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Removable Prosthodontics for the Management of Severe Toothwear Liam Addy Matthew Thomas Carly Cummings Elizabeth King Dental Update 2024 47:5, 707-709.
Authors
LiamAddy
BDS, MFDS, MPhil FDS (Rest Dent)
Consultant in Restorative Dentistry, Cardiff University Dental Hospital, Heath Park, Cardiff CF14 4XY
Toothwear is becoming increasingly more common for dentists to manage as the population is maintaining its teeth for longer. A large proportion of cases can be managed by means of adhesive dentistry in conjunction with preventive advice. There are, however, patients with severe toothwear alone, or toothwear in conjunction with missing teeth, which would be best served with a removable prosthodontic approach. This is particularly the case where dental implants are not indicated or appropriate. This article illustrates the use of removable prosthodontics for the management of toothwear and highlights the importance of these restorations in certain cases. It also considers the supportive programme required to ensure success of this treatment modality.
CPD/Clinical Relevance: Toothwear is a prevalent dental problem that cannot always be addressed with an adhesive restorative or fixed prosthodontic approach, particularly when the toothwear is severe and or in combination with existing missing teeth.
Article
Toothwear, also known as non-carious tooth surface loss, is defined as the loss of dental hard tissue by mechanisms other than caries or trauma. Toothwear can be caused by many processes but typically has a multifactorial aetiology, usually as a combination of erosion, attrition and abrasion.1,2,3,4,5 Although some toothwear is normal or physiological due to natural ageing, severe toothwear at a higher rate than normal can produce symptoms and even masticatory, functional or aesthetic concerns. In partially dentate patients with severe toothwear, successful management can be challenging.
Toothwear is a dental condition of increasing concern in the UK population, as demonstrated by the findings of the 2009 Adult Dental Health Survey. Seventy–six percent of dentate adults in 2009 showed signs of wear, compared to 66% in the 1998 survey.1 Of those dentate adults, 15% experienced moderate wear, exposing large areas of dentine and 2% displayed severe wear, which exposed the pulp or secondary dentine. Men (70%) were affected by toothwear more than women (61%) and even some adults in the younger age group (16–24 years) showed signs of moderate wear (4%). As the younger generation retain more of their teeth into old age, early identification and management of their disease will be essential in order to prevent increased numbers of adults with excessive wear.
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