September 15, 2020

Don’t get nervous, this isn’t a mathematics article.  Abfractions are a common finding in middle aged to older adults.  We often notice grooves at the necks of the teeth near the gum line, especially if there is some gum recession.  These are usually not symptomatic, although some patients notice some cold sensitivity.  What makes them appear?

Well, there are a couple of theories, and in reality, the cause is probably a combination of both.  In the past, the cause was often attributed to toothbrush abrasion.  Scrubbing with a stiff brush and some of the older type coarse toothpastes could cause this type of problem, but it was thought that would lead to a generalized condition.  Often, we see this effect on just a few teeth or even just one tooth.  How can we be overbrushing just one tooth?  It turns out that many of us do indeed spend more time scrubbing just one or two areas and according to one researcher, the toothpaste abrasives are to blame.  The bottom line; Stop scrubbing and use a very small amount of toothpaste.

The other theory is that slight flexing of these teeth when they function in the bite will cause the enamel to fracture microscopically at the neck of the tooth.  These add up over time to cause these grooves.  This is magnified in teeth that are in heavy bite contact, or in individuals who routinely grind their teeth together.

When the damage gets great enough, your dentist may decide to recommend bonding to fill the void and prevent a nerve exposure.  If the tooth has other fillings, a crown may be the treatment of choice.

Thanks to today’s modern restorative techniques, filling these defects is easier and more esthetic than ever.  Instead of needing to prepare teeth with deep undercuts so that fillings would have a mechanical lock to stay in, we can do a minimal amount of cleaning of the surface and simply bond a beautiful tooth colored restoration in place.  These will often last for many years, especially if the cause of the defect is discovered and eliminated.