Tooth Erosion: Risk Factors and Therapeutics

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1. Which of the following techniques is not considered appropriate management for patients with erosion?

  a. Advise patients not to brush their teeth immediately after drinking an acid drink, after self-induced vomiting or after a reflux episode

  b. Encourage the use of sugar-free chewing gum

  c. Advise rinsing with antacid

  d. Advise brushing with 0.4% Stannous Fluoride in methylcellulose and glycerin base

  e. Advise rinsing with milk

2. Which of the following statements is true?

  a. Erosion results from demineralization by Strep viridans

  b. Erosion is a microbiologically sterile process

  c. Erosion causes bruxism, abrasion and attrition

  d. Erosion is a disease of enamel dissolution that cannot occur in the absence of fermentable carbohydrates

  e. None of the above statements are true

3. Which of the following is true in regard to the below equation? Ca10(PO4)6OH<_ _ _>10Ca2++6PO43-+2OH

  a. At low pH a higher concentration of ions is needed in the liquid phase surrounding the crystallites to maintain saturation and so the driving force is towards dissolution.

  b. At low pH a lower concentration of ions is needed in the liquid phase to maintain saturation which leads to precipitation.

  c. At high pH this equation is in balance, with dissolution (to the right side of equation) occurring at the same rate as precipitation (to the left side of equation).

4. Which of the following is not a true statement regarding the use of dentin bonding agents to treat erosion lesions?

  a. Dentin boding agents can be used to cover sensitive, exposed dentin.

  b. Dentin bonding agents do not permit re-contouring of the eroded area.

  c. Dentin bonding agents that are nanofilled resins can penetrate into the demineralized dentin and contribute to formation of the hybrid layer.

  d. The particles of nanofilled resins are smaller than the wavelength of visible light they result in greatly improved esthetes.

  e. Fluoride releasing nanofilled bonding agents are more effective on unprepared tooth surfaces than non-fluoride releasing agents.

5. Which stage of erosion is characterized by flattening of the bicuspid and molar cusps with a consequent loss of vertical dimension and increased sensitivity or pain?

  a. Mild erosion.

  b. Moderate erosion.

  c. Advanced erosion.

  e. Maintenance of a calcium and phosphate supersaturated solution on the tooth

6. What is the preferred order of procedures in the management and treatment of erosion?

  a. Monitor the progression of tooth wear with study casts and photographs, treat the pain, treat the causative condition

  b. Treat the pain, treat the causative condition and apply preventative strategies

  c. Perform definitive restorative treatment, monitor the progression of tooth wear with study casts and photographs

  d. Consider provisional or temporary treatment until the erosion is controlled and stabilized, treat the pain

7. The success of implants to restore the dentition where advanced erosion has left no recourse to extraction, is not dependent upon

  a. the medical condition of the patient

  b. the quality and quantity of the maxillary and/or mandibular bone

  c. the occlusion

  d. patient gender

  e. the patient anatomy in particular, the proximity of the tooth to nerves and sinuses

8. Additional significant clinical findings in which condition include Russell’s or Crisp’s sign), salivary gland enlargement (especially involving the parotid glands) and reports of frequent sore throats?

  a. Anorexia nervosa

  b. GERD

  c. Illegal drug use

  d. Bulimia nervosa

  e. Bruxism

9. Which of the following is true regarding the restoration of teeth with advanced erosion?

  a. Stainless steel crowns can be used as a temporary means of providing until the erosion process is stabilized.

  b. Where there is widespread perimolysis, lost vertical dimension should not be restored

  c. Stainless steel crowns are preferred where there is a need for antagonistic occlusal reconstruction.

  d. Stainless steel crowns can routinely be used in the treatment in the permanent dentition when cost prohibits the use of gold coverage.

  e. Stainless steel crowns can only used to restore primary teeth.

10. Which of the following is not considered a high risk factor for the development of tooth erosion?

  a. Self-induced vomiting

  b. GERD

  c. Illegal drug use (especially amphetamines)

  d. Bruxism

  e. Sucking lemons

11. Which of the following is not a major factor to be considered in the treatment of bruxism in children?

  a. Treatment of intestinal parasites

  b. Treatment of nutritional deficiencies

  c. Treatment with occlusal splints

  d. Treatment of allergies

  e. Treatment of endocrine disorders

12. Which of the following statements are untrue regarding tooth erosion and Bulimia nervosa?

  a. Bulimia nervosa is more common than Anorexia nervosa

  b. Perimylolysis is caused by chemical and mechanical effects of regurgitated gastric contents and is characteristically seen on the lingual surfaces of the anterior maxillary teeth

  c. Perimylolysis is diagnostic in itself of Bulimia nervosa

  d. Patients may report thermal sensitivity, chipping of incisal surfaces, anterior open bite

  e. Patients often deny that they are suffering from Bulimia nervosa

13. Which of the following statements regarding soft drinks are untrue?

  a. The three most common acids in soft drinks are phosphoric acid, citric acid and malic acid.

  b. Phosphoric acid (0.0055 M) has a pH of around 2.5

  c. The acids used as additives in soft drinks are weak acids in comparison with the organic acids produced by oral bacteria

  d. “Diet” drinks have similar pH values to non-diet drinks

  e. Dilution of fruit drinks has not been shown to decrease their erosive potential

14. The pathogenesis of dental erosion is considered to be multifactorial. Which of the following factors do not play and integral role in the development of erosion?

  a. The critical pH of enamel (5.5)

  b. Diet

  c. Frequency of low pH events

  d. Patient age

  e. Host modifying factors