A dental erosion (abfraction) is a loss of tooth structure in the root portion of the tooth which typically does not contain dental decay. In other words, they are non-carious (non-cavity) cervical tooth lesions. They are often angular shaped and have very straight edges. They can occur in the front or back portion of a tooth but are more prevalent on the front (buccal) surface of teeth. Patients may first become aware of these lesions by an increase in tooth sensitivity. This is because abfractions typically happen in close proximity to the internal tooth nerve.
If the gum tissue (gingival tissue) recedes around a tooth it exposes the root of the tooth. The root is made of cementum tissue which is much weaker than the crown portion of the tooth. When this exposed root is subjected to erosion forces such as acidity from drinks, abrasion from brushing, the root may wear inwards causing cervical tooth loss. There is also a high correlation between grinding or clenching forces and the presence of abfraction lesions. Most patients are surprised to hear this fact because there is no grinding which takes place of the abfraction surface. The theory behind this correlation is that the weaker or thinner abfraction area can micro flex in the presence of grinding and clenching.
If patients have abfraction lesions further damaged can be minimized by brushing gently and also avoiding long exposure to the root surfaces to acidic food and drink such as colas.
Fortunately, there is a simple but highly technique sensitive treatment for dental erosion. Many dentists have had mixed results with treating abfractions. Dr. Hawryluk explained the reason behind any less than stellar results relates to material selection and the technique used. Dr. Hawryluk Jr. at St. Lawrence Dentistry has treated these areas for many years and has refined the treatment technique. Dr. Hawryluk first cleans the area and then applies and root conditioner. This is followed by application of a dental bonding agent made by GC Corporation. Finally, a layer of 3M filtek supreme composite resin is applied. Very thin diamonds are used after the placement to shape the bondings. Finally, if Dr. Hawryluk determines the cervical tooth loss is related to how the teeth interrelate, conservative bite adjustment is sometimes done.
It is always best to treat dental erosion early before too much tooth is lost. If you suspect you may have a dental abfraction and you live in the Mississauga or Toronto area please call St. Lawrence Dentistry for an assessment.
Below are actual examples of abfractions treated by Dr. Hawryluk Jr.