MANAGING TOOTH WEAR. A COMPREHENSIVE GUIDE TO GENERAL PRACTICE

• 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

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.

Author
Dr. Andrea Shepperson is a highly respected dentist and educator, renowned for her expertise in managing tooth wear and interdisciplinary reconstruction of the worn dentition. Dr. Shepperson graduated from the University of Otago, New Zealand in 1984. As the owner of Shepperson Education, a dedicated teaching facility on Waiheke Island, Auckland, New Zealand she runs intensive two- and three-day events for clinicians, with a strong focus on evidence-based clinical strategies that can be implemented with clarity. With a wealth of international knowledge and networking, Dr. Shepperson engages with some of the leading dentists in the world and stays up-to-date with changing global trends and technologies in the industry. She is a mentor and alumna of the Kois Center in Seattle, USA, and a Digital Smile Design KOL. She is an Honorary Life Member of the NZ Academy of Cosmetic Dentistry and a Global Ambassador for Slow Dentistry. Dr. Shepperson’s motivation is to provide novel solutions that offer life-changing outcomes for both dentists and patients. Patients who value longevity, wellness, and a true understanding of their needs seek her services, and dentists who value evidence and authenticity value her insights. As a sought-after author and speaker, Dr. Shepperson enjoys being at the forefront of dentistry. She contributes to publications, podcasts, webinars, and expert panels, and has been a contributing author to Practical Procedures In Aesthetic Dentistry.