A P R I L Diagnosis and Management of Dental Wear Impact of Sports Drinks Journal Effects of Nutrition + Richard T. Kao, DDS, PhD; and Lisa A. Harpenau, DDS, MS, MBA Vol Nº TDIC_April2011_Journal.pdf 1 3/17/11 11:41 AM Getting all of your insurance through the most trusted source? C M Good call. Y CM MY CY Protect your business: Protect your life: CMY K TDIC Optimum bundle • Life/Health/Disability • Professional Liability • Long-Term Care • Building and Business • Business Overhead Personal Property Expense • Workers’ Compensation • Home and Auto • Employment Practices Liability Protecting dentists. It’s all we do.SM 800.733.0633 tdicsolutions.com CA Insurance Lic. #0652783 Coverages specifically written by The Dentists Insurance Company include Professional Liability, Building and Business Personal Property, Workers’ Compensation and Employment Practices Liability. Life, Health, Disability, Long-Term Care, Business Overhead Expense and Home and Auto products are underwritten by other insurance carriers and offered through TDIC Insurance Solutions. April 11 cda journal, vol 39, n 4 º departments 2 0 1 The Editor/On the Same Page 203 Letter to the Editor 207 Impressions 2 1 1 Periscope 2 1 3 CDA Presents 267 Classifieds 276 Advertiser Index 207 278 Dr. Bob/Sweet Vengeance Is Like Ice Cream: Best Served Cold f e at u r e s 222 Dental erosion anD tooth Wear An introduction to the issue. Richard T. Kao, DDS, PhD, and Lisa Harpenau, DDS, MS, MBA 225 Diagnosis anD ManageMent of Dental Wear This paper focuses on the recognition, diagnosis, and general management of dental wear. Lisa A. Harpenau, DDS, MS, MBA; Warden H. Noble, DDS, MS, MSEd; and Richard T. Kao, DDS, PhD 233 sports Drinks anD Dental erosion This article is a discussion of sports drinks and how consumption of these beverages may contribute to dental erosion. Warden H. Noble, DDS, MS, MSEd; Terence E. Donovan, DDS; and Marc Geissberger, DDS, MA 239 Changing DaMaging Beverage Behavior: Your CDa at Work This paper presents how CDA and CDA Foundation activities have collectively improved the public’s oral health in a multitude of ways. Gayle Mathe, RDH 243 the effeCt of nutrition anD Diet on Dental struCture integritY This paper discusses the nutritional and dietary implications on dental structure integrity. Randy Q. Ligh, DDS, MA; Joseph Fridgen, DDS; and Claire Saxton, MS, RD, CNSC 2 5 1 interaCtion of Dental erosion anD BruxisM: the AmplifiCation of tooth Wear This paper discusses dental erosion and bruxism and its effect on tooth structure. Craig A. Pettengill, DDS 259 DeCision-Making in the ManageMent of the patient With Dental erosion This article outlines clinical examples of patients with dental erosion that highlight the strategy of early identification, patient education, and conservative restorative management. Donald A. Curtis, DMD; Jay Jayanetti, DDS; Raymond Chu, DDS; and Michal Staninec, DDS, PhD april 2011 199 cda journal, vol 39, n º 4 CDA Journal Volume 39, Number 4 Journal april 201 1 Richard T. Kao, DDS, PhD Reader Guide: Lisa H. Harpenau, , DDS, MS, MBA guest editors upcoming topics letters to the editor may: General Topics Kerry K. Carney, DDS Journal of the California editorial june: Aggressive [email protected] Dental association Robert E. Horseman, Periodontitis DDS july: Barriers to Care subscriptions published by the contributing editor The subscription rate is California Dental Manuscript submissions $18 for all active members association Patty Reyes, CDE Patty Reyes, CDE of the association. The 1201 k st., 14th floor assistant editor assistant editor subscription rate for sacramento, Ca 95814 [email protected] others is as follows: 800.232.7645 advertising 916-554-5333 Non-CDA members and cda.org Corey Gerhard Author guidelines institutional: $40 advertising manager are available at Non-ADA member Management cda.org/publications/ dentists: $75 Kerry K. Carney, DDS Jenaé Gruchow journal_of_the_california_ Foreign: $80 editor-in-chief traffic/project dental_association/ Single copies: $10 [email protected] coordinator submit_a_manuscript Subscriptions may commence at any time. This Ruchi K. Sahota, DDS, CDE production Classified advertising Please contact: associate editor Matt Mullin Jenaé Gruchow Jenaé Gruchow cover design traffic/project traffic/project Brian K. Shue, DDS coordinator coordinator is why associate editor Randi Taylor [email protected] [email protected] graphic design 916-554-5332 916-554-5332 Peter A. DuBois executive director Kathie Nute, Western Type Display advertising permission and reprints we’re typesetting Corey Gerhard Jeanne Marie Tokunaga Jennifer George advertising manager publications manager vice president, California Dental [email protected] JeanneMarie.Tokunaga@ marketing and association 916-554-5304 cda.org here. communications Andrew P. Soderstrom, 916-554-5330 DDS When you give to the Robert F. Spinelli president vice president, Journal of the California Dental Association (issn CDA Foundation, you help member enterprises Daniel G. Davidson, DMD 1043-2256) is published monthly by the California Dental fund local clinics, support president-elect Association, 1201 K St., 16th Floor, Sacramento, CA 95814, dentists who serve in rural Alicia Malaby 916-554-5330. Periodicals postage paid at Sacramento, communications Calif. Postmaster: Send address changes to Journal areas, and give countless Lindsey A. Robinson, DDS director vice president of the California Dental Association, P.O. Box 13749, kids healthy, happy smiles. Sacramento, CA 95853. Jeanne Marie Tokunaga James D. Stephens, DDS publications manager secretary The Journal of the California Dental Association is published under the supervision of CDA’s editorial staff. Jack F. Conley, DDS Clelan G. Ehrler, DDS Neither the editorial staff, the editor, nor the association editor emeritus treasurer are responsible for any expression of opinion or statement of fact, all of which are published solely on the authority Alan L. Felsenfeld, DDS of the author whose name is indicated. The association speaker of the house reserves the right to illustrate, reduce, revise, or reject any manuscript submitted. Articles are considered for Thomas H. Stewart, DDS publication on condition that they are contributed solely immediate past to the Journal. president Copyright 2011 by the California Dental Association. cdafoundation.org 200 a p r i l 2 0 1 1 Editor cda journal, vol 39, n 4 º on the same page kerry k. carney, dds entists just want to do the right thing. We follow the Disregarding the recommendations would be rules. We stay in the lines. We are conservative by nature. an invitation to litigation should a patient We conserve tooth structure, Drestore function, and promote oral and develop an infection after dental treatment. overall health. When it comes to patient safety, we all want to be on the same page. That is why it is so discombobulating to find we are the quality of evidence was limited to a n IE prophylaxis for dental procedures not on the same page with some of our few case control studies, expert opinion, should be recommended only for patients colleagues in medicine. clinical experience and descriptive stud- with underlying cardiac conditions as- Take the example of antibiotic pro- ies.1 Over time, there has been increasing sociated with the highest risk of adverse phylaxis. Years ago, when a patient had collaboration with other specialties with outcome from IE. a medical history that included, for ex- overlapping concerns for patient safety. n For these patients, prophylaxis is ample, mitral valve prolapse (MVP), that In 2008, a writing group was appointed recommended for all dental procedures was a red flag. Our office team was trained by AHA to review the 1997 recommenda- that involve manipulation of gingival to follow the current recommendations tions. The members of the group were tissue or the periapical region of teeth or for the prevention of infective endocardi- chosen for their “expertise in prevention and perforation of the oral mucosa. tis (IE) published by the American Heart treatment of … IE with liaison members rep- n Prophylaxis is not recommended Association (AHA) and endorsed by the resenting the American Dental Association, based solely on an increased lifetime risk American Dental Association (ADA). the Infectious Diseases Society of America, of acquisition of IE.1 We want to give our patients a safe and the American Academy of Pediatrics.”1 The 1997 and 2008 revisions of the rec- environment for receiving their dental care. It was found that “the collective published ommendations have made for a significant We do not want our therapeutic interven- evidence suggests that of the total number decrease of the number of patients who tion to be the cause of a life-threatening of cases of IE that occur annually, it is likely receive prophylactic antibiotic coverage. infection. We follow the recommended that an exceedingly small number of these Everyone seems to be on the same guidelines for antibiotic prophylaxis. We cases is caused by bacteremia-producing page. We are all trying to operate in a safe prescribe the recommended regimen even dental procedures … There should be a shift environment for our patients. We are bal- though we learned in dental school that in emphasis away from a focus on a dental ancing risk versus benefit for the patient. there did not appear to be scientific evi- procedure and antibiotic prophylaxis toward We are all trying to reduce the potential im- dence to support an antibiotic regimen that a greater emphasis on improved access to pact that antibiotic prophylaxis might have targeted a large fraction of the population. dental care and oral health in patients with on the emergence of microbial resistance. We all want to be on the same page underlying cardiac conditions associated Now comes the discombobulating part. for legal reasons in addition to patient with the highest risk of adverse outcome A patient comes into the office in 2009 safety.