This standard specifies the diagnostic criteria and treatment principles for occupational tooth erosion. This standard applies to occupational tooth erosion caused by exposure to various acid mists or acid anhydrides at work. GB 16381-1996 Occupational tooth erosion diagnostic criteria and treatment principles GB16381-1996 Standard download decompression password: www.bzxz.net

National Standard of the People's Republic of China
Diagnostic criteria and principles of managementof occupational dental erosionGB16381-1996
Occupational dental erosion is a demineralization defect of the hard tissue of the teeth caused by long-term exposure to various acid mists or acid anhydrides. Its clinical manifestations include different degrees of defects in the crowns of the anterior teeth, as well as teeth sensitive to cold, hot, sour, sweet and other stimuli, often accompanied by gingivitis, gingival bleeding, toothache, loose teeth, etc. In severe cases, most of the crowns are defective, or only residual roots are left, and the pulp cavity may be exposed and pulp lesions may occur. 1 Subject content and scope of application
This standard specifies the diagnostic criteria and management principles of occupational dental erosion. This standard applies to occupational dental erosion caused by exposure to various acid mists or acid anhydrides at work. 2 Diagnostic principles
Based on the occupational history of exposure to acid mist or acid anhydride, the clinical manifestations are mainly anterior tooth hard tissue damage, and the results of the on-site labor hygiene survey are referred to for comprehensive analysis. Only after excluding other dental hard tissue diseases can the diagnosis be made. 3 Diagnosis and grading standards
3.1 Observation subjects
Those with two or more teeth in the anterior teeth area that are suspected of tooth erosion can be listed as observation subjects. 3.2 Degree tooth erosion
Those with two or more teeth in the anterior teeth area that are first-degree tooth erosion can be diagnosed as first-degree tooth erosion. 3.3 Second-degree tooth erosion
Those with two or more teeth in the anterior teeth area that are second-degree or third-degree tooth erosion can be diagnosed as second-degree tooth erosion. 3.4 Third-degree tooth erosion
Those with two or more teeth in the anterior teeth area that are fourth-degree tooth erosion can be diagnosed as third-degree tooth erosion. 4 Treatment principles
4.1 For patients with symptoms of dentin hypersensitivity, they can be given fluoride or acid-resistant desensitizing toothpaste for brushing or fluoride water for gargling. If necessary, desensitization treatment can be performed with drugs.
4.2 Whether or not to perform tooth restoration for first-degree tooth erosion can be determined based on the specific situation. Second-degree tooth erosion should be restored as soon as possible. Third-degree tooth erosion can be restored after pulp disease and its complications are treated. 5 Labor capacity assessment
5.1 Observation subjects: Review every six months, no special treatment is required. 5.2, Second and third-degree tooth erosion: After treatment and restoration, under enhanced protection conditions, acid-free work can be continued. Approved by the State Administration of Technical Supervision on May 23, 1996 and implemented on December 1, 1996
Requirements for health examination
GB16381-1996
6.1 Personnel who are engaged in work in contact with acid or anhydride shall undergo pre-employment physical examination and regular health examination, and physical examination shall be conducted every 1 to 2 years according to the contact situation.
6.2 In addition to the general routine physical examination, detailed examinations of stomatology, ophthalmology, and otolaryngology shall be conducted during the physical examination. Contraindications of occupational drugs
Severe enamel hypoplasia or other full-mouth dental hard tissue diseases; various nasal diseases that affect breathing,bzxz.net
Excessive wear of lower front teeth due to malocclusion and deep overbite. A1 Oral examination requirements
GB16381-1996
Appendix A
Oral examination requirements and judgment criteria
(Supplement)
A1.1 When asking about the medical history, attention should be paid to whether there is a history of toothache, the location and nature of the pain, whether it is spontaneous pain or provoked pain, the provoking factors, etc. A1.2 Oral examination should be conducted under appropriate lighting (daylight or light can be used), and routine examinations should be conducted using a mouth mirror, probe, and tweezers by inspection, probing, and percussion. If necessary, cold and hot stimulation tests or electric vitality tests, X-ray examinations, etc. should be performed. The examination results should be recorded separately according to the tooth position. A2 Judgment criteria for tooth erosion
A2.1 Suspected tooth erosion (code O+): The enamel surface on the labial side is smooth and shiny, the incisal transparency is increased, the incisal edge is rounded and blunt, or the tooth surface transparency is reduced, and it is ground glass-like milky white, but there is no tooth substance defect. A2.2 Grade 1 dental acid erosion (code 1): only the enamel of the labial surface is defective, which is more common in the 1/3 of the lateral lip incision end. The incision edge becomes thin and translucent, or the enamel in the middle of the labial surface is arc-shaped and concave. The surface is smooth, and there is no obvious boundary with the surrounding enamel. A2.3 Grade 2 dental acid erosion (code): The defect reaches the shallow layer of dentin, and is mostly star-shaped and sloped, starting from the incision edge and cutting towards the labial surface of the crown. A relatively transparent enamel layer can be seen around the exposed dentin. A2.4 Grade 3 dental acid erosion (code Ⅱ): The defect reaches the deep layer of dentin, and the center of the dentin is exposed on the defect surface, which is equivalent to the original pulp cavity. A round or oval brown-yellow dentin area can be seen. However, there is no pulp cavity exposure and no pulp lesions. A2.5 Grade IV dental erosion (code NV): The defect reaches the deep layer of dentin. Although the pulp cavity is not exposed, there is secondary pulp lesion; or the defect has reached the pulp cavity, or most of the crown is defective, leaving only residual root. Appendix B
Correct use of standard instructions
(reference)
B1 This standard is only applicable to occupational dental erosion caused by long-term exposure to acid mist or acid anhydride during the manufacture and application of various acids.
B2 Occupational dental erosion mainly manifests in the anterior teeth of the upper and lower jaws, namely the central incisors, lateral incisors and canines. Early lesions are mostly in the labial 1/3 of the incisal end.
B3 Non-occupational factors such as acidic food, beverages, drugs and certain diseases can also cause dental erosion. Wear, abrasion, trauma, enamel hypoplasia and fluorosis can also cause damage to the hard tissues of teeth, which should be identified based on occupational history, medical history and clinical characteristics. B4 Usually, there are multiple teeth with different erosion levels in a person's mouth. As a whole, the diagnostic grade of dental erosion should be determined based on the two or more teeth with the most severe erosion level. Example 1:
Example 2:
Example 3:
First degree dental erosion
Second degree dental erosion
Third degree dental erosion
If only one tooth has the most severe erosion level, in order to avoid misdiagnosis, its diagnostic grade should be determined based on the second tooth with the most severe erosion level. 327
Example 4:
Example 5:
GB16381—1996
First degree dental erosion
Second degree dental erosion
In addition to symptomatic treatment, the treatment of dental erosion mainly adopts various methods to repair according to the condition of tooth defects. Additional Notes:
This standard was proposed by the Ministry of Health of the People's Republic of China. This standard was drafted by the Occupational Disease Prevention and Control Department of the Zhuzhou Smelter Employees Hospital, and this standard was interpreted by the Institute of Labor Hygiene and Occupational Diseases of the Chinese Academy of Preventive Medicine, the technical unit entrusted by the Ministry of Health.
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