Tooth Wear 2 - Oral and Dental Sciences
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Questions and Answers

According to the study by Salas MM, et al., what was the primary focus of their research?

  • The systemic review of gastroesophageal reflux disease and dental lesions.
  • The prevalence of erosive tooth wear in different risk groups.
  • The relationship between physical activity and erosive lesions in adolescents.
  • The impact of diet on tooth erosion prevalence in children and adolescents. (correct)
  • In the study "Terminology of Erosive Tooth Wear," what was the key objective of the authors?

  • To analyze the relationship between physical activity and erosive lesions.
  • To investigate the prevalence of erosive tooth wear in different risk groups.
  • To determine the impact of diet on tooth erosion prevalence.
  • To establish a standardized terminology for describing erosive tooth wear. (correct)
  • Which of the following studies focused on the impact of physical activity on dental erosion?

  • Schlueter N, et al. (Terminology of Erosive Tooth Wear: Consensus Report)
  • Salas MM, et al. (Diet influenced tooth erosion prevalence)
  • Pace F, et al. (Gastroesophageal reflux disease and dental lesions)
  • Nijakowski K, et al. (Regular Physical Activity as a Potential Risk Factor for Erosive Lesions) (correct)
  • What is the BEWE score assigned to a premolar showing erosive tooth wear covering more than 50% of the tooth surface?

    <p>BEWE 3 (B)</p> Signup and view all the answers

    What is a key characteristic of a BEWE score of 2?

    <p>Discrete area of wear with less than 50% loss of tooth structure. (B)</p> Signup and view all the answers

    What is the recommended toothbrush bristle type for patients with tooth wear?

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

    What did the study by Schlueter, et al., titled "Erosive tooth wear – a review on global prevalence and on its prevalence in risk groups" investigate?

    <p>The prevalence of erosive tooth wear worldwide and in specific risk groups. (A)</p> Signup and view all the answers

    Which research paper focused on the association between gastroesophageal reflux disease (GERD) and dental lesions?

    <p>Pace F, et al. (Gastroesophageal reflux disease and dental lesions) (B)</p> Signup and view all the answers

    What is the main purpose of the BEWE score?

    <p>To guide treatment options for tooth wear (A)</p> Signup and view all the answers

    Which BEWE score is characterized by a 'halo effect'?

    <p>BEWE 3 (D)</p> Signup and view all the answers

    Which of the following is NOT a recommended preventative measure for tooth wear?

    <p>Brushing immediately after consuming acidic foods (C)</p> Signup and view all the answers

    What is the significance of the BEWE score in clinical management?

    <p>It provides a quantitative measure of tooth wear. (B)</p> Signup and view all the answers

    What is the primary purpose of the BEWE system?

    <p>To assess the severity of tooth wear. (D)</p> Signup and view all the answers

    What is the recommended frequency of acidic drinks for patients with tooth wear?

    <p>Limit acidic drinks to meal times and 1/day (D)</p> Signup and view all the answers

    A BEWE score of 1 typically indicates:

    <p>Early, localized erosive wear. (B)</p> Signup and view all the answers

    Why is saliva considered a significant modifying factor in tooth wear?

    <p>Saliva helps to neutralize acid (A)</p> Signup and view all the answers

    What is the maximum concentration of fluoride in toothpaste that is available by prescription?

    <p>22600ppm (D)</p> Signup and view all the answers

    The BEWE score is independent of:

    <p>The cause of wear. (B)</p> Signup and view all the answers

    Which of the following images would most likely have a BEWE score of 0?

    <p>An image showing a premolar with no signs of erosive wear. (D)</p> Signup and view all the answers

    What are the two main types of interventions for tooth wear?

    <p>Preventative and Restorative (A)</p> Signup and view all the answers

    Which of the following dietary factors is NOT recommended for patients with tooth wear?

    <p>Avoiding fruits (C)</p> Signup and view all the answers

    What is the first step in managing tooth wear, if the erosion is under control?

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

    Which of the following may be necessary to address tooth wear once it stabilizes?

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

    Which of the following conditions might necessitate a referral to a General Dental Practitioner (GDP)?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the primary focus of a preventative approach to tooth wear management?

    <p>Preventing further damage (C)</p> Signup and view all the answers

    When might an occlusal splint be considered for tooth wear management?

    <p>Only when erosion is under control (D)</p> Signup and view all the answers

    What does BEWE stand for in the context of tooth wear assessment?

    <p>Basic Erosive Wear Examination (A)</p> Signup and view all the answers

    Which of the following is NOT a common factor considered in the assessment of tooth wear?

    <p>Genetic predisposition (A)</p> Signup and view all the answers

    What is the primary reason why bonding materials are often challenging to use in restorative procedures for tooth wear?

    <p>They are difficult to bond to worn tooth surfaces (D)</p> Signup and view all the answers

    What can be examined during a clinical detection for tooth wear?

    <p>Buccal surfaces of the teeth (A), Palatal and Lingual surfaces of the teeth (B), Patient history (C), Occlusal surfaces of the teeth (D)</p> Signup and view all the answers

    What is the systematic screening tool used for detecting tooth wear?

    <p>Basic Erosive Wear Examination (BEWE) (C)</p> Signup and view all the answers

    The maximum score for a BEWE assessment on a single sextant is:

    <p>3 (B)</p> Signup and view all the answers

    In terms of BEWE scoring, what would a score of 0 indicate?

    <p>No erosive wear (B)</p> Signup and view all the answers

    What is one of the key pieces of information a dentist should keep in mind when assessing tooth wear?

    <p>Most adults will show some signs of tooth wear as a result of normal physiological processes. (C)</p> Signup and view all the answers

    What is a key step in the BEWE screening tool?

    <p>Using a 3-in-1 mirror and cotton wool rolls to dry the tooth surface (D)</p> Signup and view all the answers

    What type of wear does the BEWE system specifically focus on?

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

    What information can be gleaned from patient factors during tooth wear detection?

    <p>All of the above (D)</p> Signup and view all the answers

    Flashcards

    BEWE

    A scoring system for assessing tooth wear and its management.

    BEWE 0

    Indicates no signs of erosive tooth wear on the premolar and molar.

    BEWE 1

    Shows discrete areas of early erosive tooth wear with small lesions present.

    BEWE 2

    Indicates less than 50% tooth wear with some loss of clinical crown height.

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    BEWE 3

    More than 50% of the tooth surface is affected by erosive wear.

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    Erosive Tooth Wear

    Loss of tooth structure due to acids, leading to sensitivity and aesthetic issues.

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    Cuspal Changes

    Alterations in tooth cusps due to wear, leading to flattened tops and sensitivity.

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    Dentine Hypersensitivity

    Sensitivity in teeth due to exposed dentine from wear.

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    Gastroesophageal reflux disease (GERD)

    A chronic digestive condition where stomach acid or bile irritates the esophagus.

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    Erosive lesions

    Damages on teeth caused by acidic substances leading to wear and erosion.

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    Diet's role in tooth erosion

    Certain diets can increase the prevalence of tooth erosion in children and adolescents.

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    Regular Physical Activity and tooth erosion

    Increased physical activity may be linked to a higher risk of erosive lesions in adolescents.

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    Terminology of Erosive Tooth Wear

    A consensus on defining terms related to the erosive wear of teeth, established by dental experts.

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    Tooth Wear Symptoms

    Signs and symptoms indicating tooth wear include changes in morphology and sensitivity.

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    Clinical Detection

    The process of identifying tooth wear through clinical examination and patient history.

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    BEWE Tool

    Basic Erosive Wear Examination (BEWE) is a systematic tool for assessing tooth wear in sextants.

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    BEWE Scores

    A scoring system based on observable tooth wear: 0 (none) to 3 (severe), summed for a maximum score of 18.

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    Tooth Morphology Knowledge

    Understanding the normal shape and structure of teeth helps in detecting wear.

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    Subtle Changes in Teeth

    Early signs of wear might be subtle and require careful observation of tooth shape.

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    Age and Wear Assessment

    Evaluate the rate of tooth wear in context of the patient's age.

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    Preventive Management Strategies

    Approaches to reduce or manage tooth wear include lifestyle changes and dental interventions.

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    Preventative Monitoring

    Assessing changes over time through impressions and clinical photographs.

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    Occlusal Splint

    A device made from impressions to manage stress and occlusal issues.

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    Restorations

    Procedures to repair wear once it stabilizes, using materials like bonding and crowns.

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    Specialist Referral

    Guiding patients to dental specialists for complex cases beyond general practice.

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    Bruxism Management

    Addressing teeth grinding, often requiring splints and stress strategies.

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    Eating Disorder Consultation

    Referral to a general practitioner for patients with suspected eating issues impacting dental health.

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    GORD Query

    Referral to a GP for patients with gastroesophageal reflux disease symptoms affecting teeth.

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    Risk Assessment Factors

    Factors to evaluate when assessing dental risk in patients.

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    Saliva's Role

    Saliva significantly influences dental health and tooth wear.

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    Preventive Care

    Strategies to prevent dental issues before they occur.

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    Home Care Advice

    Guidelines for patients to maintain oral health at home.

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    Dietary Advice

    Guidelines to manage and reduce the intake of acidic foods.

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    Fluoride Toothpaste

    Toothpaste containing fluoride to strengthen enamel.

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    Fluoride Varnish

    A high-concentration fluoride treatment for severe tooth wear.

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    Study Notes

    Tooth Wear 2 - Miss Felix

    • Course: Oral and Dental Sciences
    • Lecturer: Miss Felix
    • Institution: Eastman Dental Hospital, LSBU

    Tooth Wear Lectures and Assessments

    • Lectures:
      • Tooth Wear 1: Pre-recorded lectures with workbooks
      • Tooth Wear 2: Pre-recorded lectures with quizzes
      • Tooth Wear 3: Live lectures with case studies for application of theory
    • Assessments:
      • Formative: Workbooks, quizzes, and case studies
      • Summative: E-assessments and/or case studies

    Intended Learning Outcomes

    • Students will be able to describe clinical signs and symptoms of tooth wear, and how to detect them.
    • Students will be able to describe the BEWE screening tool.
    • Students should be able to outline preventive management strategies.
    • GDC learning outcomes relevant to the topic include 1.1.2, 1.1.4, 1.1.8, 1.7.7, 1.10.1, 1.10.2, 1.10.3, 1.10.4, and 1.10.6

    Clinical Detection: Signs and Symptoms

    • Key factors for clinical detection include clinical signs, the BEWE tool, and patient history.

    Detection

    • Tooth wear risk assessment is conducted by combining clinical examination (signs) with patient factors (symptoms and history).

    Clinical Detection

    • Preparation: Mirror, dry surface (3 in 1 or cotton wool rolls)
    • Examination: Occlusal, palatal/lingual, buccal clinical signs
    • BEWE: Systematic screening tool, including sextants, similar to BPE assessment for hard tissue.

    Tips to Detect Clinical Signs

    • Morphology: Use knowledge of normal tooth morphology to detect subtle changes
    • Early Stages: Early tooth wear may not be obvious; look for subtle changes
    • Physiological Processes: Most adults exhibit tooth wear due to normal physiological processes
    • Age Comparison: Assess the rate of wear in comparison to patient age

    Basic Erosive Wear Examination (BEWE) Index

    • Scoring:
      • 0: No erosive wear
      • 1: Initial loss of surface texture (e.g., "frosted glass" appearance)
      • 2: Distinct defect, hard tissue loss <50% of the surface area.
      • 3: Hard tissue loss >50% of the surface area.
    • Cumulative Score: Scores per sextant are added for a total score; this score informs risk assessment for clinical management.
    • Purpose: Used to record tooth wear regardless of etiology.

    Patient Factors in Risk Assessment

    • Age: Rate of wear specific to the patient's age
    • History: Etiological factors of past and current frequent exposures to internal/external acids, occupation, and medical history
    • Habits: Dietary factors, patient symptoms/concerns, sensitivity due to exposed dentine, chipping of anterior teeth, and grinding habits
    • Saliva: Saliva plays a significant role in modifying tooth wear

    Interventions

    • Preventive: Risk assessment, preventive care and advice, and monitoring
    • Restorative: Restorative care or referral. This is considered only when tooth wear is under control.

    Restorative Options

    • Bonding difficult: Depending on complexity, specialist referral is possible
    • Options: Bonding materials, veneers, crowns, complex build-ups
    • Stability: Restorative options are considered when tooth wear is stable.

    Referrals

    • Limits of Care: Sever tooth wear, Bruxism, complex restorative care, eating disorders, and gastroesophageal reflux disease (GORD) may require referrals outside of immediate scope
    • Specialists: Recommendations for referring to GDP/specialist.

    Summary

    • Detection: Risk assessment, patient history, and clinical signs (such as BEWE).
    • Interventions: Preventive, monitoring, and restorative care.

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    Description

    This quiz focuses on the clinical signs and symptoms of tooth wear, specifically designed for the Oral and Dental Sciences course by Miss Felix at Eastman Dental Hospital. Students will explore detection methods and preventive management strategies, including the BEWE screening tool. Test your knowledge and understanding of tooth wear and its implications in dental health.

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