Introduction:
Cervical dental abrasion can occur anywhere, even between teeth, and is most frequently observed at the cervical necks of teeth. However, it can also happen when using dental floss incorrectly or vigorously. While toothbrush abrasion has long been believed to be the main cause of cervical abrasion, acid erosion has been linked to the beginning and progression of the cervical lesion. Identifying the risk factors is crucial for changing behaviors and offering the right guidance.
What Is Cervical Abrasion?
Cervical abrasions are a deep concavity on the buccal side (outer side of the teeth facing the lips and the cheek) of the upper and lower teeth near the gingiva. It is mostly seen in canines and premolars and sometimes involves the first molars. They usually occur due to one’s intensive brushing habit where one just grinds one’s brush against the teeth so roughly that, along with some plaque and debris, one loses the microscopic layer of enamel, too. Hence, dental abrasions lead to teeth sensitivity (teeth sensitivity might also be due to dental erosions).
In other words, tooth abrasion occurs when an outside mechanical force physically wears down the teeth, causing them to begin to lose enamel. This differs from tooth erosion and dental attrition, in which acids dissolve the enamel (where the upper and lower teeth rub together and damage each other). To fix the damage effectively, one must identify the precise cause of the problem.
What Are the Main Causes of Cervical Abrasion?
There are numerous potential causes of tooth abrasion, such as
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The vigorous and horizontal brushing motion results in enamel abrasion and loss of enamel and dentin rather than teeth cleansing.
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Stiff bristles of toothbrushes are considered the myth of faster cleaning. Using old toothbrushes results in abrasion because the bristles get hardened over time due to reactions to the oral cavity and toothpaste chemicals.
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Biting the fingernails.
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Rubbing the teeth with mouth jewelry.
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Chewing pen tips or other rough items.
What Is Meant by Toothbrush Abrasion?
Toothbrush abrasion is the most common cause of tooth abrasion, where the stiff bristles of the toothbrush or bruising very aggressively can result. When the enamel is worn out due to excessive brushing, it can result in discoloration of the tooth, sensitivity, and sometimes fracture.
How Can Abrasion Caused by Toothbrushes Be Treated?
Proper brushing technique is the most important way to prevent abrasion. The person should use a toothbrush with soft bristles and gentle circular motions, which can help prevent abrasion. Aggressive brushing and brushing back and forth should be avoided to prevent damage to the teeth and gums.
What Are the Characteristics of Cervical Abrasion?
Dental abrasion, which primarily affects premolars and canines, is tooth wear that results from friction or mechanical pressures from an outside item. A wedge- or V-shaped tooth indentation at the gum line is a characteristic sign of tooth wear from abrasion. The tooth also appears worn, glossy, and frequently stained at the cervical boundary. Rough, lateral tooth brushing, biting nails, chewing on pens, smoking pipes, putting on and taking off denture clasps, abrasive dentifrices, and stiff toothbrushes are a few causes of abrasion. Bringing a tooth-colored filling over the tooth's abraded area can correct toothbrush abrasion.
What Are the Preventive Measures for Dental Abrasion?
The purpose of brushing is to eliminate food particles and plaque, and the tooth and gum area should only be subjected to extremely mild pressure. The best strategy to preserve the teeth is to prevent abrasion from occurring in the first place since enamel cannot regenerate once it has been damaged. The preventive measures include,
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Gentle brushing.
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Use a nonabrasive toothpaste (preferably fluoride) with a soft-bristled toothbrush.
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It is recommended to employ brief, back-and-forth motions while holding the brush at a 45-degree angle.
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Brushing twice a day helps in preventing cavities and periodontal problems. When it is above two times (more than three to five minutes at a time), it increases the chance of the enamel and dentin abrasion at a microscopic level—and may be left unnoticed by the patients.
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Make a note of any undesirable behaviors, such as nail biting, and restrict them as soon as possible.
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Make sure to schedule routine visits with the dentist.
What Are the Treatment Options for Dental Cervical Abrasion?
When the lesion is within the enamel, no treatment is required. Adequate oral hygiene maintenance is sufficient. The other treatment options involve
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Glass Ionomer Cement: Glass ionomer cement (GIC) is a restorative material used for filling in dentistry. The lifespan is typically long since it chemically adheres to the tooth structure with sufficient strength and is aesthetically appraising. However, it has to be protected from the oral environment to prevent contamination and reduce interference with dissolution. GIC increased resistance to demineralization and the continual release of fluoride over an extended period protect the teeth from cavities.
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Composite Resin Restoration: Composite resin fillings are considered the best treatment option for cervical abrasion. The composite is made of plastic and a fine glass of distinct materials. Resin closely resembles the appearance of natural teeth and is superiorly esthetic. A composite restoration can continue for at least five years and occasionally even longer. But still, a variety of factors can affect how long a combined filling lifespan is, like the chewing and biting pressures, bruxism, filling size, and position.
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Other Treatments: Recession or other disorders affecting the gums are prevalent issues with dental abrasion. It is essential to initiate periodontal treatment and esthetic surgery.
What Is the Difference Between Dental Abrasion and Erosion?
Dental abrasion is caused by excessive force or constant contact from harsh brushes, whereas erosion results from a chemical wear process. Additionally, excessive use of acidic or sweetened foods and beverages, as well as the use of specific medications, can damage the enamel of teeth. On the other hand, abstraction is a symptom that frequently co-occurs with tooth abrasion, which describes wear-related damage to the tooth's structure. This wedge-shaped notch on the gum line that exposes the tooth's root may cause additional issues, such as sensitivity unless the inner portion of the tooth is left exposed.
Conclusion:
Abrasion-related cervical loss may result in symptoms and effects, including greater tooth sensitivity, increased plaque trapping that will cause periodontal disease and cavities, a decreased ability to use dental appliances like retainers and dentures, and eventually, it may be unattractive or esthetically compromised. Hence, these conditions can be treated with appropriate dental cement. According to studies of resin-modified glass ionomer (RMGI), repair material is recommended in clinical settings since it functions well - provided esthetics are not the priority when healing these lesions.
