RESUMO
Tooth wear has an increasing prevalence in the UK population. The aetiology is commonly multifactorial, and the aetiopathology is through a combination of erosion, attrition, abrasion and abfraction. Erosion is associated with intrinsic or extrinsic acids, and therefore subjects with reflux disease and eating disorders are at increased risk. Fruit juice, fruits and carbonated drink consumption, frequency of consumption and specific habits are also risk factors. Attrition is more prevalent in bruxists. Other habits need to be considered when defining the risk of tooth wear. Abrasion is usually associated with toothbrushing and toothpastes, especially in an already acidic environment. Patients with extensive lesions that affect dentin may be at higher risk, as well as those presenting with unstained lesions. Monitoring of the progress of tooth wear is recommended to identify those with active tooth wear. Indices for tooth wear are a helpful aid.
Assuntos
Erosão Dentária/etiologia , Ácidos/efeitos adversos , Bebidas/efeitos adversos , Bruxismo/complicações , Bebidas Gaseificadas/efeitos adversos , Diagnóstico Precoce , Comportamento Alimentar , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Frutas , Refluxo Gastroesofágico/complicações , Humanos , Concentração de Íons de Hidrogênio , Medição de Risco , Abrasão Dentária/etiologia , Atrito Dentário/etiologia , Erosão Dentária/diagnóstico , Desgaste dos Dentes/etiologia , Escovação Dentária/efeitos adversos , Escovação Dentária/instrumentação , Cremes Dentais/efeitos adversosRESUMO
In July 2009, California eliminated funding for most adult non-emergency Medicaid dental benefits (Denti-Cal). This paper presents the findings from a qualitative assessment of the impacts of the Denti-Cal cuts on California's oral health safety-net. Interviews were conducted with dental safety-net providers throughout the state, including public health departments, community health centers, dental schools, Native American health clinics, and private providers, and were coded thematically using Atlas.ti. Safety-net providers reported decreased utilization by Denti-Cal-eligible adults, who now primarily seek emergency dental services, and reported shifting to focus on pediatric and privately-insured patients. Significant changes were reported in safety-net clinic finances, operations, and ability to refer. The impact of the Denti-Cal cuts has been distributed unevenly across the safety-net, with private providers and County Health Departments bearing the highest burden.