What are dental abfractions and what should be done about them?

Abfractions are erosive lesions found on the necks of individual teeth associated with continuing bone loss, gingival recession and erosion of tooth structure. The cause is still being debated. At this point the cause is generally multifactorial but in part the lesion is caused and aggravated by sideways forces placed on the tooth by the tooth in the opposing jaw. This force causes bending to take place at the neck of the tooth, that results in bone loss, reseeding gums and erosion at that area of the tooth. Once the enamel covering of the tooth is lost for any reason the exposed dentin naturally erodes. This exposed dentin is softer than enamel and therefore will erode faster once exposed. Some people relate this to “tooth brush abrasion”, which is one of the causes for faster erosion. One good solution for dental abfractions or “toothbrush abrasion” is for Dr. Davis to place a bonded composite restoration to cover these exposed erosion surfaces. This effectively seals the abfraction and tends to limit the extent of further erosion. The resultant restoration, not only prevents further deterioration, but also improves the appearance of the teeth. Only minimal preparation of the abfraction defect is required, since it is only used to increase the retention of the bonding surfaces that will help keep the bonding in place. The good thing is, most times no anesthesia is needed for the patient if he or she is not experiencing any discomfort in that area to begin with.

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