Cervical Tooth Wear (Cervical Lesions)
Restoration of notch-shaped structure loss at the gum margin.
Why Does This Wear Occur?
There is no single cause; several factors are usually present together. Gum recession exposes the root surface. Horizontal brushing with pressure using a hard-bristled brush abrades the area. Acidic foods and drinks, and reflux, dissolve the surface chemically. Clenching and grinding may concentrate the forces on the tooth at the cervical region and fatigue the microstructure.
Why Does It Cause Sensitivity?
The root surface is not covered by enamel; the dentine beneath contains microscopic channels extending towards the tooth nerve. When wear opens these channels to the outside environment, cold, sweet and even brushing can produce a brief sharp sensation.
How Is the Restoration Carried Out?
After the area is cleaned and the surface prepared, the loss of structure is reshaped with composite resin matched to the tooth colour. As the work is carried out very close to the gum margin, isolating the area from moisture and achieving a smooth marginal fit are important; an overhanging margin creates the ground for gum inflammation.
What Prevents Recurrence?
The restoration closes the loss of structure but does not remove the cause. Switching to a soft-bristled brush, using a gentle circular technique, rinsing rather than brushing immediately after acidic food, and assessing any clenching habit help reduce recurrence.
Frequently Asked Questions
What causes a notch at the neck of the tooth?
Where the gum has receded, the narrow zone at which the enamel meets the root surface becomes exposed. Enamel is at its thinnest here, and the area is open to three factors at once: mechanical wear from hard brushing, erosion from acidic food and reflux, and flexural forces from clenching. Whether the notch is V-shaped or saucer-shaped gives an indication of which factor predominates; a definitive assessment is made by examination.
How is sensitivity from gum recession reduced?
On an exposed root surface, the microscopic tubules within the dentine beneath the enamel come into contact with the outside environment, and cold or sweet stimuli are perceived as pain through these tubules. Switching to a soft brush, using a circular rather than a horizontal motion, and pastes containing potassium nitrate or stannous fluoride can reduce the complaint within a few weeks. If it persists, covering the exposed surface with a restoration may be considered; suitability is determined by clinical examination.
Does hard brushing wear down the neck of the tooth?
Brushing pressure and bristle stiffness are common contributors to cervical wear. Brushing with a horizontal back-and-forth motion and hard bristles can, over time, cause loss of tooth substance in this already thin region. Brushing immediately after acidic drinks also increases loss on the softened surface. A soft-bristled brush, light pressure, and delaying brushing for a while after acidic food are protective habits.
Do cervical fillings fall out?
Restorations in this region are subject to forces arising from flexure of the tooth during chewing, which makes it a more demanding area than others. If the underlying cause of the wear is not removed — for example if clenching continues or the brushing habit does not change — repeated debonding of the restoration may be seen. For this reason the treatment plan addresses not only the filling but also the factor that initiated the wear.
The information on this page is for general information purposes and does not replace a clinical examination. The suitability, duration and alternatives of treatment can only be determined by your dentist after clinical and, where required, radiological evaluation.
This treatment is carried out at the clinic in Yeşilbahçe, Muratpaşa, Antalya. Location and directions.