Tooth Wear Quiz PDF

**[Tooth Wear Quiz]** **A cumulative BEWE score of 18 for a patient means:** **Question 1Select one:** a\. **There is more than 50% tooth wear in each sextant** b\. There is a severe amount of tooth wear evident c\. There is less than 50% tooth wear in all sextants d\. There is a moderate amou...

**[Tooth Wear Quiz]** **A cumulative BEWE score of 18 for a patient means:** **Question 1Select one:** a\. **There is more than 50% tooth wear in each sextant** b\. There is a severe amount of tooth wear evident c\. There is less than 50% tooth wear in all sextants d\. There is a moderate amount of tooth wear evident **Clinical signs of dental erosion include (select 2):** **Question 2Select one or more:** a\. Early lesions on the mesial and distal surfaces of first permanent molars b\. Jagged deep cavities on the incisal surfaces of anterior teeth **c. Labial surface lesions on the maxillary incisors** d\. Smooth, flat facets on the occlusal surfaces of posterior teeth **e. Scooped out lesions on the occlusal surfaces of the first permanent molars** **Clinical signs of dental erosion (caused by acid dissolution) include the following:** - **Labial surface lesions on maxillary incisors: Acid erosion often affects the labial (front) surfaces of the upper front teeth, particularly in cases of dietary acid exposure or gastric acid reflux.** - **Scooped out lesions on the occlusal surfaces: Erosion can lead to characteristic \"scooped-out\" or cupped lesions, often seen on the occlusal (chewing) surfaces of molars and premolars.** **Why not the other options?** - **a. Early lesions on the mesial and distal surfaces of first permanent molars: This is more indicative of caries (tooth decay), not erosion.** - **b. Jagged deep cavities on the incisal surfaces of anterior teeth: Jagged cavities are usually a sign of caries or trauma, not erosion, which tends to cause smooth and rounded defects.** - **d. Smooth, flat facets on the occlusal surfaces of posterior teeth: This describes attrition (wear caused by tooth-to-tooth contact), not erosion.** **Dental abrasion is tooth wear resulting from:** **Question 3Select one:** a\. Frequent exposure to acids b\. Tooth-to-tooth contact c\. A combination of occlusal forces at the cervical region **d. Frequent exposure to objects/factors other than teeth or acids** e\. Erosion of the buccal and labial surfaces Dental **abrasion** refers to the wear of tooth structure caused by mechanical actions from external objects or factors, such as: - Improper toothbrushing techniques (e.g., brushing too hard or using abrasive toothpaste) - Using toothpicks excessively - Chewing on pens or other hard objects **Why not the other options?** - **a. Frequent exposure to acids**: This describes **erosion**, not abrasion. - **b. Tooth-to-tooth contact**: This describes **attrition**, not abrasion. - **c. A combination of occlusal forces at the cervical region**: This refers to **abfraction**, not abrasion. - **e. Erosion of the buccal and labial surfaces**: This is also caused by **erosion**, not abrasion. **Dentine hypersensitivity symptoms:** **Question 4Select one:** a\. Can indicate that tooth wear is stable **b. May be a sign of active tooth wear if dentine is exposed** c\. May signify active tooth wear in enamel only d\. Are not relevant in the aeitiology of tooth wear **Explanation:** Dentine hypersensitivity occurs when the protective layers of the tooth (enamel or cementum) are lost, exposing the underlying dentine and its tubules. This exposure can result from **active tooth wear** due to erosion, abrasion, attrition, or abfraction. Sensitivity indicates that wear is ongoing and dentine has become vulnerable. **Why not the other options?** - **a. Can indicate that tooth wear is stable**: Hypersensitivity typically suggests **active** wear, not stability. - **c. May signify active tooth wear in enamel only**: Dentine hypersensitivity requires **dentine** exposure, not just enamel wear. - **d. Are not relevant in the aetiology of tooth wear**: Hypersensitivity is directly related to tooth wear and is highly relevant when dentine is exposed. **In preventing dental erosion, dietary advice should include:** **Question 5Select one:** a\. Recommending small frequent meals to limit exposure to acids **b. Limiting acid consumption to three or less times per day** c\. Recommending salt water mouth rinses to buffer acids d\. Encouraging healthy eating with a high consumption of fruits e\. Avoiding brushing teeth within 10 minutes of acid attacks **Explanation:** To prevent dental erosion, it is important to minimize the frequency of acid exposure to teeth. Limiting acidic food and drink consumption to three or fewer times a day reduces the risk of enamel and dentine breakdown caused by prolonged or repeated acid attacks. **Why not the other options?** - **a. Recommending small frequent meals to limit exposure to acids**: Frequent meals, especially if they are acidic, can increase acid exposure and exacerbate erosion. - **c. Recommending salt water mouth rinses to buffer acids**: While salt water rinses may be soothing, they do not neutralize acid effectively. Alkaline rinses (e.g., with bicarbonate) are better for neutralizing acids. - **d. Encouraging healthy eating with a high consumption of fruits**: While fruits are healthy, many are acidic (e.g., citrus fruits), which can contribute to erosion if consumed excessively. - **e. Avoiding brushing teeth within 10 minutes of acid attacks**: Brushing should be avoided for **at least 30--60 minutes** after an acid attack to prevent additional wear to softened enamel. 10 minutes is insufficient. **In the BEWE, a sextant score of 2 is given for:** **Question 6Select one:** a\. A sextant where there is more than 50% loss of tooth structure b\. A quadrant where there is less than 50% loss of tooth structure **c. A sextant where there is less than 50% loss of tooth structure** d\. A quadrant where there is more than 50% loss of tooth structure In the **BEWE (Basic Erosive Wear Examination)** scoring system, a **sextant score of 2** is assigned when there is **loss of less than 50% of the tooth structure** in a sextant. Specifically, it represents moderate erosive wear, with distinct defect areas that do not yet extend to involve more than 50% of the surface. **Why not the other options?** - **a. A sextant where there is more than 50% loss of tooth structure**: A BEWE score of **3** is used when the loss of tooth structure is more than 50%. - **b. A quadrant where there is less than 50% loss of tooth structure**: The BEWE is assessed by sextants (not quadrants). - **d. A quadrant where there is more than 50% loss of tooth structure**: Again, the BEWE is based on sextants, not quadrants. **In the BEWE, a sextant score of 3 is given for:** **Question 7Select one:** a\. A quadrant where there is less than 50% loss of tooth structure b\. A quadrant where there is more than 50% loss of tooth structure **c. A sextant where there is more than 50% loss of tooth structure** d\. A sextant where there is less than 50% loss of tooth structure In the **BEWE (Basic Erosive Wear Examination)** scoring system, a **sextant score of 3** is assigned when there is **loss of more than 50% of the tooth structure** in a sextant. This represents severe erosive wear, with extensive damage to the tooth surfaces. **Why not the other options?** - **a. A quadrant where there is less than 50% loss of tooth structure**: The BEWE evaluates **sextants**, not quadrants, and a score of 3 requires more than 50% loss. - **b. A quadrant where there is more than 50% loss of tooth structure**: Again, the BEWE evaluates **sextants**, not quadrants. - **d. A sextant where there is less than 50% loss of tooth structure**: A score of **2** is given for less than 50% loss **Select the incorrect statement:** **Question 8Select one:** a\. Tooth wear prevalence increases with age **b. Tooth wear is reversible** c\. Tooth wear is difficult to detect in the early stages d\. Tooth wear is multifactorial, often a combination of dental erosion, dental abrasion and dental attrition e\. Tooth wear can result from frequent exposure to acids external and internal Tooth wear is **not reversible** because the loss of enamel and dentine is permanent. Once tooth structure is lost due to erosion, abrasion, attrition, or other causes, it cannot regenerate. Management focuses on prevention, early detection, and restoration if necessary. **Why the other options are correct:** - **a. Tooth wear prevalence increases with age**: This is true because cumulative exposure to wear factors over time leads to increased prevalence in older populations. - **c. Tooth wear is difficult to detect in the early stages**: This is correct, as early signs of wear can be subtle and are often missed without careful examination. - **d. Tooth wear is multifactorial, often a combination of dental erosion, dental abrasion, and dental attrition**: This is true; tooth wear commonly involves a combination of these factors working together. - **e. Tooth wear can result from frequent exposure to acids external and internal**: Correct, as acids from diet (external) or gastric reflux (internal) are key contributors to erosion, a major component of tooth wear. **The BEWE acronym stands for;** **Question 9Select one:** a\. Basic Tooth Wear Examination **b. Basic Erosive Wear Examination** c\. Basic Erosive Wear Exposure d\. Basic Erosion Wear Exam The **BEWE** (Basic Erosive Wear Examination) is a tool used to assess and score the severity of erosive tooth wear across sextants in the mouth. It helps clinicians evaluate the extent of damage and monitor progression over time. **The critical pH of enamel is:** **Question 10Select one:** a\. 7 b\. 6.5 **c. 5.5** d\. 4.5 **The critical pH of enamel is approximately 5.5, which is the pH level at which demineralization of enamel begins. Below this pH, acids dissolve the hydroxyapatite crystals in enamel, leading to tooth structure loss. Saliva and fluoride can help buffer acids and remineralize enamel when the pH rises above 5.5.** **Why not the other options?** - **a. 7: This is neutral pH, which is not acidic enough to cause demineralization.** - **b. 6.5: While slightly acidic, this is still above the critical threshold.** - **d. 4.5: At this pH, enamel demineralization is severe, but the critical threshold is higher at 5.5.** **The critical pH of enamel:** **Question 11Select one:** a\. Reduces when fluoride is incorporated in the structure of enamel b\. Increases when the tooth surface is exposed to acids c\. Is not significant in the aeitiology of tooth wear d\. Is the point at which enamel remineralises When **fluoride** is incorporated into the structure of enamel, it forms **fluorapatite**, which is more resistant to acid attack than hydroxyapatite, the main mineral component of enamel. As a result, the **critical pH** at which enamel demineralizes is lowered (i.e., enamel is more resistant to demineralization at lower pH levels). **Why not the other options?** - **b. Increases when the tooth surface is exposed to acids**: Exposure to acids actually lowers the pH, making enamel more vulnerable to demineralization. - **c. Is not significant in the aetiology of tooth wear**: The critical pH is significant in the context of dental erosion (acid-induced wear), which is an important factor in tooth wear. - **d. Is the point at which enamel remineralises**: The critical pH is the point at which enamel begins to **demineralize**, not remineralize. Remineralization occurs when the pH rises above the critical level. **The main purpose of the BEWE tool is:** **Question 12Select one:** a\. To measure erosive tooth wear **b. To screen for signs of tooth wear** c\. To prevent tooth wear d\. To monitor the progression of tooth wear **The prevalence of tooth wear is significantly associated with agE. This means that:** **Question 13Select one:** **a. As people age, they are more likely to experience tooth wear** b\. The younger you are, the more tooth wear you experience c\. The older you are, the more tooth wear you experience d\. Over time, tooth wear increases The prevalence of tooth wear **increases with age**, as it is a cumulative process. Over time, teeth undergo repeated exposure to factors that cause wear (e.g., acid exposure, tooth-to-tooth contact), leading to an increased likelihood of experiencing tooth wear as people get older. **Why not the other options?** - **b. The younger you are, the more tooth wear you experience**: This is generally not true, as younger people typically have less cumulative exposure to wear factors. - **c. The older you are, the more tooth wear you experience**: This could be a misleading way of phrasing it, as it\'s about **prevalence**---not necessarily that everyone experiences more wear as they age, but the likelihood increases. - **d. Over time, tooth wear increases**: This is true in the sense of cumulative wear, but the correct interpretation of the question focuses on age being a significant factor. **Tooth wear where the dominant aietioloical factor is tooth-tooth contact is called:** **Question 14Select one:** a\. Dental abfraction **b. Dental attrition** c\. Dental erosion d\. Dental abrasion **Dental attrition** refers to tooth wear caused by **tooth-to-tooth contact**, such as grinding (bruxism) or clenching. It involves the mechanical wearing down of tooth surfaces due to the friction between opposing teeth. **Why not the other options?** - **a. Dental abfraction**: This is caused by occlusal forces that lead to tooth flexure, often seen at the cervical (neck) region of teeth, but it\'s not specifically about tooth-to-tooth contact. - **c. Dental erosion**: Erosion is caused by **chemical** factors, particularly acids, not mechanical contact. - **d. Dental abrasion**: Abrasion refers to wear caused by **external objects or factors**, such as improper brushing or chewing on hard objects, not tooth-to-tooth contact. **When assessing a patients' risk of tooth wear, it is essential to consider:** **Question 15Select one:** **a. The rate and severity of wear compared to the patients' age** b\. The significance of dentine exposed c\. The shape of the incisal edges d\. The rate of aging compared to the severity of tooth surface lost When assessing a patient\'s risk of tooth wear, it is essential to consider the **rate and severity of wear in relation to the patient\'s age**. Age plays a significant role because wear is cumulative over time, and comparing the rate and severity to what would be expected for a person of that age helps determine whether the wear is progressing unusually or rapidly, which can indicate a higher risk for further damage. **Why not the other options?** - **b. The significance of dentine exposed**: While exposed dentine is important to note, the key risk factor involves understanding how fast and severe the wear is relative to the patient\'s age. - **c. The shape of the incisal edges**: The shape of the incisal edges may give insight into wear, but it\'s not the primary factor in assessing risk. - **d. The rate of aging compared to the severity of tooth surface lost**: Aging and severity of wear are related but more directly through age-based wear expectations, rather than a comparison of rate of aging. **When dentine is exposed, the minimum BEWE score for the sextant would be:** **Question 16Select one:** a\. No score **b. 2** c\. 1 d\. 0 e\. 3 When **dentine is exposed**, this typically indicates **moderate to severe wear**, which is at least a **BEWE score of 2** for the affected sextant. The BEWE (Basic Erosive Wear Examination) scale ranges from 0 to 3, with higher scores indicating more severe wear. - A **score of 2** is given when there is **moderate wear**, and dentine exposure typically falls into this category. - A **score of 3** would be given for severe wear, where more than 50% of the tooth structure is lost, but dentine exposure itself generally signals at least moderate wear. **Why not the other options?** - **a. No score**: A sextant with exposed dentine should be scored. - **c. 1**: A score of 1 corresponds to mild wear, where dentine exposure is not present. - **d. 0**: A score of 0 means no wear, so it wouldn\'t apply to a sextant with exposed dentine. - **e. 3**: A score of 3 would indicate severe wear, not just dentine exposure. **Where there are no signs of tooth wear in a sextant, the BEWE score would be:** **Question 17Select one:** a\. 2 b\. 1 c\. 3 d\. No score **e. 0** **In the BEWE (Basic Erosive Wear Examination) system, a score of 0 is given when there are no signs of tooth wear in a sextant. This indicates that the teeth are free from erosive or other forms of wear.** **Why not the other options?** - **a. 2: A score of 2 is given for moderate wear, not for no signs of wear.** - **b. 1: A score of 1 is for mild wear, indicating some signs of wear.** - **c. 3: A score of 3 is for severe wear, which is not applicable here.** - **d. No score: A score is required in BEWE for each sextant, even if no wear is observed. It would be assigned a score of 0.** **Which salivary factor enhances the protection of the teeth against tooth wear:** **Question 18Select one:** a\. Frothy saliva quality where the bubbles neutralise oral acids b\. Reduced saliva quantity enabling acids to contact the teeth **c. Buffering action of stimulated saliva that neutralises oral acids** d\. Quality of unstimulated saliva bathing the teeth during acid exposure The **buffering action of stimulated saliva** is a key factor in protecting teeth from tooth wear, particularly from **erosion** caused by acids. Stimulated saliva (produced when eating, drinking, or chewing) has a higher flow rate and contains bicarbonate ions that help **neutralize acids** in the mouth, reducing the potential for enamel demineralization. **Why not the other options?** - **a. Frothy saliva quality where the bubbles neutralize oral acids**: While frothy saliva may occur during certain conditions, it\'s the **buffering capacity** (not the frothy nature) of the saliva that is more important in neutralizing acids. - **b. Reduced saliva quantity enabling acids to contact the teeth**: Reduced saliva quantity increases the risk of tooth wear, not enhances protection, because there is less buffering capacity and less protection against acids. - **d. Quality of unstimulated saliva bathing the teeth during acid exposure**: Unstimulated saliva does not provide the same buffering action or protective effects as stimulated saliva, as its flow rate is much lower and it has reduced capacity to neutralize acids. **Which salivary factors can pre-dispose a patient to tooth wear?** **Question 19Select one:** a\. A lack of saliva exposing teeth to acids **b. Reduced quantity and quality of saliva limiting protective potential** c\. Alkaline saliva reduces buffering capacity d\. Increased buffering capacity to neutralize acids A **reduced quantity and quality of saliva** can predispose a patient to tooth wear by limiting the mouth\'s ability to **neutralize acids** and protect the teeth. Saliva helps to buffer acids, provide essential minerals for remineralization, and wash away harmful substances. When saliva production is insufficient or of poor quality (such as in dry mouth or xerostomia), these protective functions are compromised, leading to an increased risk of tooth wear, especially erosion. **Why not the other options?** - **a. A lack of saliva exposing teeth to acids**: Lack of saliva can increase the risk of tooth wear, but it\'s specifically the reduced buffering and protective function that\'s problematic, not just exposure to acids. - **c. Alkaline saliva reduces buffering capacity**: This is incorrect because **alkaline saliva** actually helps neutralize acids, increasing the buffering capacity. It's acidic or neutral saliva that would be less protective. - **d. Increased buffering capacity to neutralize acids**: This would **protect** against tooth wear, not predispose to it. Increased buffering capacity is a beneficial factor, not a risk factor. **Which statement best describes dental erosion:** **Question 20Select one:** a\. Dental erosion is the irreversible loss of hard tissue due to alkaline foods and drinks b\. Dental erosion is caused by acids produced by bacterial plaque **c. Dental erosion is the irreversible loss of hard tissue due to chemical process of acid dissolution** d\. Dental erosion is the reversible loss of enamel due to acids e\. Dental erosion is due to eating a diet consisting of acids **Dental erosion** refers to the **irreversible loss of tooth enamel** (and sometimes dentine) caused by **acid dissolution**, rather than mechanical wear. The acids responsible can come from various sources, including acidic foods and drinks, gastric acid from reflux, or environmental factors. This process is **chemical**, not bacterial, and the damage is irreversible since enamel does not regenerate. **Why not the other options?** - **a. Dental erosion is the irreversible loss of hard tissue due to alkaline foods and drinks**: Alkaline foods and drinks do not cause erosion; it is acidic substances that lead to enamel loss. - **b. Dental erosion is caused by acids produced by bacterial plaque**: This describes **dental caries (cavities)**, not erosion. Erosion is caused by acids from non-bacterial sources. - **d. Dental erosion is the reversible loss of enamel due to acids**: Dental erosion is **irreversible**; once enamel is lost, it does not regrow. - **e. Dental erosion is due to eating a diet consisting of acids**: While acidic foods can contribute to erosion, it is not solely dependent on diet. Other factors, such as gastric acid and environmental acids, also play a role.