Shepperson, A.

General dental practice has never been more interesting, and the field of tooth wear satisfies so many aspects of the skills we are trained to use: applying a medical diagnostic model to dentistry, design and artistry, sculpture and engineering, use of innovative technology, and the science of dental materials. It requires detective work and lateral thinking, empathy, and listening. Most of all, it’s about offering confidence and reassurance to patients who are often discovering for the first time that chemical and physical forces are damaging their teeth. But not all toothwear needs treatment. How then, does a clinician make the distinction, and what drives us to intervene? Does a patient believe they have a problem, and what is the distinction between physiologic and pathologic wear? Was it necessary when more conservative interdisciplinary solutions would be more appropriate? How can we combine interdisciplinary dentistry, such as orthodontics,to offer less aggressive alternatives to patients? This book will weigh all aspects of the treatment options and the motivation for managing tooth wear. Aboveall, it focus on biologic, functional, and ethical rationale with the goal of enamel conservation and protection at the forefront.

CONTENTS:

CHAPTER 1 Tooth Wear in General Practice 

• Does Tooth Wear Matter?
• Early Recordings of Tooth Wear
• Education and Tooth Wear for General Practitioners
• Is It Just Aging? Demographic Patterns
• Population Trends in Tooth Wear
• Should I Treat or Refer? 

CHAPTER 2 Etiology of Tooth Wear: Causes and Recognition 

• Recognizing Patterns of Wear
• An International Grading System and Risk Assessment of Tooth Wear
• Common Indices for Assessing Tooth Wear
• Active Wear or Adapted Wear?
• Tooth Wear Definitions and Clinical Appearance
• The Role of Gastric Acid in Tooth Wear
• Recreational Drug Use
• Sports and Tooth Wear
• Diet and Tooth Wear
• Occupational Tooth Wear
• Sleep-Related Breathing Disorders
• The Role of Saliva 

CHAPTER 3 Occlusion and Tooth Wear 

• Early Occlusal Concepts
• Engrams and Adaptation
• Key Occlusal Concepts 

CHAPTER 4 Diagnosis of Tooth Wear: The Clinical Exam 

• Thinking Laterally
• Initial Interview: Gathering a History
• Medical History
• Lifestyle Clues
• Conditions and Medication Associated with Tooth Wear
• Drug-Induced Bruxism
• Diseases Associated with Hyposalivation
• The Changing Medical Status of a Patient
• Discussing Sensitive Issues in a Dental or Medical History
• X-ray Appearance of Tooth Wear
• Is It Active or Passive?
• Intraoral Evaluation of Tooth Wear
• Clinical Records at the New Patient Examination 

CHAPTER 5 The Team and Tooth Wear: The Role of the Hygienist and Therapist 

• Introduction
• The Role of the Hygienist/Therapist
• Planning a Separate Appointment for Tooth Wear Diagnosis and Prevention
• Establishing Awareness of the Condition
• Saliva Testing
• Dietary Analysis, Frequency, and Habits
• Risk Assessment Questionnaires
• Tooth Wear Risk Assessment Appointment
• Remineralization Strategies
• Improving Saliva Quality and Quantity
• Dentifrices and Prophylaxis Techniques
• Fluorides
• High pH Protective Solutions
• Sports
• Supplements 

CHAPTER 6 Developing the Blueprint for Restorative Tooth Wear Management 

• Facially Driven Planning
• Smile Design Rules, Attractiveness, and Biology
• Starting the Blueprint
• An Interdisciplinary View in Planning
• Tooth Wear Blueprint: Establishing the Functional Starting Point
• Articulation: Analog and Virtual Assessment of Tooth Wear
• Assessing the Need for an Increase in Vertical Dimension 

CHAPTER 7 Testing Your Design: The Pretreatment Mock-up 

• The New Standard for Case Approval
• New Materials for Test-Driving a Design
• Starting the 3D Design: The Additive Wax-Up
• How to Deliver a Mock-up
• The Functional Mock-up
• The Orthodontic/Restorative Mock-up
• Presenting the Options
• Flipping Treatment Planning on Its Head: The Emotional Mock-up
• Integrating Interdisciplinary Care
• The Bonded Functional and Aesthetic Mock-up
• Steps to Create an Index for a Motivational Mock-up
• Mock-up Delivery Steps
• The Mock-up Photo Shoot
• The Mock-up Presentation
• Important Aesthetic and Functional Tests after the Presentation
• Informed Consent
• Moving to Treatment After the Mock-up 

CHAPTER 8 Restorative Options: Material Selection in Tooth Wear Cases 

• Building a Framework for Restorative Treatment
• Remaining Enamel: An Important Biomechanical Factor in Restorative Solutions
• Restorative Materials
• Transitional or Temporary Restorations? 

CHAPTER 9 Treatment 

• About Treatment
• Where Do I Start?
• A Risk Assessment Approach to Care
• A Classification of Tooth Wear
• Sequencing Treatment in Complex Cases
• Managing NCCLs
• Composite or Porcelain? 

CHAPTER 10 Longevity in Tooth Wear Cases 

• The Importance of Continuing Care in Case Stability
• Digital Monitoring in Tooth Wear Cases
• Aging of Restorations: Survival Rates of Different Materials
• Imbrication of Lower Incisors and Orthodontic Relapse
• Aging and Medication
• Review of Temporary and Transitional Restorations
• Occlusal Splints
• Preventive Trays
• The Patient Relationship and Continuing Care 

Bibliography 

Acknowledgments 

The Author

• ISBN 9781957260334

• Hardcover

• Pages: 526