Abfractions are difficult to explain to patients. Here is a simplified explanation

“Doctor, I always thought these notches are from brushing too hard. They are painful and I have them on my teeth on both sides. What causes them?”  

Here is a simplified explanation:

An abfraction occurs on the lower part of the crown of a tooth, near the gum line.

            The enamel covering the crown tapers down to its thinnest there. When the occlusion (bite) is not balanced, there will be uneven pressures on the biting surfaces of teeth. Those pressures cause a torque on the tooth which produces a slight bend at the center where the crown meets the root. As the tooth keeps bending, the thin enamel at the bottom of the crown, near the gum line, chips away. The sensitive “dentin” surface inside the enamel is now exposed. Vigorous, improper teeth brushing will then wear away the unprotected dentin and the notches will grow deeper and larger.

The dentin also becomes vulnerable to acid erosion from foods such as citrus.

             The uneven bite pressures also cause a loss of gum and bone attachment around the roots so the roots become progressively exposed adding to the acute sensitivity to touch and cold. Advanced effects can be fracture of the tooth at the crown-root junction, tooth mobility and serious gum disease. 

            Abfractions can resemble other conditions like decay or toothbrush abrasion, but the treatment is more specific. The treatment, after diagnosing the cause as a bite dysfunction, consists of balancing the bite to equally and properly distribute the pressures and then to restore the lost tooth structure. An occlusal guard may be required. About 25% of the population clench or grind their teeth at night (and are completely unaware of it!). Obviously, the earlier this condition is discovered, the less damage to the teeth and bone will have occurred. In advanced cases crowns may need to be placed to protect the weakened teeth. There are some cases where orthodontic treatment may be necessary. 

 

Abfractions are non-carious cervical lesions (NCCL) caused by flexural forces, usually from cyclic loading; the enamel, especially at the cementoenamel junction (CEJ), undergoes this pattern of destruction by separating the enamel  rods.  Studies show that within the same patient, teeth with abfractions presented more gingival attachment loss than those without abfractions. However, associations were not demonstrated between premature contacts in centric relation (PCCR) and the presence of abfractions or increased attachment loss.

Abfractions are common in patients with Obstructive Sleep Apnea. Nocturnal bruxism plays a major role.

 QUIZ

True/False

1. Abfractions are usually caused by improper teeth brushing.                   (F)
2. Abfractions are a specific type of dental decay.                                       (F)
3. Correction of an abfraction requires more than just a cervical filling.       (T)
4. Nutrition plays a role in worsening abfractions.                                         (T)

Multiple Choice

Which are correct?

1. .Abfractions occur primarily on the facial surfaces of teeth.
2. A porcelain veneer can have an abfraction.
3. Abfractions occur only on maxillary teeth.
4. An abfraction may be able to cause a separation fracture of a tooth crown.
5. All the above.

The treatment options include all except one of the following:

1. Orthodontics
2. Nutritional adjustments
3. Occlusal adjustment
4. Periodontal Therapy
5. Cervical restorations

AGD TEAMS WITH SGS TO PRESENT DSM: AN EFFECTIVE PRACTICE GROWTH POTENTIAL

 The Southern California Academy of General Dentistry (SCAGD) and

Sleep Group Solutions (SGS) present a 2-day Dental Sleep Medicine training seminar.

TREATING SNORING AND SLEEP APNEA IN THE DENTAL PRACTICE:

AN EFFECTIVE PRACTICE GROWTH POTENTIAL

Including Medical Billing for Dentists

Date: May 8 & 9, 2015. Time: 8:45 am to 5 pm. Continental Bkfast & Lunch

Place: Hilton LAX Hotel        16 CE Units         Instructor: Marty Lipsey, DDS

For special discount offer call:  855-475-3374

Of the next 3 patients that walk thru your doors, one is suffering from Sleep Apnea.

Will you be able to identify and treat that patient?

Today’s “Hot Button,” Dental Sleep Medicine, can make you stand out, be sought out and become your unique  skill to serve the needs of your existing patients, as well as attracting many new patients. Remember how it was about 25 years ago when teeth whitening was the new dental “hot button”? After that we had a “porcelain age” in dentistry when the media made patients very image-conscious for smile enhancements at any cost.  Then there were dental implants. All  these former dental miracle therapies are routine today in most practices.

With sleep apnea therapy, especially in this sluggish dental economy, you will be able to offer relief to hundreds of new and existing patients that have been suffering for years.  You will be able to make a profound difference in their health, feelings of well-being and their lives. The time has come to brand yourself as the “Sleep Dysfunction Dentist” in your community.

Sleep Group Solutions is the world’s largest Sleep Apnea company, concentrating on education, intra-oral appliances and supplies for the dental community.

Also learn why it is important for general dentists to be members of the AGD.

Dr. Marty Lipsey :

Dr. Marty Lipsey, received his DDS degree from UCLA and a Master of Science from Northwestern University Dental School. Dr. Lipsey is the founder of Dental Sleep Med Systems, offering dental teams assistance in implementing and/or improving their dental sleep medicine practices, including electronic medical billing and successful insurance coding and processing. Dr. Lipsey is also a Sleep Group Solutions Instructor, and teaches Dental Sleep Medicine regularly.

OBSTRUCTIVE SLEEP APNEA- JUST A MAN’S DISEASE??

Obstructive Sleep Apnea Does Not Discriminate Against Sex or Age. In the European Respiratory Journal, Swedish scientists reported that OSA  is common in both sexes, a disorder that was thought to mainly affect men.  Dr. Karl Franklin and his team set out to find out how prevalent sleep apnea is among women and how often symptoms occur. Out of a population-based random sample of 10,000 women between the ages of 20 and 70 years, they gathered data on 400 of them. The test group were given questionnaires which included several questions regarding their sleeping habits and sleep quality. They also underwent overnight polysomnography. The authors concluded: “Obstructive sleep apnea occurs in 50% of females aged 20-70 years. 20% of females have moderate, and 6% severe sleep apnea. Sleep apnoea in females is related to age, obesity and hypertension but not to daytime sleepiness. When searching for sleep apnea in females, females with hypertension or obesity should be investigated.” A apnea-hypopnea index of 30 or more (severe symptoms) affected 14% of the participants aged 55 or more 31% of the women who were obese and at least 50 years of age had severe sleep apnea  And let’s not forget our children. More reports to follow which will show corelations of OSA with children.