeth
It becomes significant when it's accelerated or affects patient function.

Abfraction

Often described as tooth wear but not generally accepted as an aetiology in the modern literature.
Loss of tooth structure in cervical region due complex cervical and occlusal forces.
Distinctive wedge shape is clinically observed in the cervical region.

Saliva and its impact

Reduced salivary quality or quantity will increase risk of erosion
Reflect on the functions of saliva

Epidemiology

Tooth wear affects a wide range of ages
Modern lifestyles and diets pose a higher risk
Early detection challenges
Generally not consistently tracked/recorded

Summary

Definitions of tooth wear, including alternative terms
Prevalence of tooth wear globally & in specific populations
Multifactorial aetiology of tooth wear (erosion, attrition, abrasion)
Significance of tooth wear's impact

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Description

Test your understanding of tooth wear, including its definition, aetiological factors, and significance for oral health. This quiz covers material discussed in the Tooth Wear 1 lecture, providing insights into the physical and chemical processes involved in the phenomenon. Prepare to assess your knowledge on erosive tooth wear and its implications for dental practice.