Can you catch your fingernail in a notch at the gumline of any of your teeth? The older you are, the more likely it is that you can. The notch may not seem to be a problem since it’s generally hidden by your lip and is invisible to you and people facing you. It may also be painless. But it can be the result of decay or the first signs of it. Call a notch to your dentist’s attention, and let her help you decide whether or not it needs attention.
How does a notch form? At the gumline, your tooth enamel is thinner than it is in the rest of your tooth. Much thinner. It has to be in order to fit tightly under your gums. Being thinner, it’s also more vulnerable to wear from abrasive toothpaste or repeated use of a stiff toothbrush. This is another reason I recommend
an electric toothbrush with soft rotary brushes to my patients along with low-abrasion toothpaste.
Notches may also indicate a bite problem. Any excessive bite force can damage teeth, and so can the friction of upper and lower teeth grinding on one another in cases of a faulty bite or nighttime bruxism—a medical term for habitual grinding of teeth. Grinding may, in fact, cause enamel to sheer off the tooth at the gumline. How? Believe it or not, teeth flex when subjected to excessive force. It’s not uncommon for molars to experience more than five hundred pounds of pressure per square inch from grinding.
If decay is found in a notch, your dentist may
1. remove the decay and place a white filling,
2. ask you about your brushing habits,
3. recommend a low-abrasion toothpaste,
4. evaluate your bite,
5. recommend a night guard to protect your teeth,
6. test your saliva for acidity since an imbalance in your oral pH can easily
be corrected by changing the products you use in your home dental care, and/or
7. recommend a tissue graft (described in Chapter 3).
In any case, decay in a gumline notch can’t be ignored. It can lead to worse problems, ultimately requiring a root canal or extraction of the tooth. Gum recession (shrinking) can also occur around tooth notches. Ask your dentist if he sees recession. If so, a tissue graft may be recommended.
By the way, if your dentist uses the word abfraction, which sounds pretty bad, worry not. It’s simply the professional term for a form of tooth notching.