Is it necessary to have abrasion fillings done to prevent any further erosion of teeth at the gum line? One dentist told me it was very necessary, so that the situation doesn’t worsen and necessitate a root canal on those teeth. But another dentist told me it wasn’t necessary to have these eroded areas at the gum line filled, and even stated that it may make the situation worse. How can a lay person know what to do, when one dentist says one thing, and another dentist says the complete opposite?
- Monica
Dear Monica,
Thanks for an excellent question.
Actually, it may be that both dentists are right – which may seem a little strange, but let me explain.
The correct term for these dished out areas of your teeth near the gumline is abfraction lesions. I think the problem may be that the second dentist doesn’t know the right way to fill these, and may have outdated information about what causes them. These types of fillings are notorious for popping out, but when the dentist really understands them, the fillings have a high rate of retention.
It used to be thought that these lesions were caused from too vigorous brushing. But recent research shows that they are actually caused by flexing of the teeth, and they usually occur in patients who grind or clench their teeth a lot. Some dentists, frustrated by the tendency these fillings have to pop out of the teeth, try stronger and stronger filling materials. But the answer to the problem is to use very flexible filling materials – microfilled composites such as Silux Plus, Renamel, or Heliomolar.
If these areas aren’t protected, more and more tooth structure will wear away, and yes, in some cases they can cause a tooth to need a root canal treatment, or to become so weakened that it breaks off.
Before the dentist fills these lesions, I would quiz him or her by asking if they’re familiar with the theory that the tooth needs to be filled with a flexible microfill material. If the tooth isn’t filled correctly, the filling will probably pop out within a few months. And in that case, the second dentist will be right, because continually refilling the tooth will cause more harm than good.
If you’re interested to read the experience of another patient with a problem similar to yours, where the dentist simply couldn’t get the fillings to stay in, read the posting on the mynewsmile.com blog about afraction lesions.
Links: read more about tooth bonding and white fillings.
Read about Monica’s follow-up comment where she confirms that she grinds her teeth at night, thus validating the idea that these lesions are caused by flexing of the teeth from grinding or clenching forces.