Tooth Surface Loss - Aetiology and Diagnosis

what is the aetiology of erosion

exposure to acids from the diet or GIT

what is the chemistry of erosion

is corrosion - gradual destruction of material by chemical reaction in its environment

H+ diffuses through plaque and pellicle and penetrates the protein lipid coating of individual hydroxyapatite crystals

once in dentine, process is faster as crystals are smaller and higher surface area

what is H+ mode of attack

dissolves by combining with carbonare/phosphate ions - like etching

complexes with ca to remove from lattice - called surface softening

sutrface softening makes attrition and abrasion easier

subsoftening is more reversible

what are the intrinsic aetiological factors

vomiting - forceful expulsion of the stomach contents through the mouth

regurgitation and reflux

rumination

what organic and psychosomatic disorders are associated with vomiting

disorders of GIT

CNS disorders with raised intracranial pressure

neurological

metabolic and endocrine eg diabetes

psychosomatic eg bulimia

what is russel sign

It is a sign in Bulimia nervosa where there are lesions/calluses on the knuckles from chronic induction of vomiting (knuckles scrape the teeth).

what is the scoff questionaire

- do u make urself feel sick because u are uncomfortably full

do u worry if u have lost control over how much u eat

have u lost more than 1 stone in a month

do u think ur fat when ur not

does food dominate ur life

score more than 2 indicates anorexia or bulimia

what is cage questionnaire

cut down, annoyed, guilty, eye opener

for alcohol

what happens if GORD is untreated

oesophagitis

barretts epithelium

oesophageal carcinoma

aspirational pneumonitis

what is spechler

7 day diary noting;

times of heartburn

severity of oesophageal discomfort

difficulty swallowing

coughing/wheezing