January 22, 2007

Tooth Abfraction Lesions


Abfraction lesions are small cracks or notches in your teeth caused by chewing. Each time you clench your teeth, chew or bite down on something, pressure is put on your teeth. Eventually, this pressure can cause the enamel to crack and split.

Abfraction lesions can show up as notches on the chewing points (cusps) of a back tooth. They also show up as lines or cracks in the enamel of a tooth. They can be seen if you shine a flashlight or bright light on your teeth and look in a mirror. The lines usually run up and down (vertical) for the length of a tooth. You also can have cracks in the neck of a tooth (the part closest to, or just under, your gums).

People who grind their teeth are more likely to get abfraction lesions because their teeth are subjected to repeated pressure when grinding.

Abfraction lesions are relatively common in adults, especially older adults. They occur more often in premolars and molars, but they can occur on any tooth.

Teeth with abfraction lesions are not more likely to decay, but they can weaken over time and be at a higher risk of fracture.

Abfraction lesions are not painful. They affect only the enamel (outermost) layer of the tooth, although sometimes the dentin (middle layer) can be exposed, which can cause tooth sensitivity. Otherwise, the lesions do not cause symptoms.

Your dentist can see abfraction lesions during a regular dental exam.

Expected Duration
Abfraction lesions do not heal over time. Some may worsen, but in most cases they do not need to be treated.

Abfraction lesions happen due to the natural wear of your teeth. There usually is no way to prevent them. If you grind your teeth, you can wear a night guard to reduce the pressure on your teeth.

Many abfraction lesions do not need treatment. Whether to treat the lesions depends on where they are, how many there are and other factors. If your dentist notices that your bite (the way your teeth come together) puts increased pressure on certain teeth, he or she will correct your bite to reduce this pressure.
Treated lesions are filled with composite material or glass ionomer cement. This procedure sometimes is similar to filling a cavity. In other cases, the tooth does not need to be drilled first.

Sometimes abfraction lesions increase the risk of tooth fracture, and treatment will strengthen the teeth. Some people may think the lesions are unattractive and ask their dentists to cover them. However, in most cases the lesions do not cause problems, and it is up to you and your dentist whether they should be treated.

When To Call a Professional
If you notice abfraction lesions, you do not need to call your dentist right away. You can point them out at your next appointment. However, if the lesions are causing tooth sensitivity, or if they are obvious enough to make you feel self-conscious, you can make a special appointment to have them examined.

A cracked tooth is a more serious situation than a tooth with abfraction lesions. Deep cracks that affect the pulp of the tooth are painful, and these teeth need immediate treatment.

Adapted from: Columbia University Medical Center, School of Dental & Oral Surgery