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A 38-year old patient, whom we will refer to as Kevin, came to the Cosmetic
Dentistry Center because his teeth were becoming extremely sensitive to cold
water and air. He explained he had first noticed this one night several weeks
back while drinking ice tea, and that the condition had become increasingly
worse and painful, not only when he drank something cold, but even when he
breathed in cold air while running in Memorial Park in the morning. He also said
that his wife had woke him up a number of times in the past few weeks, telling
him that she had heard him grinding his teeth in his sleep. Kevin was afraid
that he might have an abscess and require a root canal. We were more optimistic,
because his symptoms sounded more like dental abfraction.
Both sensitivity to cold and the grinding of his teeth (a condition called
Bruxism), are symptoms of dental abfraction—an all too common condition where
the teeth at or below the gum line become notched. This causes heightened tooth
sensitivity and discomfort, and, depending on the degree of dental abfraction,
can result in conditions such as bicuspid drop-off, worn anterior teeth that
become frayed around the edges, gingival recession, exposed dentin, and bruxism.
Dental abfraction is caused by teeth that are not perfectly aligned. One tooth
impacts the opposing row of teeth sooner than the rest, causing too much stress
on that individual tooth. This causes enamel to separate from the inner dentin
layer and created notches at or below the gumline.
Milder cases of this syndrome can often be treated with something as simple as
conservative topical treatments of either fluoride gel or Sensodyne tooth paste.
These treatments can be applied with custom, flexible trays to fit the patient’s
mouth and applied for 20 minutes each day. Other, more severe cases, however,
may call for more aggressive forms of treatment. In Kevin’s case, we simply
would not know until we conducted a thorough case history study and intraoral
analysis of his teeth.
When Kevin arrived, the first thing we did was to pull up his medical history on
the computer. Each of our dental treatment rooms has one or more computers that
allow us to conduct his type of preliminary research. Kevin’s medical history
revealed that he had been involved in a minor accident where he had been hit in
the mouth by a falling object. Although he bled severely enough to require
stitches, he had not lost any teeth, so he had assumed it was only his lip that
had been cut in the accident. Actually, some of his teeth had been knocked
slightly out of alignment. This had not altered the appearance of his smile or
caused noticeable pain when he chewed, but over time, it had eroded two of his
teeth with severe dental abfraction.
Another advantage that the Cosmetic Dentistry Center offers is the ability to
closely examine teeth and gums with an intraoral camera that produces an
exceptionally high-resolution, full-color image of the teeth and gums so we can
make accurate diagnoses of otherwise mysterious ailments. In Kevin’s case,
intraoral examination revealed a very acute case of gingival recession and
dental abfraction below the receding gum line. Both tooth roots were also
exposed, and revealed themselves to be the source of his pain. While it is true
that abfraction can result in an exposed nerve that then becomes inflamed, this
does not always mean that the root is dying and requires removal. Under close
examination, we discovered both tooth roots to be only inflamed, but otherwise
alive and healthy.
This level of precise diagnosis would not have been possible without the help of
advanced technology, which in turn allowed us to make a precise and accurate
diagnosis of the severity of Kevin’s dental abfraction. At the end of the day,
we were able to circumvent a full root canal in plenty of time, and apply
tooth-colored, bonded filling material over the surfaces of both roots.
Since then, Kevin’s’ symptoms have disappeared, and further topical treatments
of Sensodyne have successfully reversed much of the gingival recession that
resulted from his dental abfraction.
If, after reading Kevin’s story, you fear that you may be suffering from dental
abfraction because of recent sensitivity, receding gums, or Bruxism, please call
us today to schedule an appointment.
Cosmetic Dentistry is a
specialized field that requires extensive knowledge and experience to be done
correctly. The Medical Center Dental Group in Houston, Texas brings all of that
and more to the direct benefit of each and every patient we treat. Although we
are located in the world famous Houston Medical Center at Scurlock Towers, we
routinely see dental patients who travel from Austin, San Antonio, Dallas, San
Antonio, Brownsville, El Paso, Fort Worth, Corpus Christi, Beaumont and Midland
Texas to see
Dr. Dale Brant,
Dr. Charles Campbell or Dr. Elizabeth O’Sullivan-Winslow for their cosmetic
denistry services.
Regional Cosmetic Dental Area Coverage
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