V-shaped notches at the junction of the tooth crown and root that are non-carious – that is, not caused by decay.
Causes of Abfractions
The etiology (cause) of these notches is not completely understood, but the most common theory is that they are due to the destruction of enamel caused by the flexing of individual teeth.
- Grinding and clenching your teeth: These actions put too much force on the teeth; the associated flexing and stress will cause the destruction of the enamel rods within the tooth
- Crooked teeth or a misaligned bite: When teeth do not come together evenly, too much force can be placed on the teeth, gums, and bone. This results in the destruction of the enamel, dentin, and cementum.
- Acidic Erosion: A diet that includes regular acidic intake will result in the thinning of enamel. This process makes the teeth more prone to notching.
Risks of Abfractions
- The underlying tooth structure is exposed to the sugars, acids, and abrasion of normal diet and function.
- Increased sensitivity to temperature and sweets due to the exposure of these delicate structures
- As the wear continues, the tooth becomes more at risk for fracture
Dental Abfractions Treatment
Once we determine the etiology of the abfraction, we can determine the appropriate treatment. Our best treatment for abfractions is diagnosis and prevention.
For grinding and Clenching
- During the day: conscious effort to not clench and grind, avoidance of chewing on inedible items that contribute to this habit
- At night: fabrication of a night guard for nightly wear, which will allow us to lessen the traumatic forces caused by this habit
For Crooked Teeth/Misaligned Bite
Equilibration (superficial adjustment of your bite)
Orthodontic treatment with either traditional braces or Invisalign.
For Acidic Erosion
- Diet modification! Avoid overly acidic, sugary foods, and rinse with water after their consumption
Early, preventive treatment in one of the above forms should be implemented as soon as possible. Immediate adjustments to your home care should be initiated as necessary. This includes brushing with a soft-bristled toothbrush or Sonicare electronic toothbrush and sensitivity toothpaste.
Since the root is not designed to be exposed, notching will typically occur shortly after exposure. Once the root notches out 2mm, we become concerned about the overall strength of the tooth. In addition to relieving the stresses on the teeth, we recommend filling in the notch with a tooth-colored, composite material to prevent further notching.