Abfraction — Everything You Need to Know

Abfractions are a little-known dental condition in the form of tooth loss by the gingival margin.

About Abfractions 

An abfraction is the loss of enamel and cementum at the base of the tooth by the gumline. The enamel is the hard outer surface, and the cementum is a rigid, calcified layer that shields the root and keeps the periodontal ligament attached firmly to a tooth. The damage usually appears as a wedge or V-shaped notch, and it begins as an indentation and gradually grows deeper over time. Abfractions are not cavities but are considered non-carious cervical lesions (NCCL). It is not caused by bacteria, infection, or decay. If you have any specific questions, enter this link.

A Few Key Facts

Abfractions are permanent and pose a risk to oral health because they can expose the dentin and pulp, the softer portions of the teeth. That increases the risk of tooth decay and infection, mimicking the symptoms of a cavity and causing other problems. In addition, abfraction lesions leave teeth more vulnerable to fractures. If left untreated, a severe abfraction can lead to the need for invasive dental procedures and even complete tooth loss. It is easy to confuse the condition with other dental complications, and discovering the source is a necessary step for abfraction treatment and management.

What Are the Signs of an Abfraction?

You may never acquire noticeable signs of abfraction, but left untreated, if the damage continues, it could lead to:

  • Translucency, worn and shiny facets on the tooth.
  • Chipping of the tooth surface.
  • Food getting stuck in the wedge of the tooth.
  • Tooth sensitivity, though they are typically painless.
  • The loss of enamel or dentin, making the tooth vulnerable to bacteria and decay.
  • The diminishing of the structural integrity and eventual loss of the whole tooth.

What Causes Abfractions?

There remains some mystery surrounding the exact produces abfractions, as there are a few possible contributing factors, including chemical, biological, and behavioral considerations. Still, most experts agree that the condition usually develops when the teeth repeatedly come under extreme stress and pressure, for example, from aggressive biting or chewing, which leads to the weakening and the eventual breakdown of the enamel near the gum line. Sometimes there are multiple contributing factors for each individual. Your dentist may not be able to determine the exact cause.

Abfractions can come about if some teeth are repeatedly impacted by a bite that is not properly aligned, too. You might not be aware of the grinding or clenching that occurs during sleep. Habits such as chewing on items like pens or pencils might also put excess tension on the teeth. 

Tooth erosion occurs from subjugation to acids from the stomach or consumed via drinks and foods. Tooth abrasion may result from improper brushing techniques or the overuse of abrasive toothpaste and cleaners. The incidence of abfraction can also worsen with age.

Common causes of abfraction lesions include:

  • Bruxism: habitually teeth grinding or clenching.
  • Malocclusion: misalignment of the teeth.
  • Acidic erosion or mineral loss of the teeth due to a highly acidic diet, eating disorders, reflux, or abrasive factors.
  • Medications that lead to dry mouth.

Abfractions Treatments

Proper abfraction dental treatment depends on the severity of the lesion, the reported sensitivity, aesthetic interests, and co-existing dental problems. An abfraction doesn’t always require action, but it’s important to consult with a dentist to be sure.

The damage can’t be reversed, but you can ease discomfort and improve the overall appearance of your smile with restorative dentistry techniques, used to rebuild the tooth. 

Repair alone does not address the underlying reason. Treatment must occur in two stages: curing the abfraction to repair the physical injury and overseeing the cause by adopting lifestyle changes, stress reduction techniques, and tailored night guard therapy to prevent further disfigurement. 

When needed, your dentist will plug the space of the lesion with a composite resin material, similar to a cavity filling. Dental fillings can be made to match the color and look of your natural tooth. If the damage is more significant, it may be recommended to cover the entire tooth with a dental crown. 

If bacteria or infection has reached the pulp and root, endodontic or root canal therapy will be required. If necessary, a gum graft can also be performed to cover the exposed root and protect your new tooth filling, by removing soft tissue from the mouth, usually from the palate (roof of the mouth), and suturing the flesh to an area where little or no gum tissue remains. 

If the abfraction is due to malocclusion, correcting the alignment can be achieved using orthodontic therapy to reduce the uneven levels of force. Keep in mind that properly aligned teeth are much easier to keep clean with adequate oral hygiene. If teeth grinding is the trigger, your dentist may fit you with a custom-fit mouthguard to protect your teeth, especially while you sleep. 

Also, not that bruxism can bring about a painful ailment called Temporomandibular Joint Disorder (TJD), so it’s advantageous to get specialized treatment for this concern from an oral surgeon. In addition, desensitizing toothpaste or gel might help soothe the discomfort associated with tooth sensitivity.

Preventing Tooth Abfractions

Abfractions on the teeth might not always require immediate attention, but it is best to keep an eye on the situation to prevent the condition from worsening. 

There are many ways to prevent dental abfractions, depending on the origin of the lesion. For example, in the case that the condition has developed due to bruxism, then an oral appliance should be suggested, designed to cushion the teeth and put the jaw into a more relaxed position. Stress management might also help with destructive habits fueled by anxiety. 

Another way is to ensure your bite is correct by seeing your dentist for assessment and referral for the best-fitting orthodontic treatment. Dietary modifications and rinsing after every meal might soothe problems with acidic erosion.

If you notice a tooth has increased in sensitivity and you’ve found a lesion beginning to form, contact a dental professional who will work with you to select the best plan to restore your smile. Regular checkups will help monitor any matters and changes. Always maintain an excellent oral care routine by brushing and flossing regularly.