Dental Implants: Pros and Cons

A Problem at the Base: Abfraction Lesions and Your Teeth

by Brett Clark

The loss of any of your tooth structure can be a cause for alarm. Your tooth is compromised and will continue to deteriorate, and it doesn't matter if the loss was due to an accident that damaged a tooth or if the loss was gradual and caused by tooth decay. Accidents and decay aren't the only ways in which you can lose tooth structure. When structure is progressively lost towards the base of a tooth, you might be experiencing an abfraction lesion.

At the Base of the Tooth

Abfraction lesions present as a small depression at the base of the tooth, near the gum line. It's similar to a cavity in that the surface enamel has become compromised, exposing the dentin underneath. They're generally visible, looking like patches of discolouration, although discolouration towards the base of a tooth isn't necessarily always going to be an abfraction lesion.

The Cementoenamel Junction

Without treatment, an abfraction lesion will continue to deepen, eventually leading to tooth loss. They're particularly problematic due to their location since they occur at the point where the tooth arguably needs to be strongest — towards its cementoenamel junction. This is where your enamel meets your cementum. This cementum is a tough, mineralised substance that protects the tooth's root.

A Combination of Factors

There's some debate as to what actually causes an abfraction lesion, and it's thought to be due to a combination of factors. General enamel erosion (tooth decay) can contribute to the issue, as can bruxism (excessively grinding your teeth). An improperly aligned bite can also play a role, as it places undue pressure on the tooth's structure.

Multistage Treatment

Just as the condition is caused by a combination of factors, a number of different treatment methods might be required for your dentist to correct the issue. The eroded enamel can be replaced with a synthetic alternative (via dental bonding), or it might be that particularly compromised teeth will need dental crowns. To prevent a recurrence of the problem, additional measures can be needed.

Night Guards and Orthodontics

For bruxism, your dentist might prescribe a night guard. These are lightweight, non-intrusive mouth guards to be worn while you sleep. If your bite is misaligned, you might also require orthodontic treatment (which can also correct your bruxism).

Abfraction lesions are generally identified during regular dental checkups, but if you should notice suspicious discolouration towards the base of a tooth, particularly if it's combined with an increase in tooth sensitivity, then you should make an appointment with your dentist.