Gingival clefting, abfractions, "notching"

Gingival clefting, abfractions

What causes this?
Abfraction lesions are small notches caused by stress (forces) on your teeth. Biting, chewing, clenching and grinding put pressure on your teeth. Over time, this pressure can cause cracks and splits in the outer layer of your teeth. This occurs in the thinnest part of your enamel, near the gumline.  As the process continues you will notice the gums receding, sometimes becoming sensitive.  A composite filling will correct the problem for a short time, but it does not correct the cause.

Grinding your teeth puts pressure on them over and over. For this reason, people who grind their teeth are more likely to get abfraction lesions.

Abfraction lesions are fairly common in adults. Older adults are especially likely to have them. They occur more often in the back teeth, called premolars and molars. But they can occur in the front teeth as well. They appear as crescent-shaped or wedge-shaped notches near the gumline.

Teeth with abfraction lesions are not more likely to decay, but they can get weaker over time or become sensitive to sweets and cold. Weak teeth may be more likely to break.

Expected duration and Treatment

Abfraction lesions do not heal over time. Some may worsen, but in some cases they do not need to be treated.  If the abfraction is caused by bruxing (someone who grinds their teeth) it is usually treated with a biteguard.  If the abfraction is caused by the bite being off, it is usually treated by equilibration, which is selective adjusting of the bite.  Abfractions occur most commonly in the back teeth, the premolars and molars.


Dr's Rich and Row have received extensive advanced training at the Pankey Institute ( in treating occlusal disease.  Please call our office at 559.673.3698 if you have any further questions.


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