Hard Tissue Changes



Abrasion at the neck of the tooth may be the result of long-term use of a hard bristle toothbrush or a lifetime of excessive force during brushing.

Image courtesy of Howard E. Strassler. DMD, FADM, FAGD


Abfraction lesions are also non-carious and typical appear as angulated notches at the gingival margin of premolars. Their origin and management remain controversial and may be restored to prevent progression.



The teeth of older patients frequently show signs of extreme wear. This may be due to the long-term effects of diet, occupational factors, lack of replacement of missing teeth, or bruxism. Incisal or cuspal fractures or chipping may be noted. Severely worn teeth are often food impaction sites and may be associated with localized sites of interproximal bone loss.

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