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Practice-Based risk assessment − a practical guide for oral healthcare teams: tooth wear

From Volume 46, Issue 2, February 2019 | Pages 171-178

Authors

Saoirse O'Toole

BA, BDentSc, MFD, RCSI, PhD, FHEA, FFD (Pros)

General Dental Practitioner, Smiles Dental Surgery, 4 South Anne Street, Dublin 2

Articles by Saoirse O'Toole

Email Saoirse O'Toole

Petros Mylonas

BDS, MMedEd, PhD (Lond), MJDF RCS (Eng) MFDS RCPS (Glasg), FHEA (UK)

Department of Prosthodontics, King's College London Dental Institute, Guy's Tower, Guy's Hospital, London SE1 9RT, UK.xs

Articles by Petros Mylonas

David Bartlett

BDS, MRD FDS, PHD, FDS

Senior Lecturer/Honorary Consultant in Restorative Dentistry, Guy's, King's and St Thomas' Dental Institute, London.

Articles by David Bartlett

Abstract

Abstract: This paper discusses the presence of, and interplay between, erosion, abrasion and attrition as risk factors of tooth wear progression. The Basic Erosive Wear Examination is recommended as a simple practice-based screening tool to integrate into a risk assessment. Finally, the risk indicators are summarized and categorized using a high, medium or low risk classification system to facilitate practical risk assessment.

CPD/Clinical Relevance: This paper provides a practical guide for oral health providers to screen and risk assess tooth wear.

Article

Tooth wear is a multi-factorial, complex process involving erosion, attrition and abrasion.1 Erosive tooth wear is a term commonly used by European colleagues to represent that severe tooth wear rarely occurs without an underlying erosive aetiological component. Dental erosion is described as the loss of tooth tissue due to the effects of acid only, whilst attrition and abrasion describe the involvement of tooth-to-tooth and tooth-to-foreign object contact, respectively. Current evidence indicates erosive tooth wear is common and the prevalence is increasing, particularly in younger age groups.2, 3

Patients with erosive tooth wear can be difficult to risk assess as they are often unaware of their condition and may not see their dentist until their tooth wear is significantly advanced. Being able to risk assess patients when they do present is necessary to minimize the progression of erosive tooth wear.

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