The term dental abfraction refers to the entire complex situation that leads to a tooth lesion. The definition also includes much of the tooth sensitivity that we see in our dental office. Areas at the gumline near the base of teeth are often sensitive, so it is a common complaint for us to hear about discomfort in this area.
Patients will also complain of cold sensitivity around the necks of their teeth. This was once called toothbrush abrasion, but the cause is more complicated than that. It is primarily caused the flexing of the teeth in people who suffer from Bruxism (teeth grinding).
The extreme forces that cause dental abfraction typically lead to several other problems. The most common of these problems is detailed as follows:
1. Abfractions
2. Sensitive teeth
3. Loosening of teeth
4. Excessive wear of teeth
5. Change in alignment of teeth
6. Bone breakdown and bone loss
7. Broken or destroyed restorations
8. Non-bacterial, non-plaque related gingival recession
9. Opening of contacts
There is a range of treatment options for dental abfraction, depending on the patient and the severity of the problem.
Care should center on efforts in the direction of management of forces, this is the most dominant factor in this multifactorial problem.
When there is only a small amount of tooth structure gone from the neck of the tooth, and there is minor tooth sensitivity to cold, then there is little or no procedural treatment necessary for dental abfraction. A dental professional may recommend occlusal equilibration, which essentially means taking steps to adjust a persons bite. Aside from that, dentists encourage more proactive dental self care, such as dental varnishes, topical fluoride, and Sensodyne tooth paste.
More aggressive dental abfraction treatment is typically needed when we encounter significant sensitivity to cold. This state of the condition also usually involves soft tissue recession and visible loss of tooth structure. In addition to self care at home and bite adjustment, a dentist may fit the patient with an acrylic guard to prevent bruxism. Also bonding materialmay be placed over the root surface to cover and protect it.
In severe cases, dentists often find root sensitivity that is severe and irreversible. Dentists may have to use dental bonding resin to fill the fracture in teeth, or crown the tooth for advanced coverage. Root canals are sometimes needed for such cases as well in order to save the function of the tooth even if the life of the tooth cannot be saved.
Several types of filling materials can be used, depending on the severity of the case and the discretion of the dentist.
1. Composite resins
2. Flowable composite resins
3. Glass ionomers
As with many medical conditions, the complexity of the problem often determines both our perspective on the problem and the approach taken to solving it. In the case of abfraction, more needs to be considered than simply what material to use as filling. An overall approach to tooth health is needed to bring lasting change and improvement to the patient.
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