If you’ve ever noticed a small notch forming near the gumline of a tooth, it may not be a cavity. In many cases, these wedge-shaped defects are caused by a condition known as abfraction.
Abfraction occurs when repeated biting and chewing forces cause a tooth to flex slightly over time. This stress concentrates near the neck of the tooth, where the enamel is thinnest, eventually leading to the loss of small amounts of tooth structure. While researchers continue to study exactly how abfraction develops, dentists generally agree that excessive biting forces often play an important role.
Abfraction Is Different from Tooth Decay
Abfraction lesions are commonly mistaken for cavities because both involve missing tooth structure. The difference is that cavities are caused by bacteria producing acid, while abfraction is considered a mechanical form of tooth wear.
These lesions usually appear as narrow, V-shaped notches near the gumline. They’re often smooth, hard to the touch and free of the softened tooth structure associated with decay. In some cases, the exposed dentin becomes sensitive to cold temperatures, sweet foods or brushing.
Because other conditions can create similar defects, such as abrasion from aggressive brushing or erosion caused by acids, a clinical examination is necessary to determine the true cause.
Why Do These Notches Form?
Every bite places force on your teeth. Ideally, those forces are distributed evenly throughout the mouth. When a tooth experiences repeated stress from grinding, clenching or an uneven bite, the tooth can flex microscopically near the gumline.
Over thousands of chewing cycles, that repeated flexing may contribute to the gradual loss of enamel and dentin in this area.
Abfraction is often associated with other signs of excessive bite forces, including flattened chewing surfaces, small cracks in enamel, fractured fillings and jaw muscle tenderness. Many patients who develop abfraction also grind or clench their teeth while sleeping without realizing it.
Rather than looking at the notch alone, we evaluate the entire bite to identify the underlying source of the stress.
How Is Abfraction Treated?
Treatment depends on the size of the lesion and whether it’s continuing to progress. Small defects that are not sensitive may simply be monitored during routine dental examinations. If sensitivity develops or the notch continues to deepen, tooth-coloured composite bonding can often restore the missing structure while protecting the exposed dentin.
If grinding or clenching is contributing to the problem, a custom night guard may be recommended to reduce excessive forces while you sleep. In some situations, adjusting the bite or replacing worn dental restorations may also help reduce ongoing stress on affected teeth.
Early Treatment Helps Preserve Your Teeth
Abfraction usually develops slowly, making it easy to overlook until sensitivity or visible damage appears. Identifying the cause early allows us to protect the tooth before additional structure is lost.
At Dr. Caroline’s family dental practice in Red Deer, we carefully examine changes near the gumline as part of every comprehensive dental assessment. If you’ve noticed small notches, sensitivity or changes in the shape of your teeth, we’ll determine whether abfraction or another form of tooth wear is responsible and recommend the most appropriate treatment.