Tooth abfraction


Abfractions are notches on teeth that develop along the gum line, which are not caused by decay. These lesions develop as the result of mechanical stress due to excessive pressure when teeth bite together. This condition is often seen in people who have a bad bite and people who grind and clench their teeth.  Other potential factors include regular biting of hard objects (ice cubes, nails, pen caps, etc.), ill-fitting fillings, crowns or bridges.

Teeth are not rigid structures, reason why they can flex when submitted to extreme pressure, resulting in tooth wear. Use of a hard toothbrush, vigorous brushing technique and regular exposure to acids from food and drinks can cause even more damage.

Dental abfraction



Because teeth bite together in an unbalanced way when there is a bad bite, it generates undue pressure on certain areas. The enamel is the hard layer that covers the crown; the cementum is less hard and it covers the root. The root is covered by the gum, however, it be exposed when the gum recedes.

Over the years, the excessive forces can cause enamel and cementum to loose minerals and break down. If not treated, the conditions progresses to expose dentin, which lies underneath enamel and cementum. Due to its softer nature, dentin wears out quicker than enamel, resulting in the indentations. The forces concentrate at the gum line, reason why those are the areas that typically develop abfraction.

With tooth grinding, even more pressure is put on the dental structures, more than they were built to handle. Grinding usually takes place during the night as an unconscious habit that can last for hours on end, hence the increased risk for tooth abfraction.



Abfractions are not unusual in adults and, if left untreated, the lesions can become deeper, affecting dentin and eventually the tooth nerve, with the potential to cause pain and lead to tooth loss.

The treatment needs to address the lesion itself and the cause of the abfraction. Sensitivity and esthetic concerns also need to be taken into account.

The most common treatment is the filling of the notched out areas with composite resin, which blends well with the natural color of the tooth.



Although the treatment options discussed above can limit the progression of dental abfraction lesions, they do not eliminate their primary cause.

Since most cases of dental abfraction have a component of excessive biting forces, it is advisable to correct and balance the bite to avoid serious consequences. A bad bite is not only bad for the teeth and bones, but it also has negative effects in the jaw joint, ears, eyes, posture and muscles of the head, neck, shoulders and spine areas.

Hence, adjustment of the bite and correction of misaligned teeth through orthodontic treatment is the ultimate solution. Restorations, rotated, tilted and crooked teeth, as well as problems with the relation between the jaws can cause a bad bite.

With clear aligner therapy, teeth and jaws can move into their ideal position in a subtle way. This option is more convenient for adults, as it does not affect cosmetics or everyday life. The devices are clear and discrete; they are simply removed during meals and oral hygiene.

The process is straightforward: with the help of a special computer program, your teeth are digitally scanned and your treatment is planned step by step on the computer. You can visualize the final result even before you put the devices in your mouth.

If bruxism is present, a customized mouth guard can help improve the distribution of the forces and protect the teeth from wear.

Your dentist can easily recognize dental abfraction, so do not wait until it is too late. Get regular check-ups, correct your bite and your smile at once. Invest in your health!