What is a tooth abfraction lesion?

Tooth abfraction lesions are fascinating yet problematic conditions in dental health. These lesions are characterized by the loss of tooth structure at the gumline. Unlike cavities or decay, tooth abfraction lesions are not caused by bacterial action. Instead, they are believed to result from biomechanical forces exerted on the teeth. This occurs when there is flexing and bending of the tooth under stress, often as a result of clenching or grinding teeth, a condition known as bruxism. The result is small, V-shaped notches or grooves that appear on the teeth near the gum line. These lesions can vary in depth and size and are often found on the outer surfaces of the teeth. They may initially be asymptomatic but can lead to sensitivity and an increased risk of tooth damage if left untreated.

The causes of tooth abfraction lesions are multifactorial and can be traced to a combination of mechanical and environmental factors. The primary cause is believed to be the abnormal stress exerted on the teeth due to occlusal forces. This means that when a person bites down, chews, or grinds their teeth, especially with excessive force or in an abnormal manner (as seen in bruxism), it can lead to minute flexing at the tooth's cervical region (near the gum line). Over time, this repeated stress causes the enamel and underlying dentin to flake away, forming the characteristic lesions. Other contributing factors include aggressive tooth brushing techniques, which can exacerbate the wear on already weakened areas, and misaligned teeth or an uneven bite, which distribute bite forces unevenly across the teeth. Furthermore, age-related wear and tear and certain acidic diets can also play a role in the development of these lesions.

The treatment of tooth abfraction lesions is tailored to the individual's needs and the severity of the condition. The first step is often managing the underlying cause, such as addressing bruxism with night guards or treating misalignment with orthodontic interventions. When it comes to repairing the lesion itself, dental bonding is a common and effective treatment. Here, a tooth-colored resin material is applied to fill the notch and restore the tooth's shape. This not only improves aesthetics but also protects the tooth from further damage and sensitivity. In cases where the lesion has led to significant tooth structure loss or if there's a risk of tooth fracture, more extensive restorative treatments like crowns may be necessary. It's also essential to adopt a gentle tooth brushing technique and possibly switch to a softer toothbrush to prevent aggravation of the condition. Regular dental check-ups are crucial for monitoring the progression of the lesions and adjusting treatment as needed.