Detailed Insights on Non-Carious Tooth Surface Loss

Introduction to Non-Carious Tooth Surface Loss

  • Speaker: Musab B. Haga
  • Focus: Mechanics and types of non-carious tooth surface loss (TSL)
  • Objectives:
    • Define TSL
    • Identify etiology and classify TSL
    • Provide management strategies for TSL

Types of Non-Carious Tooth Surface Loss

  1. Attrition:

    • Caused by wear from mastication or occlusal contact.
    • Affects primarily the occlusal and incisal surfaces.
    • Signs: Flattened cusp tips, localized facets, dentin exposure.

  2. Abrasion:

    • Loss of tooth structure due to non-dental object contact (e.g. vigorous tooth brushing, pipe smoking).
    • Characterized by V-shaped cervical lesions that are angular and smooth.

  3. Erosion:

    • Progressive loss of dental tissue due to chemical processes not involving bacteria.
    • Influenced by dietary acids, regurgitation, and environmental factors.
    • Specific signs: Smooth and polished teeth, rounded surfaces.

  4. Abfraction:

    • Mechanical wear and stress resulting in loss of tooth structure at the cervical area.
    • Associated with occlusal stresses leading to chipping and angular losses.

Etiology of TSL

  • Pathological vs. Physiological Loss:

    • Physiological: Normal process over life; can become pathological if causing concern for the patient or impairing tooth survival.
    • Affects individuals differently based on age, lifestyle, and environmental factors.

  • Influence of diet:

    • Dietary erosion can result from citric acid in soft drinks and fruit juices.
    • Low-calorie drinks also can be acidic, contributing to erosion.

  • Regurgitation Erosion:

    • Gastric acids from regurgitation (involuntary, e.g., hiatus hernia; voluntary, e.g., eating disorders).
    • Common sign includes perimolysis, which affects palatal surfaces of maxillary teeth.

  • Salivary Role:

    • Saliva dilutes and buffers acids, lubricating teeth during mastication.
    • Reduced salivary flow increases risk of erosive damage.

  • Environmental Erosion:

    • Occurs in occupational settings with acid exposure affecting labial surfaces of incisors.

Clinical Features of Erosion

  • Smooth, polished tooth surfaces indicating loss of characteristic features due to chemical erosion.

Management Strategies

  • Recognizing TSL symptoms is crucial for patient management.
  • Treatments may vary depending on the type of loss (e.g., occlusal adjustment, restorative treatments).
  • Preventive Measures:
    • Encouraging proper oral hygiene to avoid dental abrasion.
    • Dietary counseling to minimize erosive potential from substances.
    • Assessing and managing salivary flow issues.