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The term “dental abfraction” refers to the entire complex situation that leads to a tooth lesion. The definition also includes much of the tooth sensitivity that we see in our dental office. Areas at the gumline near the base of teeth are often sensitive, so it is a common complaint for us to hear about discomfort in this area. Patients will also complain of cold sensitivity around the necks of their teeth. This was once called “toothbrush abrasion”, but the cause is more complicated than that. It is primarily caused the flexing of the teeth in people who suffer from Bruxism (teeth grinding).
The extreme forces that cause dental abfraction typically lead to several other problems. The most common of these problems is detailed as follows:
1) Abfractions
2) Sensitive teeth
3) Loosening of teeth
4) Excessive wear of teeth
5) Change in alignment of teeth
6) Bone breakdown and bone loss
7) Broken or destroyed restorations
8) Non-bacterial, non-plaque related gingival recession
9) Opening of contacts
There is a range of treatment options for dental abfraction, depending on the patient and the severity of the problem.
We focus our efforts in the direction of management of forces, as we believe this is the most dominant factor in this multifactorial problem.
Minor Involvement
When there is only a small amount of tooth structure gone from the neck of the tooth, and there is minor tooth sensitivity to cold, then there is little or no procedural treatment necessary for dental abfraction. We may recommend occlusal equilibration, which essentially means taking steps to adjust a person’s bite. Aside from that, we encourage more proactive dental self care, such as dental varnishes, topical fluoride, and Sensodyne tooth paste.
Moderate Involvement
More aggressive dental abfraction treatment is typically needed when we encounter significant sensitivity to cold. This state of the condition also usually involves soft tissue recession and visible loss of tooth structure. In addition to self care at home and bite adjustment, we may fit the patient with an acrylic guard to prevent bruxism. We may also place bonding material over the root surface to cover and protect it.
Advanced Involvement
In severe cases, we often find root sensitivity that is severe and irreversible. We may have to use dental bonding resin to fill the fracture in teeth, or crown the tooth for advanced coverage. Root canals are sometimes needed for such cases as well in order to save the function of the tooth even if the life of the tooth cannot be saved.
The Bonding or filling material used in the treatment of abfraction may vary.
Several types of filling materials can be used, depending on the severity of the case and the discretion of the dentist.
1. Composite resins
2. Flowable composite resins
3. Glass ionomers
As with many medical conditions, the complexity of the problem often determines both our perspective on the problem and the approach we take to solving it. In the case of abfraction, more needs to be considered than simply what material to use as filling. An overall approach to tooth health is needed to bring lasting change and improvement to the patient.
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, Beaumont and Midland Texas to see Dr Dale Brant, Dr. Charles Campbell or Dr. Elizabeth O’Sullivan-Winslow for their cosmetic denistry services.
For any other questions related to cosmetic dentistry, you can Contact Us at 713.795.5905, visit our Dental Blog or Ask the Dentist. Seek professional care on a regular basis as well. Some things, such as teeth cleaning and a full oral examination, can only be done in a dental office.
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