Abfraction would not be rolling off many non-dentist tongues, in my best guess on the matter. Some would speculate it to be some obscure mathematical term to do with fractions. However, they would be wrong on that score. Abfraction & abfraction lesions: What are they? Abfractions are to do with grinding and clenching your teeth. These legions are notches on the teeth, which occur along the gum line. Mechanical stress causes these abfractions because of the excessive grinding pressure of teeth biting up against each other. A bad bite just makes the situation worse and can be a major contributory factor.

“Abfraction is a type of noncarious cervical lesion (NCCL) characterized by loss of tooth tissues with different clinical appearances. Evidence supports that abfraction lesions, as any NCCLs, have a multifactorial etiology. Particularly, the cervical wear of abfraction can occur as a result of normal and abnormal tooth function and may also be accompanied by pathological wear, such as abrasion and erosion. The interaction between chemical, biological, and behavioral factors is critical and helps to explain why some individuals exhibit more than one type of cervical wear mechanism than others. In an era of personalized dentistry, patient risk factors for NCCLs must be identified and addressed before any treatment is performed. Marked variations exist in dental practice concerning the diagnosis and management of these lesions. The lack of understanding about the prognosis of these lesions with or without intervention may be a major contributor to variations in dentists’ management decisions.” – Nascimento MM, Dilbone DA, Pereira PN, Duarte WR, Geraldeli S, Delgado AJ.
Abfraction lesions: etiology, diagnosis, and treatment options. Clin Cosmet Investig
Dent. 2016 May 3;8:79-87. doi: 10.2147/CCIDE.S63465. PMID: 27217799; PMCID:
PMC4861607.

Abfraction & The Bad Bite

In the halls of dentistry, when we talk about a bad bite, we are not referring to problems with vicious dogs or short sighted vampires. No, we are returning to the dental heartland, where functionality lords it over form. We, dentists, have built our foundation around the bite, the perfect clenching together of those two opposing rows of teeth, the dental arches. These architectural wonders found in the jaws of most mammals and, indeed, many animals come together to rip, grind, and tear. This is the mighty bite, upon which, predators depend upon to get the job of feeding themselves done. A bad bite. A misaligned bite can cause all sorts of problems. Not the least of, are abfractions and abfraction lesions.

Identifying Where Abfractions Occur

The term ‘cervical’ in dentistry refers to the narrowing of the contours of the surface area of the tooth. Particularly where the crown of the tooth meets the root. The cervical margin of the tooth is identified as the surface area above the junction of the crown and the root. This is akin to both the apical and gingival parts. Abfraction is a certain type of damage to the tooth, which happens near the gumline.

The Roots Of Teeth

Hands up among readers who have had a tooth removed and a large molar in particular. These beauties are prodigious specimens with deep roots and look prehistoric to my eye, especially when viewed outside of their natural home. Once removed from the depths of the lower arch in the jaw, one is reminded of ancient creatures and savage predators. The length of these with root is impressive and puts one in mind of great carnivores. Teeth are, in many ways, our roots to our evolutionary past, the great apes. When we bite down hard into things the force released via the jaw is incredibly powerful. The human jaw is capable of exerting a force of 125kg in a single bite. A bad bite, therefore, can cause all sorts of problems like abfraction lesions.

Defining Abfraction & Consequences If Untreated

The damage to the tooth is usually in the shape of a V or wedge shaped, and most importantly is not related to a cavity. Getting little bits of food stuck in the wedge is another means of identifying a possible abfraction. Tooth sensitivity can result from abfraction, which can give you trouble with hot and cold foods and drinks. Chipping of the tooth surface can, also, occur and loss of enamel and exposing the dentin. The dentin is the soft pulpy stuff within your tooth. Bacteria can become a problem and infections can then cause more serious health issues to arise. Losing the tooth is another unfortunate fate awaiting the untreated abfraction lesion.

Bruxing or Teeth Grinding

If you are partial to grinding your teeth in your sleep or clenching and grinding whilst awake, then, abfraction is a common outcome. A bad bite or malocclusion can make things worse on this front. Getting older makes abfraction more likely according to statistical studies. Stress is a common cause of bruxism, as individuals grind their teeth in frustration. Your dentist can help you identify what might be happening in your specific circumstances. Dentists deal with this problem all the time and have proven pathways to treat and prevent bruxing in the future.

Eating Disorders & Acid Reflux

In addition to those causes already mentioned, acidic environmental factors can contribute to your teeth being damaged and prone to abfraction. Eating disorders, which cause the subject to not eat or binge eat and then vomit excessively produce stomach acid, which eats the enamel off teeth. Similarly, a highly acidic diet with lots of soft drinks, citric juices, and alcoholic drinks can, also, contribute to the damage to the surface of teeth. Certain medications exacerbate dry mouth and result in similar outcomes as well. Talk to your dentist about such things for best results in treating abfractions and dental problems of this nature. Utilise the expertise available at your local dental practice for help in reducing the likelihood of these issues causing further problems.

Receding Gum Issues & Abfraction

“Tooth grinding or biting with an unstable bite can affect the gums as well as the tooth. It’s not unusual to have receding gums with abfraction. Over time, as the gums continue to pull back, root surfaces can become exposed. This combination can cause extreme tooth sensitivity and tooth pain. Without treatment, abfraction and abfraction lesions can lead to loosening of the tooth or tooth loss.”
– Healthline 

Abfraction & Erosion

Abfraction is different from erosion and abrasion. Erosion is the just the general wearing away of the tooth enamel. Erosion is caused via a chemical reaction on the surface and subsurface of teeth. It is usually the acid content in our own saliva, which is the culprit. Of course, your diet impacts this greatly, as does lots of vomiting. Bulimics and heavy drinkers take note of this.

Tooth abrasion most often occurs on the teeth nearest your cheeks – this is called the buccal side in dental-speak. Abrasion is a flat form of damage, whereas abfraction is V shaped. Abrasion is the result of friction generated by such things as fingernails, pencils, mouth piercings, or a hard toothbrush or abrasive whitening toothpastes.

Your Dentist Is Watching Out For You

When you think about it there are plenty of things that can go wrong within our oral cavity. Luckily there are dentists to bear this mental load. This is just another reason to ensure that you visit your local dentist for regular checkups. This is especially relevant, as we get older and old man time ups the ante when it comes to treating us badly. Like a car, when it reaches a certain age, usually around 7 years old, everything starts to loosen and break down. Do yourself a favour and consult with your dentist before things become an emergency – it will save you both pain and money.

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