Abfraction lesions are wedge-shaped or V-shaped areas of tooth structure loss near the gumline. They are not cavities, although decay, gum recession and sensitivity can occur in the same area.
Written and dentally reviewed by Dr. Manish Pandey, BDS, Dental Surgeon.
What is an abfraction lesion?
Abfraction is a term used for a non-carious cervical lesion at the neck of a tooth. The exact mechanism remains debated. Current evidence supports treating these defects as multifactorial: tooth loading, acidic wear, abrasive brushing and individual anatomy may interact.
What does an abfraction lesion look like?
It may appear as a smooth notch at the gumline, often on the cheek side of a premolar or canine. Some lesions are shallow and rounded; others are sharply angled. A dentist must distinguish them from root decay, erosion, abrasion and developmental defects.
Common symptoms
- A visible notch near the gumline
- Sensitivity to cold, sweet foods or touch
- Food or plaque collecting in the defect
- Gum recession around the area
- No symptoms at all
What causes non-carious cervical lesions?
There is rarely one proven cause. Acid exposure can soften tooth surfaces, aggressive brushing may accelerate wear, and repeated loading may contribute to stress at the cervical area. Grinding or clenching should be assessed, but an abfraction-shaped lesion alone does not prove that bite forces caused it.
How is it diagnosed?
A dentist reviews symptoms, diet, brushing habits, reflux or acid exposure, tooth contacts, restorations and gum health. The lesion is examined for activity, depth and sensitivity. X-rays may be used when decay or another dental problem is suspected.
Does every lesion need a filling?
No. Small stable lesions without sensitivity may be monitored. Treatment depends on progression, symptoms, cleanability, appearance and risk to the tooth. Options may include fluoride or desensitizing products, brushing advice, management of acid exposure, a tooth-coloured restoration, or gum treatment where recession is important.
Can abfraction lesions be prevented?
- Brush gently with a soft toothbrush and fluoride toothpaste.
- Avoid scrubbing horizontally with heavy pressure.
- Discuss frequent acidic drinks, reflux or vomiting with appropriate professionals.
- Attend periodic dental reviews so changes can be photographed or measured.
- Ask for assessment if you grind, clench or frequently fracture restorations.
When should you see a dentist?
Arrange an examination for a new notch, persistent sensitivity, pain on biting, rapid enlargement, darkening, a sharp edge or gum recession. Seek urgent care for swelling, fever or severe spontaneous pain, which are not typical features of an uncomplicated abfraction lesion.
Frequently asked questions
Is abfraction the same as a cavity?
No. Abfraction describes non-carious loss of tooth structure, while a cavity is caused by dental caries. Both can occur near the gumline, so professional diagnosis matters.
Can an abfraction lesion heal naturally?
Lost enamel and dentine do not grow back. However, sensitivity and risk factors can often be managed, and a stable lesion may only require monitoring.
Which toothpaste is best?
A fluoride toothpaste is appropriate for most adults. A dentist may suggest a desensitizing toothpaste when sensitivity is present. Avoid highly abrasive products and forceful brushing.
References
- Systematic review of occlusal stress and abfraction
- Clinical guidance for non-carious cervical lesions
- Review of abfraction terminology and evidence
Dental disclaimer: This article provides general education and does not replace diagnosis or treatment by a qualified dentist.