SDS Occlusion Blog

 Loss of cervical tissue around teeth has been linked to the presence of excessive occlusal loading.

These are known as abfraction lesions, defined as “Loss of tooth structure, usually in a wedge-shaped pattern in the cervical area of the tooth, attributed to flexure and fatigue in an area away from the point of loading (usually cervical).” The true aetiology of these has been called into question, with some recent research purporting to show that a toothbrush and abrasive dentifrice are required for them to develop. 

A case I saw this week seems to contradict such an assertion – this aesthetic case need a little gingival recontouring around the anteriors:

…. so I started to work on the lateral first and look what has appeared! This photo was taken moments after removing the gingival tissue, and it hasn’t been touched by a bur: 

Now, this looks suspiciously like an abfraction lesion to me, and it has has been subjected to significant occlusal loading palatally from a deep overbite Class II div 2 situation for many years. Is this final proof that such things really do exist – it can’t possibly be toothbrush abrasion since this is the first time it’s ever seen the light of day. Any other ideas, or do you think I have found something significant?

I think we’re all aware that bulimia in particular can be a major factor in the development of occlusal changes and wear, so I’d be very grateful if members of the dental team could complete this survey on oral and dental considerations with eating disorders for a project being organised by Alexandra Day (Sheffield) with support from Dr N Martin (Sheffield), Dr A Milosevic (Liverpool) and Prof A Eder (UCL Eastman).

https://www.surveymonkey.com/s/CXW9BBR

Should take no more than a few minutes and will help highlight possible need for better support and education in this increasingly important field.

Many thanks.
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Andy Lane