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The role of orthodontics in the management of tooth wear

British Dental Journal volume 237, pages 362–368 (2024)Cite this article

Abstract

Pathological tooth wear is a dental problem that affects all age groups and appears to be increasing in prevalence. A subset of these patients may benefit from a combination of orthodontic and restorative care which will be discussed in this article. Orthodontics can help to create the necessary vertical, anterior-posterior and mesio-distal space for restorative work, reducing the need for tooth reduction and lessening the biological costs of restorative care, helping to reposition the gingival margins where this impacts upon aesthetics, as well as correcting co-existing malocclusion.

Key points

  • The orthodontist can assist in the diagnosis and prevention of tooth wear, particularly in the adolescent patient when the first signs may become visible.

  • In the presence of significant wear, orthodontics can assist in creating vertical, anterior-posterior and mesio-distal space, both for restorative management as well as treating the general features of the malocclusion.

  • It is essential to plan orthodontic retention of any restorative space created and this may be achieved best by early placement of restorative materials (even if this is temporary), fixed and removable retainers.

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Acknowledgements

The authors would like to thank Dr Akit Patel, Professor Padhraig Fleming and Dr Amerjote Bansal for some of the clinical photographs used in Fig. 2 and Fig. 3, respectively. They would also like to acknowledge Dr Guy Williams for undertaking the restorative dentistry in Fig. 5.

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Authors and Affiliations

  1. Consultant Orthodontist, Great Ormond Street NHS Foundation Trust, London, UK

    Daljit S. Gill

  2. Consultant Restorative Dentist, Honorary Clinical Associate Professor, Eastman Dental Hospital and Institute, UCLH NHS Foundation Trust, London, UK

    Kenneth W. Hemmings

  3. Consultant Orthodontist, Kingston Hospital NHS Foundation Trust and The Gillies Unit, Queen Mary´s, King´s College Hospital NHS Foundation Trust, London, UK

    Farhad B. Naini

Authors
  1. Daljit S. Gill
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  2. Kenneth W. Hemmings
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  3. Farhad B. Naini
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Contributions

All three authors contributed to the planning and final review of the manuscript. Daljit S. Gill and Farhad B. Naini advised on the orthodontic aspects and Kenneth W. Hemmings advised on the detailed restorative aspects of the manuscript.

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Correspondence to Daljit S. Gill.

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The authors declare no conflicts of interest.

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Gill, D., Hemmings, K. & Naini, F. The role of orthodontics in the management of tooth wear. Br Dent J 237, 362–368 (2024). https://doi.org/10.1038/s41415-024-7831-8

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