Tooth Wear: An Authoritative Reference for Dental Professionals and Students (BDJ Clinician’s Guides)

Foreword
Tooth Wear: Editors’ Introduction
	Introduction
	Defining Tooth Wear
	Setting the Scene
	Challenges
	Conclusion
	References
Acknowledgements
Contents
Part I: Introduction to Tooth Wear
	1: An Overview of Tooth Wear
		1.1	 Introduction
		1.2	 Types of Tooth Wear and Clinical Presentation
			1.2.1	 Attrition
			1.2.2	 Erosion
			1.2.3	 Abrasion
			1.2.4	 Abfraction
		1.3	 Tooth Wear Indices
		1.4	 Quality of Life
		1.5	 Management of Patients with Tooth Wear
		1.6	 Preventive Management of Tooth Wear
		1.7	 Monitoring Tooth Wear
		1.8	 Restorative Management of Tooth Wear
		1.9	 How Do We Rationalise Decisions?
		1.10	 Conclusion
		References
	2: Tooth Wear and Population Oral Health
		2.1	 Introduction to a Public Health Perspective
		2.2	 Epidemiology of Tooth Wear
		2.3	 Risk Factors
		2.4	 Population Advice on Tooth Wear
		2.5	 Prevention in Individuals with Tooth Wear
		2.6	 Future Research and Action
		2.7	 Conclusion
		References
	3: Risk Factors in Tooth Wear
		3.1	 Introduction
		3.2	 Increasing Importance of Tooth Wear
		3.3	 Tooth Wear Markers
		3.4	 Progression of Wear
		3.5	 Conclusion
		References
	4: Saliva and Tooth Wear
		4.1	 Introduction
		4.2	 Saliva Secretion
		4.3	 Composition and Physical Properties of Saliva
		4.4	 The Role of Saliva in Oral Health
		4.5	 Saliva and Erosive Tooth Wear
		4.6	 Saliva Tests (Sialometry)
		4.7	 Xerostomia
		4.8	 Conclusion
		References
	5: Feeding and Eating Disorders: Behaviours That Adversely Impact Oral Health
		5.1	 Introduction
		5.2	 Classification, Diagnostic Criteria and Epidemiology
		5.3	 Pica and Rumination Disorders
			5.3.1	 Oral Manifestations of Pica
			5.3.2	 Rumination Disorder
		5.4	 Anorexia Nervosa
		5.5	 Bulimia Nervosa
		5.6	 Binge Eating Disorder
		5.7	 Mental health, Behavioural and Medical Complications Related to Eating Disorders (ED)
		5.8	 Quality of Life in the Eating Disorders
		5.9	 Oro-Dental Features
			5.9.1	 Dental Erosion
			5.9.2	 Caries and Oral Microbiology
			5.9.3	 Saliva and Salivary Glands
			5.9.4	 Periodontal Disease
			5.9.5	 Soft Tissue Lesions
			5.9.6	 Temporomandibular Disorders (TMD)
		5.10	 Managing Patients with an Eating Disorder
		5.11	 Conclusion
		References
	6: Physiology of Erosive Tooth Wear and Relationship with Dentine Hypersensitivity
		6.1	 Introduction
		6.2	 A Recap on Enamel Physiology with Respect to Tooth Wear
		6.3	 A Recap on Dentine Physiology with Respect to Wear
		6.4	 Defence Systems Against Dentine Hypersensitivity and How Erosive Tooth Wear Overcomes Them
			6.4.1	 First Layer of Defence Against Dentine Hypersensitivity: Enamel
			6.4.2	 Second Line of Defence Against Dentine Hypersensitivity: The Smear Layer
			6.4.3	 Third Line of Defence Against Dentine Hypersensitivity: Secondary/Tertiary Dentine
		6.5	 Prevention
			6.5.1	 Limiting Acid Exposure
			6.5.2	 Limiting Aggressive Mechanical Exposure
			6.5.3	 The Role of Fluoride
			6.5.4	 The Role of Tubule Occluding Agents
			6.5.5	 The Role of Dentine Bonding Agents
		6.6	 Conclusion
		References
	7: Associations Between Tooth Wear and Dental Sleep Disorders: An Overview
		7.1	 Tooth Wear
		7.2	 Dental Sleep Disorders
		7.3	 Associations Between Tooth Wear and Dental Sleep Disorders
			7.3.1	 Orofacial Pain and Tooth Wear
			7.3.2	 Oral Dryness and Tooth Wear
			7.3.3	 Gastro-Oesophageal Reflux Disease (GORD) and Tooth Wear
			7.3.4	 Obstructive Sleep Apnoea Syndrome (OSAS) and Tooth Wear
			7.3.5	 Sleep Bruxism (SB) and Tooth Wear
		7.4	 Conclusion
		References
	8: Dento-Legal Considerations in the Management of Patients with Tooth Wear
		8.1	 Introduction
		8.2	 Examination and History
		8.3	 Medical History
		8.4	 Severity
		8.5	 Diagnosis
		8.6	 Special Tests
		8.7	 Management of Risk factors
		8.8	 Consent—to Intervene or Not to Intervene—That Is the Question
			8.8.1	 Should Patients Agree to Monitoring Their Tooth Wear or Should Some Restorative Intervention Take Place?
		8.9	 Risk and Benefits
		8.10	 If a Patient Declines Treatment That Is Offered
		8.11	 Second Opinion
		8.12	 Record Keeping
		8.13	 Conclusion
		References
Part II: Management of Tooth Wear
	9: A Pragmatic Philosophy of Tooth Wear Management
		9.1	 Introduction
		9.2	 The Diagnosis of Tooth Wear
		9.3	 Counselling and Monitoring
		9.4	 Restorative Intervention
		9.5	 The Outcomes of Restorative Intervention
		9.6	 Conclusion
		References
	10: Treatment Planning for Patients with Tooth Wear
		10.1	 Introduction
		10.2	 Patient History: A Guide to Diagnosis and a Tool for Assessing Risk
		10.3	 Examination and Records
			10.3.1	 Extra-Oral Examination
			10.3.2	 Intra-Oral Examination
		10.4	 Thinking Time and Space: The Planning Process
		10.5	 Restorative Treatment Concepts
		10.6	 Restorative Treatment Options
		10.7	 Conclusion: Maintenance and Review
		References
	11: Occlusion and Splint Therapy
		11.1	 Introduction
		11.2	 The Occlusion
		11.3	 How May Occlusal Stability Be Maintained or Lost?
		11.4	 The Rationale and Indications for Occlusal Splints
		11.5	 Uses of Splints
			11.5.1	 Prevention of Tooth Wear
			11.5.2	 Management of Mandibular Dysfunction
			11.5.3	 Pre-Restorative Stabilisation
			11.5.4	 Creating Space to Restore Worn Anterior Teeth
			11.5.5	 Protection of New Restorations from Parafunction
		11.6	 Types of Occlusal Splint—Advantages and Disadvantages
			11.6.1	 Choice of Materials
			11.6.2	 Partial Coverage Splints
			11.6.3	 Maxillary or Mandibular Splints?
			11.6.4	 Stabilisation Versus Repositioning Splints
		11.7	 Fabrication, Fitting, Adjusting and Monitoring a Michigan Splint
			11.7.1	 Fabrication
			11.7.2	 Fitting and Adjustment
			11.7.3	 Monitoring Splint Therapy
		11.8	 Conclusions
		References
	12: Tooth Wear in the Child and Adolescent
		12.1	 Introduction
		12.2	 Epidemiology
		12.3	 Aetiology
		12.4	 Establishing the Diagnosis
			12.4.1	 History
			12.4.2	 Examination
		12.5	 Prevention of Further Erosion
		12.6	 When to Restore
		12.7	 The Primary Dentition
		12.8	 The Permanent Dentition
		12.9	 Anterior Restorations
		12.10	 Posterior Restorations
		12.11	 Summary
		References
	13: Surgical Crown Lengthening in the Management of Tooth Wear
		13.1	 Introduction
			13.1.1	 Site factors Limiting Surgical Crown Lengthening
			13.1.2	 Patient Factors Limiting Surgical Crown Lengthening
		13.2	 Anatomical Considerations in Planning Surgical Crown Lengthening
			13.2.1	 Smile Line (Upper Lip Line)
			13.2.2	 Tooth Proportions
			13.2.3	 Gingival Outline
			13.2.4	 Gingival Biotype
			13.2.5	 Keratinised Gingivae
		13.3	 Supra-Crestal Tissue Attachment (Biologic Width)
		13.4	 Bone Sounding
		13.5	 Surgical Considerations
			13.5.1	 Soft Tissue Management
			13.5.2	 Ostectomy vs Osteoplasty
		13.6	 Restorative Considerations for Patients with Tooth Wear
		13.7	 Post-operative Considerations
		13.8	 Conclusion
		References
	14: Orthodontic Therapy in the Management of Tooth Wear
		14.1	 Introduction
		14.2	 Dahl Appliance
		14.3	 Orthodontic Treatment Considerations
		14.4	 Examination of the Patient
		14.5	 Appliances
		14.6	 The Role of Mini-Implants as Temporary Anchorage Devices
		14.7	 Conclusion
		References
	15: Adhesive Restorations
		15.1	 Introduction
		15.2	 Case Selection
		15.3	 Treatment Planning
			15.3.1	 Direct vs Indirect Restoration
			15.3.2	 Timing
			15.3.3	 Site
			15.3.4	 Cervical Wear
			15.3.5	 Occlusal Wear
				15.3.5.1	 General vs Localised
				15.3.5.2	 Anterior Wear
				15.3.5.3	 Posterior Wear
		15.4	 Choice of Materials
			15.4.1	 Cements
			15.4.2	 Restorative Materials
				15.4.2.1	 Direct Composite Resin
				15.4.2.2	 Indirect Composite Resin Occlusal Onlays and Palatal Veneers
				15.4.2.3	 Adhesive Metal Onlays and Palatal Veneers
				15.4.2.4	 Ceramic Onlays and Palatal Veneers
		15.5	 Clinical Guides
			15.5.1	 Restoration of Anterior Tooth Wear with Direct Composite Resin Build-Up at an Increased OVD (Composite ‘Dahl’)
			15.5.2	 Restoration of Anterior Tooth Wear with Adhesively-Retained Gold Alloy Palatal Veneers—With or Without Extending Incisal Length
		15.6	 Conclusion
		References
	16: Fixed Prosthodontics
		16.1	 Introduction
		16.2	 Effects of Tooth Wear
		16.3	 Approaches to Managing Tooth Wear
		16.4	 Managing Localised Anterior Tooth Wear Conforming to the Existing Occlusal Vertical Dimension
		16.5	 Introducing the Dahl Concept
		16.6	 Managing Localised Anterior Tooth Wear Using the Dahl Concept to Create Space
		16.7	 Managing Generalised Full Mouth Tooth Wear at an Increased Occlusal Vertical Dimension
		16.8	 Materials and Designs for Fixed Prosthodontics in the Management of Tooth Wear
		16.9	 Conclusion
		References
	17: Removable Prosthodontics
		17.1	 Introduction
			17.1.1	 Indications for Removable Management of Tooth Wear
			17.1.2	 Contra-Indications for Removable Management of Tooth Wear
		17.2	 Compensated or Non-compensated Tooth Wear
		17.3	 Assessing the Occlusal Vertical Dimension
		17.4	 Removable Management
		17.5	 Treatment Options
			17.5.1	 Extracting the Remaining Teeth and Providing Complete Dentures
			17.5.2	 Complete or Partial Overdentures
			17.5.3	 Complete or Partial Onlay or Overlay Dentures
			17.5.4	 Partial Dentures in Combination with Adhesive or Conventional Fixed Prosthodontics
		17.6	 Diagnostic or Provisional Appliances
		17.7	 Definitive Dentures
		17.8	 Laboratory Considerations
		17.9	 Denture Base
		17.10	 Prosthetic Teeth
		17.11	 Conclusion, Prevention and Maintenance
		References
	18: Dental Implants in the Management of Tooth Wear
		18.1	 Introduction
			18.1.1	 Macro-Mechanical Features
			18.1.2	 Micro-Mechanical Features
			18.1.3	 The Implant-Abutment Connection
			18.1.4	 Patient Selection
			18.1.5	 Patient Age
			18.1.6	 Smoking
			18.1.7	 History of Periodontal Disease
		18.2	 Bruxism and the Effects of Parafunction on Implant-Supported Restorations
		18.3	 Prosthodontic Design and the Choice of Restorative Materials
		18.4	 Restoratively Guided Treatment Protocol
			18.4.1	 Timing of Implant Placement
		18.5	 Replacing Missing Teeth in Patients with Tooth Wear
			18.5.1	 Partially Dentate Patients
				18.5.1.1	 Single Implant-Supported Tooth
				18.5.1.2	 Fixed Implant-Supported Bridge
				18.5.1.3	 Removable Implant-Supported Prosthesis
			18.5.2	 Fully Edentulous Patients
				18.5.2.1	 Removable Implant-Supported Overdenture
				18.5.2.2	 Fixed Implant-Supported Prosthesis
		18.6	 The Role of Implants to Facilitate Orthodontics in Partially Dentate Patients
		18.7	 Long Term Maintenance and the Use of Occlusal Splints
			18.7.1	 Biological Failures
			18.7.2	 Mechanical Failures
		18.8	 Conclusion
		References
	19: Prevention, Maintenance and Dealing with Failures
		19.1	 Introduction
		19.2	 Prevention
		19.3	 The Importance of Prevention
		19.4	 Restorative Intervention
		19.5	 Longevity
		19.6	 Dealing with Failures
		19.7	 Control of the Aetiological Factors
		19.8	 The Recall Appointment
		19.9	 Conclusion
		References
Tooth Wear: Future Considerations
	Raising Professional and Public Awareness
	Changing Approaches to Care
	Conclusion
References
Index