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Abfractions damage teeth

Abfractions are V-shaped indentations in the tooth structure near, or even under, the gum line, usually on the cheek side of the tooth. This may cause the tooth to be sensitive to cold or when touched at that area of the tooth.

Although all the causes of abfractions are not known, theories include improper forces on teeth caused by a misaligned bite or by grinding and clenching.

Some evidence suggests that using abrasive toothpaste, pressing too hard with a toothbrush while brushing, or not using a soft toothbrush can also be a cause.

Medical conditions such as acid reflex or gastroesophageal reflux disease, also called GERD, may also be contributors.

Causes and treatments

Abfractions could be caused by the following:

  • improper forces on teeth from a misaligned bite
    When your bite is slightly off, one tooth may hit sooner than the rest. This causes undue stress on the involved teeth, and they begin to flex. Over time, this continual flexing and stress causes the enamel to separate from the inner dentin layer of the tooth, forming a V-shaped indentation at the gum line.

    If your bite is off, we may smooth areas down so that chewing forces are evenly distributed among all your teeth.

  • Grinding and clenching Tooth grinding and clenching
    also place extra stress on teeth.

    If tooth grinding or clenching is the problem, we may prescribe a mouthguard to absorb those stresses and protect your teeth.

  • Toothpaste abrasionThe way you brush your teeth could be the problem. The abrasive ingredients in some toothpastes, often combined with aggressive brushing action, may gouge out a V-shaped indentation in the tooth's enamel.
    If we suspect you are brushing too hard, we recommend that you brush lightly, holding the brush with two fingers, and only use a soft toothbrush. We may recommend an electric toothbrush to remove the force that you may be using when brushing.

    Only use toothpastes that have been approved by the American Dental Association

  • Medical conditions If you are experiencing acid reflux or have GERD, it is necessary to indicate this on your medical history. Once the cause of the abfraction is addressed, and depending on the severity of the abfraction, we may restore the tooth by bonding a tooth-colored restoration, or recommend a gum graft or a desensitizing agent for sensitivity.

    A mouthguard may be necessary to alleviate the condition from grinding and clenching.

    Diagnosing abfractions early can prevent further damage to your teeth and restore your beautiful smile and good health.

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