Abfraction Lesion: Causes and Treatment

Abfraction lesions are lost tooth structure. The lesions occur gradually, making the tooth appear to vanish over time. They appear as wedge-shaped notches at the cementum-enamel junction (CEJ). Abfractions are not cavities, but instead non-carious cervical lesions, or NCCL. However, because it exposes the softer portions of the teeth, like dentin, it can cause tooth sensitivity and mimic the symptoms of a cavity. Discovering the cause or causes is an important first step to treatment and management.

Causes of Abfraction Lesions

The lesions have been attributed to mechanical stress from chewing function or teeth grinding. An appliance or night guard can protect the teeth from further wear. However, Clinical, Cosmetic and Investigational Dentistry recognizes that chemical, biological and behavioral factors may all contribute to the cause of the lesion.

Erosion and abrasions can also contribute, for example. Erosion occurs from exposure to acids, such as from acid reflux or acidic foods and drinks. Rarely, exposure to acids in the workplace can be a cause of tooth erosion. Abrasions, on the other hand, are attributed to improper tooth brushing and the use of abrasive toothpastes. This combination causes gum recession and exposes the softer, less mineralized parts of the teeth called the cementum and dentin.

According to the International Journal of Oral and Maxillofacial Pathology, mineral loss from acidic and abrasive factors initiates the abfraction, and stress from the bite deepens the lesion over time.

Treatment for Abfraction Lesions

Proper treatment for an abfraction is based on the severity of the lesion as well as reported sensitivity and aesthetic concerns. A dentist will generally fill the lesion when it extends below the gums, becomes decayed or difficult to clean, or exposes the pulp or nerve of the tooth. This reduces sensitivity and restores the tooth structure. The dentist can use composite or tooth-colored fillings to cover the notches to improve the smile's appearance.

Your dentist and dental hygienist are trained to recognize and modify risk factors for abfractions. If you have an NCCL, they will monitor it and provide suggestions for controlling the occasional sensitivity that the lesion may cause.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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