Over the years, I’ve been impressed by the number of dental terms that have become a household name. My patients often enter the practice already educated on the issues they’re experiencing and are one step ahead of me in understanding their treatment options.
One term that has yet to reach this level of name recognition is a dental abfraction. A dental abfraction is identified as a small notch in the tooth just above the gumline. An abfraction is a weak part of the tooth that is caused by excessive force or collisions. This force slowly chips away at the enamel and creates visible notches in your teeth that are seen by the naked eye.
To better understand what causes notches in your teeth – think of the tooth’s enamel as tile and the dentin beneath the enamel as wood. If your wood subfloor starts to warp or bend, there’s only so much force the tile can take before it buckles and warps. In the same way, your tooth’s enamel can only take so much force before it changes shape.
What causes dental abfractions?
Dental abfractions are caused by excessive force to the tooth. This can be from the top and bottom teeth colliding, or from clenching and grinding the teeth. In some cases, excessive brushing can also cause notches to form in your teeth.
If you have dental abfractions, an acidic diet or GERD can make them worse. That’s because the abfraction lesion exposes the softer part of the tooth. This makes it more susceptible to erosion from acid. The acid component of abfractions is important to understand because whether you’re getting it from your diet or your body, it must be addressed.
Do dental abfractions cause pain?
For the most part, people with notches in their teeth will not know they are there. However, sometimes abfractions do cause sensitivity. Typically, a patient will think they have a cavity because they have tooth sensitivity and may notice a small hole in their tooth. However, the idea that cavities cause sensitivity is a myth and most people will have an abfraction.
Abfractions can also come with gum recession with may cause sensitivity. It’s common to have both because when force affects the tooth it also affects the nearby gum tissue.
Can I prevent notches in my teeth?
The best way to prevent dental abfractions is to move the teeth to prevent collisions. If they are colliding because of their current placement – adult orthodontics or Invisalign are great treatment options. When the teeth fit together better, there is less of a chance of new abfractions forming. Addressing tooth grinding is also recommended.
In addition, it’s important to limit the amount of acid in your diet or treat any underlying health issues like GERD. Sports drinks and lemon water are some of the biggest culprits. The viral trend of drinking apple cider vinegar (ACV) can also be incredibly damaging to your teeth. Patients tell me that drinking ACV whitens their teeth, but in fact they are stripping the tooth of its enamel and exposing the dentin which is whiter.
When do you treat a dental abfraction?
Typically, we will discover an abfraction during a regular hygiene appointment. We will look at the size of the lesion and the recession in that area and determine the best course of treatment.
There are three reasons to treat an abfraction:
- You are experiencing tooth sensitivity.
- You don’t like the way that the tooth looks
- It’s taking away from the tooth structure.
If the abfraction is small, we will watch it over several months and see if it grows. Filling an abfraction that is too small is counterproductive because it will add volume to the tooth. What we are looking for is the tooth to reach a critical point where it is better to fill it than leave alone.
How do you treat notches in teeth?
To treat a dental abfraction, your dentist will add composite to the tooth to fill in the notch. Previously, this was done with bonding but today our office is uses Bioclear. Bioclear restorations integrate seamlessly with the tooth structure and last from five to seven years. Bioclear also requires less maintenance than a crown or bonding.
What happens if you don’t treat an abfraction?
If for some reason you do not treat an abfraction – or perhaps it’s been several years since you’ve been to the dentist and don’t know you have one – it will continue to grow, and the enamel will wear away. The longer you wait to treat an abfraction, the more tooth structure you will lose. This will make the tooth weaker and harder to repair.
Remember, there is a critical point that must be reached to treat an abfraction, but once we reach this point it’s important that you seek treatment.
See Dr. Saylor for a Free Consultation
I hope that this information will help make dental abfractions a household name. And, if you’re looking to treat a notch in your tooth that you feel empowered to ask your dentist about treatment options and timing. If you’ve noticed a notch in your tooth recently, call our dental office in Brandon, FL at (813) 689-4226 or click here to schedule an appointment.
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