Tooth Wear Part 1 GN PDF

Tooth Wear 1 Miss Felix Oral and Dental Sciences Tooth Wear Lectures and Assessments Lectures:  Tooth Wear 1: Pre-recorded + workbook  Tooth Wear 2: Pre-recorded + quiz  Tooth Wear 3: Live + case studies to apply theory Assessments:  Formative: workbook, quiz and case studies  Summ...

Tooth Wear 1 Miss Felix Oral and Dental Sciences Tooth Wear Lectures and Assessments Lectures:  Tooth Wear 1: Pre-recorded + workbook  Tooth Wear 2: Pre-recorded + quiz  Tooth Wear 3: Live + case studies to apply theory Assessments:  Formative: workbook, quiz and case studies  Summative: E-assessment and or cases Intended learning outcomes By the end of the session, students should be able to: De4ne tooth wear Describe the key ae>ological factors of tooth wear Outline the signi4cance 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 DeFni>on of Tooth Wear (TW) Tooth wear has been de4ned by the European FederaGon of ConservaGve DenGstry as: Tooth wear is the cumula>ve loss of mineralised tooth Gssue (enamel, denGne and cementum) due to physical or chemical-physical processes (Schlueter et al 2020). Therefore, tooth wear is NOT The result of bio4lm-induced diseases such as caries A consequence where tooth Gssue is lost due to trauma or resorpGon Alterna>ve terms Other terms for Tooth Wear that you may come across in the literature, see clinically or have heard of before include: Erosive tooth wear (chemical-physical) A combinaGon of erosion (chemical) aOri>on (physical), abrasion (physical) Accelerated tooth wear – where the rate of wear is signi4cant for a paGents age Severe tooth wear – tooth wear that has signi4cant impacts on a paGents life ie. self-esteem, limited chewing, sensiGvity Tooth surface loss - discourage clinically as other reasons for loss of tooth structure  Clinical appearance of Severe Tooth Wear Shiny appearance Loss of enamel Sharp enamel rims Evident loss of occlusal height Significant loss of tooth structure Darker and yellow due to exposure dentine and lack of enamel Pulp visible Epidemiology: Prevalence In the UK, 30.4% in 77% of adults 20-45% permanent globally in have some teeth of wear and 2% permanent children and teeth have severe adolescents tooth wear (Schlueter and Luka 2018) (BartleO et al 2013) (ADHS 2009) These are es>mates as it is diScult to determine prevalence (proporGon of populaGon with condiGon at point in Gme) due to inconsistency in recording – diTerent tools used, not systemaGcally monitored, varying de4niGons. Ae>ology of Tooth Wear Attrition Abrasio Erosion n Tooth Wear Erosion Dental Erosion Dental erosion, also known as Erosive Tooth Wear (ETW), is de4ned by the European FederaGon of ConservaGve DenGstry as: The chemical loss of mineralised tooth Gssue caused by exposure to acids not derived from oral bacteria (Schlueter et al 2020). Sources of acids that can contribute to dental erosion: Intrinsic Extrinsi Acids c Acids Acids Ph ng disorders SystemaGc review demonstrates associaGon (not causaGon) between eaGng disorders (Hermont et al 2014) Frequent vomi>ng Pregnancy – severe morning sickness The key thing is exposure to acids over extended period of >me. So, does this mean we should stop consuming everything acidic? Saliva and its impact Of saliva Reduced quality or quanGty can increase the erosive poten>al of intrinsic and extrinsic acids. WHY? Regect on the funcGons of saliva. Decreases risk of erosion What other factors can you think of that aTect the Increases quality and quanGty of risk of saliva? Saliva erosion quality and quan>ty AOri>on Dental AOri>on Dental a[riGon is de4ned by the European FederaGon of ConservaGve DenGstry as: The physical loss of mineralized tooth Gssue caused by tooth-to- tooth contact (Schlueter et al 2020). What causes dental aOri>on? Anything when the teeth are meeting each other and frequently wearing down causing flattening of the teeth Bruxism Malocclusion  Flattening of teeth Loss of occlusal height Clinical view of dental aOri>on Flat cusps Flat edges Canines have no point Patients may have blend of erosion and attrition Abrasion Dental Abrasion Dental abrasion is de4ned by the European FederaGon of ConservaGve DenGstry as: The physical loss of mineralized tooth Gssue caused by physical factors other than teeth (Schlueter et al 2020). Oien co-exists with erosion  Sources of Abrasion Occupa>onal/environmental Oral hygiene rou>ne Often work in abrasive environment Miners over-zealous tooth brushing or ID cleaning ConstrucGon workers Abrasive toothpastes Hold pins in teeth and cut thread with teeth Dress makers The key is Retainers Poorly fitted Some instruments require use of mouth and may develop Musicians some habits frequency of exposure Lifestyle/habits Diet Nail biGng Hard diet (ie chewing bones) Can be linked to cultural differences Pen chewing Piercings All cause abrasion on teeth Clinical examples of dental abrasion Severe tooth wear of upper anterior teeth Loss of occlusal height Sharp enamel rims Broken down Invisalign edged Yellowing from dentine — erosion Lower acrylic denture wearing down upper anterior teeth Mul>factorial ae>ology Erosion Tooth wear will occur as a result of living and using our teeth, it is normal and usually slow. Attrition Tooth It becomes signi4cant when it is Wear accelerated for a paGents age OR impacts on funcGoning Abrasion Abfrac>on Abfrac>on Oien described as tooth wear, however not generally accepted aeGology for tooth wear Loss of tooth structure in the cervical region caused by a complexity of gexure forces occlusally and cervically during funcGoning Upper 4rst premolar showing wedge shaped cervical loss DisGnct wedge shape clinically evident of Gssue as a result of forces indicated in the cervical region by arrows. For now record separately to tooth wear. Epidemiology Affects all High impact ages and on patient dentitions Modern Difficult to lifestyles and detect early diets (acids!) signs Why is Living longer - keeping teeth Tooth Not systematically longer Wear an recorded issue? Summary DeFni>ons Tooth wear and alternative terms Prevalence Mul>factorial ae>ology Dental erosion Dental attrition Dental abrasion SigniFcance Impact of tooth wear References Aránguiz V, Lara JS, Marró ML, et al. RecommendaGons and guidelines for denGsts using the basic erosive wear examinaGon index (BEWE). BriGsh Dental Journal. 2020 Feb;228(3):153-157. DOI: 10.1038/s41415-020-1246-y. D Bartle[, C Ganns and A Lussi (2008). Basic Erosive Wear Examina0on (BEWE): a new scoring system for scien09c and clinical needs. Clinical Oral InvesGgaGons. 12, Sp65-8 Bartle[ D W, Lussi A, West N X, Bouchard P, Sanz M, Bourgeois D. Prevalence of tooth wear on buccal and lingual surfaces and possible risk factors in young European adults. J Dent 2013; 41: 1007–1013. Bartle[ D, O'Toole S. Tooth wear and aging. Aust Dent J. 2019 Jun;64 Suppl 1:S59-S62. doi: 10.1111/adj.12681. PMID: 31144323. Clapp, O., Morgan, M. & Fairchild, R. The top 4ve selling UK energy drinks: implicaGons for dental and general health. Br Dent J 226, 493–497 (2019). h[ps://doi.org/10.1038/s41415-019-0114-0 Hermont AP, Oliveira PAD, MarGns CC, Paiva SM, Pordeus IA, et al. (2014) Tooth Erosion and EaGng Disorders: A SystemaGc Review and Meta- Analysis. PLOS ONE 9(11): e111123. h[ps://doi.org/10.1371/journal.pone.0111123 O'Toole S, Bernabé E, Moazzez R, Bartle[ D. Timing of dietary acid intake and erosive tooth wear: A case-control study. J Dent. 2017 Jan;56:99- 104. doi: 10.1016/j.jdent.2016.11.005. Epub 2016 Nov 14. PMID: 27856311. Pace F, Pallo[a S, Tonini M, Vakil N, Bianchi Porro G. Systema0c review; gastroesophageal reCux disease and dental lesions. Aliment Pharmacol Ther 2008; 27:1179–1186. Nijakowski K, Walerczyk-Sas A, Surdacka A. Regular Physical AcGvity as a PotenGal Risk Factor for Erosive Lesions in Adolescents. Interna0onal Journal of Environmental Research and Public Health. 2020; 17(9):3002. h[ps://doi.org/10.3390/ijerph17093002 Salas MM, Nascimento GG, Vargas-Ferreira F, Tarquinio SB, Huysmans MC, Demarco FF. Diet inguenced tooth erosion prevalence in children and adolescents: Results of a meta-analysis and meta-regression. J Dent. 2015 Aug;43(8):865-75. doi: 10.1016/j.jdent.2015.05.012. Epub 2015 Jun 7. PMID: 26057086. Schlueter N, Amaechi BT, Bartle[ D, Buzalaf MAR, Carvalho TS, Ganss C, Hara AT, Huysmans MDNJM, Lussi A, Moazzez R, Vieira AR, West NX, Wiegand A, Young A, Lippert F. Terminology of Erosive Tooth Wear: Consensus Report of a Workshop Organized by the ORCA and the Cariology Research Group of the IADR. Caries Res. 2020;54(1):2-6. doi: 10.1159/000503308. Epub 2019 Oct 14. PMID: 31610535. Schlueter, N., Luka, B. Erosive tooth wear – a review on global prevalence and on its prevalence in risk groups. Br Dent J 224, 364–370 (2018). h[ps://doi.org/10.1038/sj.bdj.2018.167