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Dental abfraction: what it is and treatment

by Alivia Nyhan
Published: Last Updated on

There are various situations that can affect the structural integrity of our teeth, making them prone to significant enamel loss and even considerably increasing the risk of fracture. The most common is the well-known dental caries, which produces a destruction of enamel by the action of bacteria in our mouth, however, there are other conditions that produce a loss of tooth structure as a result of other mechanisms.

Among these, one of the most common is dental abfraction, which affects a large number of people without their being aware of what is happening. In this FastlyHealarticle we will explain everything about dental abfraction: what it is and its treatment , so that you learn to identify the characteristics of these injuries.

What is dental abfraction

Dental abfraction is considered a lesion of structural loss of the tooth that, unlike dental caries, is not the result of a colonization of bacteria on the tooth surface but is due to a constant mechanical trauma to the teeth due to a excess bite force on these.

There are other conditions that fall under the classification of non-carious lesions and that therefore can cause loss of tooth structure that resembles dental abfraction. These are:

  • Dental abrasion : It occurs due to a constant friction of an object on the surface of the teeth. It can be seen for example in people who use toothbrushes with very hard bristles for a very long time and who have an inefficient brushing technique, in people who bite their nails or other objects, and in people with poorly adapted dental prostheses.
  • Dental erosion : In this case, the structural loss is not the result of mechanical irritation, but rather due to the action of acidic substances that wear down the enamel after prolonged exposure. These substances can be contained for example in natural citrus juices, soft drinks and these lesions can also be seen in people who suffer from gastroesophageal reflux .
  • Dental attrition : It is a physiological process in which the teeth suffer wear due to use, especially during childhood, to allow the adaptation of some teeth with others. When this situation continues for many years, an excessive loss of the tooth surface begins to occur.

Causes of dental abfraction

Although the teeth represent the most rigid structure of our body, even more than the bones themselves, when subjected to constant bite forces the enamel of the tooth, the most superficial part of the tooth, flexes very slightly, producing micro chips in the region of the tooth. The neck of the tooth, which if continued long enough, begins to become evident as wedge-shaped cavities that can have a yellowish color as a result of the exposure of the dentin, the second layer of the tooth.

There are two main conditions that precipitate the formation of abfractions:

  • The first is bruxism , which represents a parafunctional habit in which affected people unconsciously exert excessive biting forces, especially during sleep, and which usually appears when the affected person is under stressful situations.
  • The second is the presence of an unbalanced bite , that is, the bite force is not well distributed over all teeth, so some teeth are subjected to a greater load. This occurs in people who have poor dental positions and in those with poorly adapted prostheses.

Symptoms of dental abfraction

Dental abfractions in many cases do not produce pain or any type of symptoms, because they are generally lesions that are limited to the enamel, and in other cases they have a very slow evolution that allows the adaptation of the teeth to their presence to avoid the pain. However, in some situations when the progression of the lesion is very rapid and reaches the dentin, the second layer of the tooth, symptoms of dental pain and sensitivity can occur , especially in the presence of cold foods and liquids.

By creating a surface where food can easily lodge and which can be difficult to clean, there is a risk that dental abfractions give rise to tooth decay , which can aggravate its evolution by now producing structural loss through two mechanisms.

When the lesions are very advanced and produce a significant dentin compromise, there may be a compromise of the pulp of the tooth, the innermost part of the tooth that contains its nerve and blood vessels. At this point, the irritation of the pulp can cause quite significant pain , or its infection.

Another risk of advanced abfractions is the possibility of fracture of the crown of the tooth at the neck level, which is a situation that is very difficult to resolve.

Treatment of dental abfraction

The treatment of dental abfractions depends on their characteristics. In general, a resin restoration is sufficient in most cases, however in cases of sensitivity, restoration with another type of protective material, such as glass ionomer, or a combination of these two materials, may be recommended. These restorations are usually quick, since there is no infected material as in the case of dental cavities, it is not necessary to wear the affected surface.

In cases where there is a compromise of the pulp, an endodontic treatment may be indicated before the definitive restoration.

It is important to try to reduce the impact of the situation that produced the abfraction , since if it continues with the same intensity, the restorations will be lost over time. If the abfraction is due to bruxism, the patient may be recommended to make a protective splint to protect the teeth, however it is even more important to try to control the emotional or stress factors that cause bruxism. In the following article we explain the home remedies for bruxism .

When abfraction is caused by an occlusal imbalance , an evaluation should be done to determine why it is. In general, the treatment of this situation involves the use of orthodontics, selective wear of the enamel of the tooth, and the making, replacement or adjustments of dental prostheses.

This article is merely informative, at FastlyHeal .com we do not have the power to prescribe medical treatments or make any type of diagnosis. We invite you to see a doctor in the case of presenting any type of condition or discomfort.

If you want to read more articles similar to Dental Abfraction: what it is and treatment , we recommend that you enter our category of Teeth and mouth .

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