Tooth abfraction lesions are commonly seen at the base of the tooth, near the gum line, and it may look as if the tooth has been notched. These lesions can look as if they’ve been created by brushing the teeth too hard, causing the enamel to be lost at the gum line, but in fact their cause is quite different.
Tooth abfraction is due to the stresses placed on teeth, and can occur if someone’s bite isn’t absolutely perfect. When this occurs it is quite common for one tooth to be bitten down on slightly before the rest, increasing the stresses on that particular tooth and causing it to flex slightly. This continual flexing eventually causes little cracks in the enamel, and can leads to the enamel beginning to separate from the dentin layer underneath. This begins to form the notching commonly associated with tooth abfraction.
Another reason for tooth abfraction is if a patient is grinding their teeth, as the clenching and grinding action can place considerable stress on the teeth. This problem is more common than you might think, and is quite often found in older adults, especially in the back teeth that are often subject to more biting forces. However these lesions can also appear in the front teeth.
The lesions don’t really create any significant symptoms, as they tend not to hurt, but they may make the tooth more susceptible to decay, and they can also weaken teeth so they may be more at risk of breaking off at the gum line. One of the earliest symptoms that this is occurring is noticing increased sensitivity due to the dentin becoming exposed.
If you do have any signs of tooth abfraction then your dentist will keep an eye on them during regular dental checkups. A lot of these types of lesions don’t require any immediate treatment, but some may need filling. They can be filled with composite resin material that is commonly used for fillings, or with another type of filling material called glass ionomer which is a mixture of glass and acrylic. Having them filled can help to strengthen the tooth, but also provides a more cosmetically pleasing result as some people are quite concerned about the way these lesions can look.
Preventing Tooth Abfraction
As these types of lesions are created by undue stress on the teeth, one way to prevent them from occurring is to make sure your bite is correct. This is something your dentist can assess for you before recommending the best orthodontic treatment plan for your needs. If the problems are created due to teeth grinding or bruxism then it’s well worth trying to get this problem sorted out. This is because bruxism can create significant problems for your teeth and gums. It can also lead to a painful disorder called temporomandibular joint disorder developing, and it’s best to get specialized treatment for this problem from an oral surgeon like Dr Jonathan Penchas. It’s usually treated through wearing a night guard that is designed to put the jaw into a more relaxed position so the biting and clenching cannot occur.
Abfractions on the teeth are not a serious problem that requires immediate treatment, but are something it is best to keep an eye on, and obviously to try to prevent from happening or becoming worse.