Tooth abrasion; if you look at your teeth in a mirror, you might notice abrasion along the gumline (see photo 1). It was reported that 80% of the population have tooth abrasion. Contributing factors include: aggressive bushing, outward tooth position and gum recession
How do we treat it? We would not be surprised to hear that many dentist would place white filling to restore these holes. A few months or even a few years later, you might notice that these fillings fall out, making these holes even bigger. You will experience sensitivity again. Each time the dentist replaces these fillings, the holes will get bigger and bigger. Even if the filling does stay, the gum will probably not react well. The gum tissue around the filling will become red and you will notice bleeding when brushing. The tissue will often continue to recede (see photo 3). The gum tissue is not compatible with filling materials, it is considered as a foreign body. The gum tissue likes to be surrounded by natural tooth structure. Therefore, when a filling is placed, the gum tissue will continue to recede away from the filling material. This is why we see patients that will continue to experience sensitivity in these areas.
This photo shows the abrasion area in photo 1 covered by gum tissue. Sensitivity disappears and gum inflammation is significantly reduced. The long term prognosis of this procedure is excellent. Keep in mind, photo 1 and photo 2 are of the same patient!
I personally do not restore any tooth that has gumline abrasion, unless of course there is decay present. No treatment is the only other option I prefer. The patient in photo 1 was complaining of sensitivity on the lower left side. After completing the gum graft procedure, the sensitivity is disappears. Six year later, the gum tissue is still covering the abrasion, and no further sensitivity is reported. For the patient in photo 3, I removed the old filling that was placed in the area where the abrasion was present and placed gum grafted from the palate over the hole. The hole is completely covered and the gum inflammation has disappeared.
White filling material was placed on two teeth. We can see how the gum has receded and is inflamed. We can also see that the filling is discoloured and is cosmetically not attractive.
Again, photo 3 and photo 4 are taken of the same patient. Excellent result!