Abfraction

What is Abfraction?

When your bite is slightly off, or you have parafunctional habits, as seen in grinding or clenching,  it’s common some teeth may hit more heavily than the rest. This causes undue stress on the involved teeth and they begin to flex. It’s this continual flexing and stress that, over time, causes the enamel to separate from the inner dentin layer, resulting enamel sheering forming a distinct pattern along the sides of the teeth. 

 

How Do We Correct Abfraction?

There can be three steps involved in solving the abfraction problem. First, we may need to adjust the way you bite. This may be limited to only the teeth in question, or we may have to adjust all your teeth. For balance and occlusal harmony, chewing forces must be evenly distributed among all your teeth. An uneven bite can lead to stress and subsequent clenching.  This occlusal adjustment may take a couple of visits to re-train you muscles to a new balanced bite. The second phase may involve restoring the damaged/missing enamel by using composite restorations and bonding them to the remaining tooth. White, natural looking fillings can fill in the damage and restore the tooth to nearly its original color and shape. Lastly an occlusal bite splint or guard is fabricated to prevent further enamel fracture or damage. 

 
Abrasion - What Causes It?

Abrasion is the commonly seen condition of notching of the teeth near or even under the gum line. There have been many variables thought to cause this notching into the side of tooth.  Brushing technique, brushing too hard, too hard of a toothbrush or even clenching and grinding can be causes.   Many times this enamel loss will cause sensitivity in the tooth to cold or sweet liquids or with stimulation like at a cleaning appointment. 

 
How Do We Manage Abrasion?

Depending upon the level of sensitivity and the depth of the notching into the tooth, over-the-counter desensitizing toothpastes will help control the sensitivity.  These must be continually applied in order to stay effective.  Prescription based high fluoride/high desensitizing toothpastes can help in cases of moderate sensitivity.  Restoratives may also be an option to eliminate or greatly reduce sensitivity.  By placing composite restorations into the notched areas the sensitivity is controlled and the tooth is protected from further abrasion by brushing the restoration instead of the tooth.