What is Abfraction?
Abfraction is a notched area (V-shaped or wedge-shaped) between the tooth and the gum. It is usually painless but may affect the sensitivity of the tooth affected. It may also be accompanied by pathological wear such as regressive alteration of the teeth.
Abfraction is basically a type of non-carious lesion characterized by loss of tissue of the tooth and with different clinical appearances.
What Causes Abfraction?
The cause of the lesion can have chemical, biological and behavioral factors(1). Abfraction can occur as a result of normal or abnormal tooth function and may also be accompanied by pathological wear (abrasion and erosion).
Long time stress on the teeth is the major contributing factor which can happen in various other ways such as,
Teeth Grinding or Bruxism: Habit of grinding and clenching the teeth frequently, mostly triggered by stress and anxiety is known as bruxism.
Malocclusion or Misalignment of Teeth
Acidic and Abrasive Factors With Lead To Mineral Loss: Acid reflux or acidic food and drinks can cause erosion of the tooth and lead to abfraction.
Improper tooth brushing and use of abrasive toothpaste can lead to gum recession and expose the less mineral part of the tooth (cementum and dentin). This can lead to abfraction.
The abrasive factors initiate the abfraction and the stress from the bite deepens it.
The incident of abrasion increases with age, with an increase from 3 percent to 17 percent between the ages of 20 and 70 years(1).
Symptoms of Abfraction
The clinical manifestation of abfraction may be dependent on the type and severity of the etiological factors involved. There are not much of sign and symptom which are seen during abfraction. It is painless but there might be tooth sensitivity to heat and cold.
Food getting stuck in the wedge, which would be visible, only when you smile widely, would make you aware of the condition.
If the damage continues and remains unchecked or untreated, it could lead to:
- Translucency or worn out shiny facets on the tooth.
- Chipping of the tooth surface
- Loss of enamel or an exposed dentin
- Long term loss of tooth enamel makes the tooth vulnerable to the bacteria and decay, affecting the structural integrity of the tooth and leading to tooth loss.
Diagnosis of Abfraction:
Just like any other clinical problem, diagnosis of this condition plays a major role in the management of the lesion.
A complete medical history and clinical examination can help achieve an exact diagnosis. Abfraction have multifactorial nature, therefore, all the potential causes much be evaluated. A medical history of gastroesophageal reflux disease, eating disorder, and dietary contributors should be included in the evaluation. Oral habits, occlusion, and occupational and ritual behaviors should also be evaluated.
- On examination, shiny facets on the teeth may indicate the presence of erosive process.
- Multiple abfraction lesions, overlapping each other occur due to forces producing tensile stress.
Treatment Options For Abfraction
Though abfraction does not mostly require any treatment it is important to get it checked by a dentist. He can help ward off any upcoming bigger problem.
The treatment for abfraction is recommended on the basis of the severity of the problem and also on the co-existing dental problems. Though the damage is irreversible, the tooth sensitivity can be eased, and the appearance of the tooth can be improved. All this can prevent any further damage. The treatment options include:
Filling: It is a good aesthetic option. Due to the exposed nerve ending, there is tooth sensitivity. The doctor can fill up the gap with the material matching the tooth color.
Mouthguard: For those who have a habit of clenching or grinding the teeth, the dentist fits a mouthguard to prevent further damage.
Toothpaste: There are certain kind of toothpaste which can help with tooth sensitivity and abrasion.
Orthodontics: Realigning the bite can also be helpful in preventing future damage, especially in those who fall in the low age group.
Make sure to get aware of all the options and the risk involved with them beforehand. The cost of the treatment also varies, so ask the dentist about it.
Use the toothbrush, toothpaste and the mouth rinse advised by the dentist. Ask the dental hygienist to instruct the proper brushing technique to prevent further damage.
Gum recession is a common problem with abfraction which can further lead to loosening of the tooth or tooth loss, it is, therefore, important to seek treatment for the condition.