52 Root Caries, Erosion, NCCL + Diff. Diagnosis

which surface is most at risk for a new caries lesion on a 68 yr old

root surface

a caries lesion originating on the root surface which is exposed due to gingival recession

root caries

where would you find initial lesions on primary teeth

occlusal surface

the more recently exposed tooth surfaces are the ones most likely to have

caries

pH needed for lesion in enamel to develop

5.5

pH needed for lesion in dentin to develop

6.5

biofilm, carbohydrates, and sugars lead to

demineralization

healthy saliva, good oral hygiene, healthy diet, + fluoride intake aid in

remineralization

- encompasses endogenous + exogenous acidic + proteolytic chemical degradation of enamel + dentin
- as well as the piezoelectric electrochemical action on the collagen in dentin

biocorrosion

electricity resulting from pressure

piezoelectric

chemical, biochemical, +/or electrochemical action, which causes the molecular degradation of the essential properties in a living tissue

biocorrosion

tooth moves due to forces of chewing, piezoelectricity resulting from that pressure cause degradation

biocorrosion

gingivitis, periodontitis, + bone less can lead to an

increase in root caries

cementum on root surfaces is very

thin

dentists should provide even more proper oral hygiene instruction for patients who have gingival recession and the development of caries on the root since the nerve is closer to the _________ towards the apex of the tooth

outside surface

what are the best toothbrushes to use

soft, narrow bristles and electric

differential diagnosis of other conditions that cause loss of tooth structure on cervical region (3aE)

attrition, abrasion, abfraction, erosion

the loss of tooth structure caused by wear in functional + parafunctional modes

attrition

attrition is typically seen in patients who

clenching/grinding (teeth are worn down)

identify the type of differential diagnosis

attrition

the loss of tooth substance through mechanical means (ie tooth brushing, type of toothpaste); characterized by rounded lesions

abrasion

identify the type of differential diagnosis

abrasion

is abrasion caused by the toothpaste or the toothbrush

both (but more the toothbrush)

identify the type of differential diagnosis

abrasion

which teeth in the dentition would have the most pronounced abrasion

canines

a right handed patient will have more lesion on which side of their mouth

right side

the loss of tooth structure by chemical or idiopathic processes where patients remove a lot of their enamel; characterized by cupping lesions

erosion

identify the type of differential diagnosis

erosion

6 dental erosion causes (DI REEF)

dietary, idiopathic, regurgitation, environmental, exposed dentin, flow of saliva

food-based dental erosion can be caused by all _______ beverages + ________-based drinks

carbonated; citrus

erode teeth with a pH as low as 3.0-3.8

wine

the acid produced in the stomach during the digestive process that can dissolve bone + teeth

regurgitation

sources of erosion from regurgitation

eating disorders, GERD (gastrointestinal disorder), chronic alcoholism

a patient population where regurgitation leads to erosion

bulimics

this is a clinical presentation of

regurgitation/erosion

regurgitation/erosion can be first be noticed on which tooth surface

lingual

possible sources of erosive acids are from exposure to chlorinated swimming pool water

environmental

seen in batter plant workers, picklers, + miners who are around the acidic fumes

erosion

in some individuals, saliva itself may be the cause of

erosion

in some individuals, salivary pH is _____ b/c of medications like vit. C, aspirin, + iron preps that alter the saliva

lower

lower salivary pH leads to more instances of

erosion

patients with dentin that is dissolving typically show _____ erosion on the ____ surfaces of the teeth

cupping; occlusal

erosion that we cannot find a definable cause

idiopathic

4 signs + symptoms of erosion (GDCT)

glossy/silky appearance, surface gloss dulling, "cupping", enamel texture loss

"cupping" erosion is seen most often on which teeth

mandibular (especially molars + premolars)

- angular (like a cutout)
- non-carious cervical lesion (NCCL)(no decay)
- subgingival (b/c of pivot point at neck of tooth = root)
- tooth flexion, multifactorial, maybe caused by tooth brush

abfraction

erosion is more _____, whereas abfraction is more _____

rounded; angular

abfraction is caused by which forces

clenching/grinding

best preventative measure and non operative procedure for a patient with abfraction

night guard

identify the lesion

initial

caries lesions are associated with

biofilm

caries lesions may become more ______ when dried

opaque

will follow the enamel development pattern + occur across multiple teeth

fluorosis

will usually occur in homologous teeth (teeth that developed at the same time)

hypoplasia

lesion not associated with a restoration

primary caries

caries left over by the dentist during restorative treatment

residual caries

lesions associated with a restoration

secondary caries/recurrent caries

secondary caries, fracture, marginal deficiencies, wear, + postoperative sensitivity

main reasons for direct + indirect restorations

can develop on exposed root surfaces and have the same etiological factors as primary coronal caries

root caries

longer retention of teeth + increase life expectancy often with comorbidities has led to an

increase in root caries diagnosis

the 2 classification for root caries

initial/non-cavitated lesions + extensive lesions

root caries can be

arrested

abrasion, abfraction, erosion, or non-caries cervical lesions (NCCL) need to be _________ from root caries

differentiated

refer to lesions around restorations

CARS/secondary caries/recurrrent caries

need to be differentiated from caries

non-caries opacities

opacity, hypoplasia, and fluorosis are examples of

enamel defects