What it looks like and how it differs from caries
The defect is located near the gum and has the shape of a wedge or step: two smooth planes converging at an angle. The surface is dense, shiny, often the same color as the tooth, less often yellowish. Caries in the cervical area looks different: it is soft, rough, with chalky or dark edges and is associated with plaque accumulation. A wedge-shaped defect is often symmetrical, affects several teeth on one side of the jaw and is combined with gum recession—exposure of the root.
- Wedge-shaped with smooth walls
- Dense shiny surface
- Location at the neck of the tooth
- Most often on canines and premolars
- Often combined with root exposure
- Tooth decay - soft, rough edges
Reasons
The modern concept combines three mechanisms. The first is excessive and improperly distributed chewing load: with bruxism and improper closure of teeth, tension arises in the cervical area, and thin enamel gradually chips in microscopic areas. The second is abrasive: a hard brush, strong pressure, horizontal movements and highly abrasive pastes, especially whitening ones for daily use. The third is chemical: sour drinks, citrus fruits, wine, as well as the reflux of gastric contents during reflux soften the tissue, and it is easier to wash off.
- Bruxism and overload of individual teeth
- Malocclusion and early contacts
- Hard brush and strong pressure when cleaning
- Horizontal sawing movements with a brush
- Abrasive and bleaching pastes
- Acidic drinks and foods
- Gastroesophageal reflux
Symptoms
Often the first manifestation is increased sensitivity: the tooth reacts with a short sharp pain to cold water, sour and sweet foods, as well as to the touch of a brush. As the defect deepens, the sensitivity increases, the person begins to avoid cleaning in this area, which is why plaque accumulates and inflammation of the gums occurs. A visible step at the gum line becomes a noticeable aesthetic problem on the front teeth. With very deep defects, inflammation of the nerve and even fracture of the crown of the tooth in the neck area are possible.
- Sensitivity to cold and sour
- Pain when brushing teeth
- Visible step at the gum
- Exposure of the tooth root
- Delayed plaque and gum inflammation
- Risk of tooth fracture with a deep defect
Treatment
Small defects are observed without complaints and treated with remineralizing and desensitizing agents, always changing the cleaning technique. Deeper fillings are filled: glass ionomer and composite materials are more often used, which can withstand the load well in this area. An important caveat: if the cause is not eliminated, the fillings will fall out and the defect will reappear, therefore, at the same time, they check the closure of the teeth, make a protective mouthguard for sleep in case of bruxism, and, if necessary, refer them to an orthodontist. If there is severe gum recession, plastic surgery is discussed.
- Remineralization and sensitivity remedies
- Filling a defect
- Correction of teeth brushing technique
- Protective mouth guard for bruxism
- Grinding and orthodontic bite correction
- Gum plastic surgery for severe recession
Prevention
The main rule is to brush your teeth with a soft or medium brush without pressure, sweeping movements from the gums to the cutting edge, and not sawing across. Highly abrasive whitening pastes are not suitable for daily use; If you are sensitive, choose special pastes. It is better to drink acidic drinks through a straw and not brush your teeth immediately after them: enamel softened by acid wears off faster, you should wait about half an hour. If you grind your teeth at night, you definitely need a mouthguard, and if you have heartburn, you need treatment for reflux from a therapist or gastroenterologist.
- Soft or medium brush without pressure
- Sweeping movements instead of horizontal ones
- Limiting abrasive and bleaching pastes
- Pastes for sensitive teeth
- Pause about 30 minutes after sour drinks
- Mouth guard for bruxism
- Treatment of reflux