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This paper presents a case demonstrating treatment of localized severe toothwear and generalized moderate toothwear, in a previously bulimic and anorexic patient. The treatment plan and rationale for treatment is discussed. The case shows the analytical diagnostic steps taken to formulate the treatment plan, which focused on prevention, treatment of disease and restoration of teeth affected by toothwear, in order to achieve the objective of establishing oral health, function and aesthetics.
CPD/Clinical Relevance: Using available interocclusal space created by repositioning the mandible into the retruded centric relation position, this case demonstrates minimally invasive direct additive composite placements to restore generalized toothwear in general practice.
Article
A 37-year-old female patient presented after complaining of a swelling she had experienced four weeks previously around the upper left side of her face, and that her upper left front tooth was symptomatic during this episode. She attended her general medical practitioner who had prescribed antibiotics and advised her to see a dentist. The swelling, pain and acute symptoms subsequently settled and, at the time of presentation, as there were no acute symptoms, the patient requested improved dental health. She complained of chronic symptoms of sensitivity, difficulty eating hard foodstuffs and of the poor appearance of her front teeth. The patient had not attended the dentist for six years, and was apprehensive of dental treatments.
Medical history revealed that the patient had suffered previously with anorexia nervosa and bulimia for 15 years. She was currently under medication for depression. The patient was a non-smoker and did not drink alcohol. There was no history of any habits or drug use.
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