Dr. Robert Axelrad Dental Office

Making Brampton Smile Since 1997

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We conclude our series on dental wear with a brief discussion of Abfraction.

This occurs during grinding or bruxing of the teeth.

If your teeth are not properly aligned then it is possible that one or several of the teeth may be subjected to a greater force than they can bear.  This will often cause the enamel at the neck of the teeth to flex.  Continued flexing and stressing of the tooth causes the enamel and dentin to separate from one another.

The neck of the tooth is the area that is closest to the gum line.  The enamel in this area is quite thin and when the force is too much for the tooth to bear, the enamel tends to fracture. This leaves a notch in the tooth near the gum line (see image above).  The Abfraction seen in this picture is most probably the result of Attrition (see blog Dental Attrition on September 9, 2013). If a tooth has a filling in the area of the neck of the tooth and it is subjected to a greater than normal force, then it is common for the filling to ‘pop’ out.

Treating the problem

To correct the problem, the chewing forces need to be distributed evenly.                         Orthodontics (see blog Get ready to Brace Yourself posted on September 2, 2012) is the best way to deal with a malocclusion.  However, the answer may be as simple as adjusting the bite; perhaps some selective grinding of the tooth that is being subjected to too much force.

If a filling has fallen out from the excessive force, then it is best to deal with the problem (adjust the bite) first then re-fill the tooth otherwise, it is likely that the filling will fall out again. Restoring the tooth after the bite has been corrected will prevent further damage.

Inter-play between the Different Types of Wear

Abfraction is not as common as Attrition, Abrasion and Erosion which we discussed in previous blogs.

It is rare that one of these wear ‘processes’ act on their own. There is usually an inter-play between them. One of the more damaging combinations is the erosion-abrasion one.      The dissolution of the enamel by acids (erosion) accompanied by the wear caused by mechanical abrasive forces has quite an effect on the substance of the tooth.

The Answer

The key is to focus on prevention of further tooth loss by making changes i.e. wearing a night guard, adjusting the bite, orthodontics (braces), fluoride (to re-mineralise damaged tooth structure, making lifestyle changes ( i.e. eating less acidic foods, using a soft tooth brush instead of a hard one, changing your brushing technique etc.)

Whatever the case, your dental team should be able to identify the type of wear by performing a proper clinical exam and asking the patient certain pertinent questions  that will give clues as to what type of wear is present.

At our dental clinic, we work together with you, our patient, to solve the problem.

Yours in good dental health,

Dr. Robert Axelrad




We're getting very excited about returning to work and seeing patients again!  The green light has yet to come from the government, but we are ready now.  Being ready means being safe.  The following safety measures have been put in place to protect patients and staff.

Safety Measures:

  • A plexiglass barrier stands on the front desk in the waiting room.
  • All patients will have their temperature taken with a non-touch digital infra-red thermometer.
  • All staff will wear a mask, gloves, gown, bonnet, goggles and face shield.
  • Hand sanitizers will be readily available for staff and patient use.
  • Patients will wait outside or in their car until their appointment time.
  • No visitors are permitted in the office.
  • Social distancing will remain in effect in the office.
  • Patients experiencing influenza-like-illness (fever with a cough, sore throat or muscle aches) should not come to the office.

We really look forward to seeing everyone again!

Until then, please stay safe and healthy.