Tooth Wear Guidelines for BSRD Part 1

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Questions and Answers

Which of the following research studies specifically focused on the relationship between gastroesophageal reflux disease and dental erosion?

  • Reid BJ, Weinstein WM, Lewin KJ, Haggitt RC, VanDeventer G, DenBesten L, Rubin CE.Endoscopic biopsy can detect high-grade dysplasia or early adenocarcinoma in Barrett's esophagus without grossly recognizable neoplastic lesions.Gastroenterology 1988; 94: 81−90.
  • Bartlett DW, Evans DF, Smith BG.The relationship between gastro‐oesophageal reflux disease and dental erosion.J Oral Rehabil 1996; 23: 289−297. (correct)
  • Agerberg G, Carlsson GE.Functional disorders of the masticatory system II.Symptoms in relation to impaired mobility of the mandible as judged from investigation by questionnaire.Acta Odont Scand 1973; 31: 335−347.
  • Millward A, Shaw L, Smith AJ, Rippin JW, Harrington E.The distribution and severity of tooth wear and the relationship between erosion and dietary constituents in a group of children.Int J Paediatr Dent 1994; 4: 151−157.

According to the provided research, what is the significance of the study conducted by Reid et al. (1988)?

  • It provided evidence that endoscopic biopsy could detect early signs of esophageal cancer in patients with Barrett's esophagus. (correct)
  • It explored the connection between eating disorders and dental health.
  • It analyzed different methods for clinically scoring dental erosive wear.
  • It investigated the prevalence of tooth wear in a large sample of dental patients.

Which of the following research papers investigated the distribution and severity of tooth wear in children?

  • Fares J, Shirodaria S, Chiu K, Ahmad N, Sherriff M, Bartlett D.A new index of tooth wear.Caries Res 2009; 43: 119−125.
  • Mulic A, Tveit AB, Wang NJ, Hove LH, Espelid I, Skaare AB.Reliability of two clinical scoring systems for dental erosive wear.Caries Res 2010; 44: 294−299.
  • Smith BG, Robb ND.The prevalence of toothwear in 1007 dental patients.
  • Millward A, Shaw L, Smith AJ, Rippin JW, Harrington E.The distribution and severity of tooth wear and the relationship between erosion and dietary constituents in a group of children.Int J Paediatr Dent 1994; 4: 151−157. (correct)

Which of the following studies focuses on the reliability of clinical scoring systems used for dental erosive wear?

<p>Mulic A, Tveit AB, Wang NJ, Hove LH, Espelid I, Skaare AB.Reliability of two clinical scoring systems for dental erosive wear.Caries Res 2010; 44: 294−299. (A)</p> Signup and view all the answers

Which of the following studies focused on the prevalence of toothwear in a large sample size of dental patients?

<p>Smith BG, Robb ND.The prevalence of toothwear in 1007 dental patients. (D)</p> Signup and view all the answers

Which of the following studies aimed to develop a new index for measuring tooth wear?

<p>Fares J, Shirodaria S, Chiu K, Ahmad N, Sherriff M, Bartlett D.A new index of tooth wear.Caries Res 2009; 43: 119−125. (C)</p> Signup and view all the answers

Which of the following studies primarily focused on the age and sex distribution of symptoms related to dysfunction of the masticatory system?

<p>Helkimo M.Studies on function and dysfunction of the masticatory system: IV.Age and sex distribution of symptoms of dysfunction of the masticatory system in Lapps in the north of Finland.Acta Odont Scand 1974; 32: 255−267. (B)</p> Signup and view all the answers

Which study focused on the prevalence of bruxism, a condition characterized by teeth grinding?

<p>Ramfjord SP.Bruxism, a clinical and electromyographic study.J Am Dent Assoc 1961; 62: 21−44. (A)</p> Signup and view all the answers

What common characteristics are observed in the cervical region of teeth during an occlusal assessment?

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

Which teeth are most commonly affected by localized tooth wear?

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

What is the primary factor that can influence the extent of tooth wear on a patient's teeth?

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

How did right-handed individuals contribute to tooth wear according to the assessment?

<p>More wear on the left side (C)</p> Signup and view all the answers

What does the Tooth Wear Index (TWI) classify tooth wear into?

<p>Mild, Moderate, and Severe (B)</p> Signup and view all the answers

What recent modification to the Tooth Wear Index aimed to study erosion in dentine?

<p>Exact Tooth Wear Index (A)</p> Signup and view all the answers

What challenge is noted in developing a universally accepted method of quantifying tooth wear?

<p>Potential for overestimation of tooth wear (D)</p> Signup and view all the answers

What is a notable limitation of some indices for recording tooth wear?

<p>They may not account for secondary dentine measurement (B)</p> Signup and view all the answers

What is the primary role of remineralizing solutions?

<p>To treat tooth sensitivity and wear (D)</p> Signup and view all the answers

Which of the following habits should be advised against to prevent tooth wear?

<p>Holding objects with teeth (A)</p> Signup and view all the answers

What type of splints may be designed to manage more severe tooth wear effectively?

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

In cases of erosive tooth wear, what therapy is beneficial?

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

What is a recommended appliance for nocturnal bruxists?

<p>Full coverage splint (A)</p> Signup and view all the answers

What is an important consideration for selecting an occlusal splint?

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

What could happen if a splint becomes a reservoir for acid in erosive tooth wear?

<p>It may cause additional tooth structure loss (A)</p> Signup and view all the answers

Which type of splint may not be durable for long-term use for bruxism?

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

What is the main cause of tooth wear according to the mixed aetiology mentioned?

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

Which condition is noted for having episodes that wear teeth during specific periods?

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

What should be done to dental appliances after episodes of vomiting?

<p>Remove and clean them (A)</p> Signup and view all the answers

What factor can influence whether patients receive treatment for tooth wear?

<p>Patient's attitude (D)</p> Signup and view all the answers

What is a commonly noted type of tooth wear not universally accepted as a distinct entity?

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

Which drinks have been studied for their effect on dental enamel erosion?

<p>Carbonated beverages and sports drinks (A)</p> Signup and view all the answers

What is the main focus of the 2013 Children's Dental Health Survey Report?

<p>Children's dental health statistics (D)</p> Signup and view all the answers

What is defined as the erosive potential of certain herbal teas in relation to dental health?

<p>pH level impact (A)</p> Signup and view all the answers

What does the BEWE primarily score?

<p>Erosion of teeth (B)</p> Signup and view all the answers

What is one notable clinical finding in severe tooth wear patients?

<p>Reduced lower facial height (D)</p> Signup and view all the answers

What is one of the parameters used in the Anterior Clinical Erosive classification (ACE)?

<p>Preservation of incisal edges (D)</p> Signup and view all the answers

Which method can be used to assess the freeway space (FWS)?

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

Which statement about the Tooth Wear Index is correct?

<p>It was designed for multifactorial tooth wear research. (D)</p> Signup and view all the answers

What common condition might lead to parotid gland enlargement?

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

Which might be an indicator of pathological wear according to Smith and Knight?

<p>Patient's age (B)</p> Signup and view all the answers

What is primarily important in assessing patient expectations related to dental restoration?

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

What tool can be employed to measure resting vertical dimension (RVD)?

<p>Both B and C (A)</p> Signup and view all the answers

Which type of restoration has shown an improvement in success and survival rates due to newer adhesive techniques?

<p>Composite resin-based restorations (D)</p> Signup and view all the answers

Which aspect limits comparison among different studies on tooth wear?

<p>Aetiology and pattern of tooth wear (C)</p> Signup and view all the answers

What is a common treatment method for patients with severe generalized tooth wear?

<p>Full mouth rehabilitation (D)</p> Signup and view all the answers

What has contributed to the advancement of management techniques for tooth wear?

<p>Improvement in resin-based material properties (B)</p> Signup and view all the answers

What factor is critical to determine prior to choosing materials for a restored dentition?

<p>Expected wear causes (B)</p> Signup and view all the answers

Which of the following represents a drawback in the application of newer adhesive techniques?

<p>High costs and invasiveness (D)</p> Signup and view all the answers

What underlying issues may arise due to the complex nature of the oral environment?

<p>Mechanical and biological failures (D)</p> Signup and view all the answers

Flashcards

Occlusal Assessment

An evaluation of bite alignment and tooth wear.

Tooth Wear

Loss of tooth material due to various factors, including abrasion, erosion, and abrasion.

Tooth Wear Index (TWI)

A scoring system used to measure and categorize tooth wear severity.

Basic Erosive Wear Examination (BEWE)

Another index used to assess dental erosion severity.

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Abfraction

A type of tooth wear characterized by notches at the gum line from stress and flexural forces.

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Scoring Criteria

Specific thresholds used to categorize severity in tooth wear assessments.

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Right-Handed Phenomenon

Right-handed individuals tend to wear down teeth more on the left side.

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Categories of Tooth Wear

Levels of tooth wear classified as Mild, Moderate, and Severe.

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Tooth Wear Index

An index to measure and monitor multifactorial tooth wear.

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BEWE

A scoring method for erosive tooth wear with good inter-examiner reliability.

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Freeway Space (FWS)

The space between the upper and lower teeth at rest, indicating vertical dimension.

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Resting Vertical Dimension (RVD)

The vertical measurement of the face when the patient is at rest, critical for assessments.

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Occlusal Vertical Dimension (OVD)

The measurement of the face when occluding teeth, important for dental settings.

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Anterior Clinical Erosive classification (ACE)

A classification system to assess tooth wear severity across five parameters.

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Facial Vertical Proportions

The relationship between different facial heights, affected by tooth wear.

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Sibilant Sounds

Sounds in speech that can be used to assess occlusal space, like 's' or 'sh' sounds.

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Mixed Aetiology

Tooth wear arises from multiple causes, including attrition, erosion, and abrasion.

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Attrition

Tooth wear caused by tooth-to-tooth contact, often due to grinding.

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Erosion

Tooth wear caused by acid exposure, leading to the loss of enamel.

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Abrasion

Tooth wear caused by external forces, such as aggressive brushing or abrasive materials.

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Bulimia Effects on Teeth

Bulimic patients may experience erosion due to frequent vomiting.

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Caries Research

Scientific studies focused on tooth decay and prevention strategies.

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Macromechanical resistance

The physical ability of restorative materials to withstand large forces and stresses.

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Aetiology of tooth wear

The study of causes and factors contributing to the wear of teeth.

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Wear resistance

The ability of a material to resist wear over time.

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Composite resin restorations

Tooth-colored materials used for restoring decayed or damaged teeth.

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Full mouth rehabilitation

Comprehensive treatment aiming to restore all teeth in a patient's mouth.

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Parafunctional patients

Patients who exhibit abnormal jaw function, leading to increased wear.

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Adhesive techniques

Methods used to bond restorative materials to teeth effectively.

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Mechanical and biological failures

Failures that can occur due to material weaknesses or biological reactions.

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Remineralizing solutions

Substances that help restore minerals to teeth, improving durability and effectiveness.

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Desensitizing agents

Materials used to reduce tooth sensitivity caused by exposure of dentine.

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Occlusal splints

Devices used to prevent tooth wear and relieve dental muscle dysfunction.

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Tooth wear prevention

Practices to protect teeth from erosion due to habits like biting objects.

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Night guard

A protective appliance worn at night to prevent teeth grinding.

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Fluoride gels

Topical treatments that help prevent tooth decay by strengthening enamel.

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Dental Erosion

The loss of tooth structure due to acid exposure, leading to sensitivity and decay.

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Bruxism

The involuntary grinding or clenching of teeth, often due to stress or sleep disorders.

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Soft vacuum-formed appliance

A flexible dental splint used to protect teeth, particularly in mild cases.

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Hard acrylic splints

Durable dental devices used to manage severe tooth wear effectively.

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Gastro-oesophageal Reflux

A condition where stomach acid backs up into the esophagus, potentially causing dental erosion.

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Masticatory Dysfunction

Impairment of the chewing process that can affect eating and overall health.

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Occlusal Dysfunction

Misalignment of the upper and lower teeth affecting bite and function.

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Eating Disorders

Conditions characterized by unhealthy eating habits which can impact dental health.

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Clinical Scoring Systems

Standardized ways to assess the degree of dental erosive wear in patients.

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Study Notes

Tooth Wear Guidelines for the BSRD

  • Guidelines cover aetiology, diagnosis, prevention, fixed management, and removable management of tooth wear
  • Part 1: Aetiology, Diagnosis and Prevention (June Dental Update)
  • Part 2: Fixed Management of Tooth Wear (July/August Dental Update)
  • Part 3: Removable Management of Tooth Wear (September Dental Update)

Prime&Bond active™

  • Universal Adhesive
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  • Active-Guard™ Technology for reliable performance on over-wet and over-dried dentin
  • Virtually no post-operative sensitivity*

Tooth Wear Guidelines for the BSRD Part 1: Aetiology, Diagnosis and Prevention

  • Tooth wear (TW) is a common condition requiring advice and treatment
  • Physiological TW is normal
  • Pathological TW requires dental care, ranging in severity from mild sensitivity to severe destruction of the dentition
  • Treatment ranges from simple operative care to full-mouth reconstruction
  • Guidelines aim to help manage tooth wear
  • Aetiology, diagnosis, and prevention of tooth wear are covered in the literature review
  • Fixed and removable management of tooth wear are discussed
  • The guidelines aim to be a quick reference checklist
  • Severe bruxism requires regular repairs/replacement
  • The society reviews and updates the guidelines every three years

Tooth Wear Guidelines for the BSRD Part 2: Fixed Management of Tooth Wear

  • Management of tooth wear presents clinical dilemmas
  • Thorough history and clinical assessment are crucial for treatment decisions
  • Uncontrolled tooth wear leads to aesthetic issues, dentine hypersensitivity and functional problems
  • Significant tooth loss complicates rehabilitation
  • Tooth wear becomes apparent once the appearance of teeth deteriorates or symptoms arise
  • Enamel thinning/discoloration, fractures, and shrinkage are common
  • Symptoms include dentine hypersensitivity (pain from chemical, thermal, tactile, or osmotic stimuli)
  • Patients may limit dietary choices due to sensitivity
  • Tooth structure preservation is critical for adhesive restorations compared to conventional crown and bridge work
  • Tooth wear can reduce interocclusal space, limiting the space for restorative materials
  • Quality-based research on management strategies for tooth wear is absent

Tooth Wear Guidelines for the BSRD Part 3: Removable Management of Tooth Wear

  • Removable prostheses are used alone or with fixed prosthodontic treatments to manage tooth wear
  • Removable treatment is useful in cases of severe tooth surface loss
  • Preservation of coronal tissue is essential for removable appliances
  • Patients will be made aware of associated limitations, maintenance, and risks
  • Severe generalized tooth loss is an indication for removable management
  • Removable options include overdentures, overlay and onlay dentures
  • Suitable abutment teeth are crucial for removable appliances
  • Removable appliances can improve patient satisfaction with aesthetics, oral comfort, and mastication

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