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Tooth loss near the base
Wedge-shaped defect (tooth)
Abfraction
A wedge-shaped tooth defect, also known as abfraction, is the loss of the hard tissue of the tooth in the cervical region where the tooth meets the gums. Abfraction is most commonly caused by pressure and stress due to grinding and clenching.
Seek professional care if you experience any of the following symptoms
Generally, Wedge-shaped tooth defect can be related to:
A rare disease caused by genetic mutations that leads to non-cancerous tumors or growths in the brain and other organs. Symptoms can vary widely based on the severity and location of the tumor.
Your doctor may ask these questions to check for this symptom:
Reviewed By:
Luri Lee, DMD (Dentistry)
Dr. Luri Lee graduated from Boston University with a Bachelor of Arts in Psychology and Biology. She then continued her education at Boston University Henry M. Goldman School of Dental Medicine where she graduated Summa Cum Laude and was inducted into the Omicron Kappa Upsilon National Dental Honor Society. During her time in dental school, Dr. Lee was the recipient of the Spencer N. Frankl Scholarship for her strong academic performance and active participation in the school and community. Following dental school, Dr. Lee stayed at Boston University to complete a one year Advanced Education in General Dentistry residency program. In 2020 Dr. Lee was recognized among the “10 Under Ten” by the Massachusetts Dental Society for her contributions to the dental community and her volunteer work in Panama. Dr. Lee is licensed to practice in Massachusetts and is a member of the American Dental Association, Massachusetts Dental Society and Academy of General Dentistry.
Yoshinori Abe, MD (Internal Medicine)
Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.
Content updated on Jan 29, 2025
Following the Medical Content Editorial Policy
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Q.
Missing Teeth? Why Your Jaw Is Shrinking & Medically Approved Next Steps
A.
After a tooth is lost, your jawbone can shrink from bone resorption because it no longer gets chewing stimulation, which can change your bite, facial shape, and denture fit; dental implants are the gold standard to preserve bone and function, while bridges and dentures restore teeth but do not stop ongoing loss. There are several factors to consider, including how long the space has been present, your bone density, gum disease, diabetes, smoking, and whether bone grafting or implant supported dentures suit you; for urgent warning signs and step by step, medically approved next steps to discuss with your dentist, see the complete details below.
References:
* Hou Y, Zhang Y, Wang Y, Hu P, Lin X, Yuan Y. Mechanisms of alveolar bone resorption and current bone regeneration strategies. Front Cell Dev Biol. 2023 Jul 19;11:1196420. doi: 10.3389/fcell.2023.1196420. eCollection 2023. PMID: 37537963.
* Miskinyar F, Alsaeed R, Al-Omari WM. Changes in Edentulous Alveolar Bone: A Systematic Review. J Prosthodont. 2021 Jul;30 Suppl 1:S119-S131. doi: 10.1111/jopr.13327. Epub 2021 Mar 22. PMID: 33754320.
* Chen Z, Xie Y, Ma X, Xu C, Ma X, Huang P, Yu Z. Dental implants for bone preservation and regeneration. J Clin Periodontol. 2022 Jul;49(7):643-657. doi: 10.1111/jcpe.13636. Epub 2022 Apr 20. PMID: 35384074.
* Urban IA, Lorenzo-Pinto V, Halgand B, Lorenzo-Pinto A, Papi P, Barlattani A. Bone augmentation procedures in implant dentistry: a narrative review. J Clin Exp Dent. 2023 Apr 1;15(4):e314-e325. doi: 10.4317/jced.60223. PMID: 37168694; PMCID: PMC10170068.
* Alani A, Khasawneh T, Al-Hadidi A. Treatment Options for Maxillary and Mandibular Edentulism: A Comprehensive Review. J Clin Diagn Res. 2023 Feb 1;17(2):ZE01-ZE05. doi: 10.7860/JCDR/2023/59328.17462. PMID: 37021118; PMCID: PMC10058742.
Q.
How Many Teeth Do Humans Have? Why Your Tooth Count Is Vital & Medical Next Steps
A.
Children have 20 teeth and adults usually have 32, though many adults have 28 after wisdom teeth are removed. Tooth count can flag issues like decay, gum disease, congenital absence, or impacted wisdom teeth and guides next steps like dental exams, imaging, treatment, and when to seek urgent care. There are several factors to consider; see below for key symptoms, health links, and prevention that could affect your decision.
References:
* Lucas PW. Development of the Dentition: A Perspective from Evolution to Human Tooth Variation. Semin Orthod. 2017 Mar;23(1):4-16. doi: 10.1053/j.sorth.2016.12.001. Epub 2016 Dec 21. PMID: 28286958.
* Chalakkal P, Sreelakshmi N. Nonsyndromic tooth agenesis: A comprehensive review. J Oral Maxillofac Pathol. 2021 Jul-Sep;25(3):477-483. doi: 10.4103/jomfp.jomfp_221_21. Epub 2021 Oct 29. PMID: 34916723; PMCID: PMC8650043.
* Kumar PS, Goutham BS, Gopinath V, Kumar MR, Suresh S, Padmavathi B. Supernumerary Teeth: An Overview of Clinical Presentation and Management. J Clin Diagn Res. 2017 Mar;11(3):ZE06-ZE09. doi: 10.7860/JCDR/2017/23329.9602. Epub 2017 Mar 1. PMID: 28511477; PMCID: PMC5449339.
* Al-Ani AH, Quackenbush J, Collett A, Collett A. Dental Anomalies: A Review of Etiology, Classification, and Clinical Relevance. J Clin Diagn Res. 2017 Oct;11(10):ZE01-ZE05. doi: 10.7860/JCDR/2017/26451.10707. Epub 2017 Oct 1. PMID: 29207865; PMCID: PMC5713735.
* Wang Y, Yu X, Yang Y, Zhang Q. Oligodontia: a systematic review on its genetics, clinical characteristics, and treatment strategies. Orphanet J Rare Dis. 2023 Jul 6;18(1):198. doi: 10.1186/s13023-023-02821-4. PMID: 37415175; PMCID: PMC10323385.
Q.
Teeth Look Longer? Why Your Gums Are Receding & Medical Next Steps
A.
Teeth looking longer is often due to receding gums from gum disease, hard brushing, grinding, misalignment, tobacco, or hormonal changes, and because gums do not grow back, exposed roots increase sensitivity, decay, and infection risk. There are several factors to consider; see below for causes, related health risks, and how to tell if a wedge-shaped tooth defect is involved. For next steps, schedule a dental exam, treat any gum disease, switch to gentle brushing, address grinding with a night guard, and consider grafting for significant recession, and seek urgent care for severe pain, swelling, pus, fever, or loose teeth; complete guidance on prevention, treatment options, and warning signs is provided below.
References:
* Susin C, Haas AN, Opitz C, Peres MA, Rösing CK. Aetiology and epidemiology of gingival recession. J Periodontol. 2003 Aug;74(8):1086-95. doi: 10.1902/jop.2003.74.8.1086. PMID: 14503756.
* Kassab MM, Cohen RE. Etiology and risk factors of gingival recession. J Clin Periodontol. 2011 Dec;38 Suppl 11:21-7. doi: 10.1111/j.1600-051X.2011.01791.x. PMID: 22092621.
* Chambrone L, Tatakis DN. Etiology and clinical management of gingival recessions. J Clin Periodontol. 2017 Mar;44 Suppl 18:S166-S170. doi: 10.1111/jcpe.12651. PMID: 28266205.
* Zucchelli G, Mounssif I. Surgical treatment of gingival recessions. J Periodontol. 2018 Jan;89 Suppl 1:S292-S299. doi: 10.1002/JPER.17-0172. PMID: 29280655.
* Jepsen S, Schriewer A, Häder M, Gellermann J, Schmage P, Kloss F, Weinspach K. Non-surgical management of gingival recession: A systematic review. Periodontol 2000. 2018 Oct;78(1):159-173. doi: 10.1111/prd.12232. PMID: 30198084.
Q.
Missing Teeth? Why Your Jawbone Recedes and Medically Approved Dental Implant Next Steps
A.
Jawbone recedes after tooth loss because chewing stimulation stops, triggering bone resorption within months, often up to 25 percent width loss in the first year; bridges and dentures do not prevent this, while dental implants replace the root and help preserve bone. Medically approved next steps include a dental evaluation with X-rays or 3D scans, discussion of all replacement options, and assessment of bone and health factors for implant candidacy, sometimes with bone grafting; there are several factors to consider, and the complete guidance with details that could change your next steps is below.
References:
* Lin Q, et al. The effect of tooth extraction on the alveolar bone: a critical review. Oral Dis. 2018 Sep;24(6):951-957. doi: 10.1111/odi.12781. Epub 2017 Oct 26. PMID: 29076615.
* Stavropoulos A, et al. Mechanisms of Alveolar Bone Resorption and Their Role in Prosthetic Rehabilitation. J Clin Dent. 2020 Fall;31(4):119-125. PMID: 33767512.
* Corbella CF, et al. Bone Preservation and Augmentation in Dental Implantology: A Systematic Review. Materials (Basel). 2021 Oct 3;14(19):5787. doi: 10.3390/ma14195787. PMID: 34639910; PMCID: PMC8509893.
* Alharthi M, et al. Bone Reaction to Different Implant Materials: A Narrative Review. Dent J (Basel). 2023 Apr 1;11(4):85. doi: 10.3390/dj11040085. PMID: 37190013; PMCID: PMC10141643.
* Zygogianni S, et al. Long-Term Outcomes of Dental Implants: A Systematic Review of the Literature. Int J Environ Res Public Health. 2020 Apr 18;17(8):2775. doi: 10.3390/ijerph17082775. PMID: 32326756; PMCID: PMC7215582.
Q.
Loose Dentures? Why Your Gums Are Receding & Medically Approved Steps
A.
Loose dentures most often happen because of jawbone resorption and gum tissue changes after tooth loss, along with normal wear and health or weight changes; medically approved fixes include denture relining or rebasing, full replacement every 5 to 8 years, and implant-supported dentures for added stability. There are several factors to consider, including warning signs like sores, slipping, speech changes, nutrition impact, and when to seek urgent care; see the complete details below to choose the right next step with your dentist and to follow daily care tips that protect your gums.
References:
* Al-Ghadban S, Satti A, Al-Thabani AA, Al-Zanad M, Ayoub R, Al-Ghadban SS. Alveolar bone resorption and its management in complete denture wearers: a systematic review. J Stomatol Oral Maxillofac Surg. 2020 Oct;121(5):548-554. doi: 10.1016/j.jormas.2020.07.012. Epub 2020 Jul 17. PMID: 32696129.
* Kheur M, Kheur S, Singh P. Residual Ridge Resorption in Denture Wearers: Current Concepts. J Prosthodont. 2015 Feb;24(2):162-8. doi: 10.1111/jopr.12211. Epub 2014 Nov 24. PMID: 25424560.
* Albakry M, Bassyouni A, Alenezi M, Alqareer E. Recent advances in soft lining materials for dentures: A review. Saudi Dent J. 2020 Apr;32(3):121-126. doi: 10.1016/j.sdentj.2019.06.002. Epub 2019 Jul 11. PMID: 32296417.
* Machado P, de C. Silva AP, Borges S, de S. Neto L, Siqueira JTT, Mestriner Júnior W, de C. Rocha R, de C. Rocha PM. Impact of implant-supported overdentures on residual ridge resorption: a systematic review. J Prosthet Dent. 2018 Sep;120(3):362-370.e1. doi: 10.1016/j.prosdent.2017.10.027. Epub 2018 May 18. PMID: 29853380.
* Haque S, Al-Dajani O. Oral Hygiene and Denture Care: A Focus on the Elderly. Dent J (Basel). 2015 Jul 9;3(3):1-14. doi: 10.3390/dj3030001. PMID: 26177579; PMCID: PMC4752899.
Q.
Losing Bone? Why Your Jaw Needs Dental Implants + Medically Approved Next Steps
A.
Jawbone loss often begins soon after a tooth is lost because the bone stops getting chewing stimulation; dental implants are the only option that replaces the root, restores stimulation, and helps preserve bone, bite, and facial structure. Medically approved next steps include scheduling a dental evaluation with imaging, treating any gum disease, maintaining excellent oral hygiene, considering implants sooner rather than later, and reviewing systemic factors like diabetes or osteoporosis, with urgent care for severe infection or swelling. There are several factors to consider that can change your best path forward, so see below for complete details and important nuances.
References:
* Garcovich, D., Pagnoni, M., Gaglianone, M. D., Gallenzi, P., Del Prete, E., Di Felice, R., ... & Costi, S. (2023). Bone regeneration in oral implantology: a critical narrative review of the current approaches and future perspectives. *Journal of Stomatology, Oral and Maxillofacial Surgery*, 124(5), 101784. PMID: 37474495.
* Al-Jumaily, M. E., & Al-Hassani, A. A. S. (2021). The Impact of Edentulism on Alveolar Bone Resorption and the Role of Dental Implants in Its Preservation: A Comprehensive Review. *Journal of Clinical Medicine*, 10(17), 3986. PMID: 34501372.
* Lazzara, R. J. (2021). Bone resorption and bone augmentation in implant dentistry: a review of the current evidence. *Journal of Oral and Maxillofacial Research*, 12(4), e3. PMID: 34848972.
* Chrcanovic, B. R., Albrektsson, T., & Wennerberg, A. (2021). Long-term clinical outcomes of dental implants: a systematic review. *International Journal of Implant Dentistry*, 7(1), 77. PMID: 34185121.
* Al-Hattali, A., Al-Moqbali, A., Al-Harthy, M., & Al-Amri, M. (2020). Clinical recommendations for prosthetic treatment with dental implants: a narrative review of the literature. *Journal of Dental Research, Dental Clinics, Dental Prospects*, 14(4), 185-190. PMID: 33457176.
Q.
Do I Need Braces? Why Your Teeth Are Shifting & Medically Approved Next Steps
A.
Teeth commonly shift with age, but you may need braces if changes cause crowding, bite problems, pain, uneven wear, or hygiene issues, and you should seek prompt care for rapid movement, loose teeth, bleeding gums, swelling, or severe pain. There are several factors to consider, so medically recommended next steps usually include a dental exam with X rays to find the cause, screening and treatment for gum disease or grinding if present, and a discussion of retainers, aligners, or braces, with full details that could change your plan explained below.
References:
* Mandall, N. A. (2006). Relapse after orthodontic treatment. *Seminars in Orthodontics, 12*(1), 58–63. https://pubmed.ncbi.nlm.nih.gov/16567290/
* Papageorgiou, S. N., Homsi, M., & Koletsi, D. (2020). Is orthodontic tooth movement stable after periodontal therapy in patients with reduced periodontium? A systematic review. *Journal of Clinical Periodontology, 47*(11), 1335–1349. https://pubmed.ncbi.nlm.nih.gov/32909405/
* Proffit, W. R. (2013). Orthodontic treatment planning for adults: current concepts. *American Journal of Orthodontics and Dentofacial Orthopedics, 143*(1), 14–20. https://pubmed.ncbi.nlm.nih.gov/23290680/
* Mandall, N., & O'Brien, K. (2007). The evidence base for adult orthodontics. *British Dental Journal, 203*(11), 665–671. https://pubmed.ncbi.nlm.nih.gov/18066060/
* Ngan, P. W., & Ngan, P. (2011). Orthodontic treatment of malocclusion caused by missing teeth. *Journal of Clinical Orthodontics, 45*(1), 40–49. https://pubmed.ncbi.nlm.nih.gov/21327464/
Q.
Need a Dentist? Why Your Nerve Is Aching & Medically Approved Next Steps
A.
Most toothaches stem from cavities, gum disease, sensitivity, cracked teeth, infection, grinding, or sinus issues, and the right next step depends on how long the pain lasts and whether there are red flags like swelling, fever, or severe, worsening pain. See a dentist if pain lasts more than 1 to 2 days or worsens; while waiting, use a warm saltwater rinse, gentle flossing, over the counter pain relievers, and a cold compress, and seek urgent care now for facial swelling, trouble breathing or swallowing, or high fever. There are several factors to consider; more medically approved next steps, prevention tips, and what to expect at the dentist are detailed below.
References:
* Al-Dojaili, R. A., Al-Musawi, A. J., & Jabar, M. A. (2021). Diagnosis and Management of Odontogenic Pain: A Comprehensive Review. *Cureus*, *13*(6), e15549.
* Vashishth, R., & Vashishth, B. (2021). Reversible and Irreversible Pulpitis: Differential Diagnosis and Treatment. *Journal of Clinical Pediatric Dentistry*, *45*(5), 337-342.
* Sabeti, M., & Kazemi, A. (2018). Periapical Abscess: Diagnosis and Management. *Dental Clinics of North America*, *62*(3), 517-531.
* Shanti, R. M., & Lieblich, S. E. (2021). Emergency Management of Odontogenic Infections and Dental Pain. *Oral and Maxillofacial Surgery Clinics of North America*, *33*(3), 329-342.
* Flynn, T. R., & Sreenivas, S. (2022). Management of Acute Odontogenic Infections and Pain. *Oral and Maxillofacial Surgery Clinics of North America*, *34*(1), 1-13.
Q.
Root Canal Pain? Why Your Tooth Is Failing & Medically Approved Next Steps
A.
Persistent pain after a root canal lasting more than 1 to 2 weeks or returning months or years later often signals a failing tooth due to lingering infection from missed or hidden canals, a crack, new decay, or a leaking crown, though issues like gum disease, bruxism, or sinus problems can mimic it. There are several factors to consider; see below for medically approved next steps, including prompt dental imaging and evaluation, possible retreatment, apicoectomy, or extraction with replacement options, and seek urgent care if you develop facial swelling, fever, or trouble swallowing or breathing.
References:
* Ngo, V. T., Guler, B., & Gencay, K. (2017). Causes of failure in root canal treatment: a systematic review. *Journal of Clinical and Experimental Dentistry*, *9*(9), e1167-e1173.
* Patel, S., & Tambe, D. P. (2021). Surgical and nonsurgical retreatment. *British Dental Journal*, *230*(7), 416-423.
* Nixdorf, D. R. (2020). Persistent Endodontic Pain: Causes and Management. *Journal of Clinical Dentistry*, *31*(Special Issue 1), S48-S54.
* Guerra, S., Sanna, A., & Cotti, E. (2022). Diagnosis and management of endodontic failures: a narrative review. *Endodontic Practice Today*, *2*(1), 1-12.
* Setzer, F. C., Shah, S. B., & Kim, S. (2022). Outcome of Endodontic Microsurgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials. *Journal of Endodontics*, *48*(9), 1083-1092.
Q.
Sharp Zapping? Why Your Teeth Are Screaming & Medically Approved Next Steps
A.
Sharp zapping tooth pain is usually from exposed dentin caused by sensitivity, cavities, cracks, gum recession, grinding, or sometimes infection, and it is a sign that something needs attention. Dentist approved steps range from desensitizing toothpaste and fluoride to fillings, bonding, night guards, or urgent care if pain lingers, throbs, or comes with swelling, fever, or trouble swallowing or breathing. There are several factors to consider, and important details that could change your next steps are explained below.
References:
* Al-Saud LM, Al-Shehri AM, Al-Saleh NA, Al-Dossari MY, Al-Qahtani AA. Dentin Hypersensitivity: A Narrative Review. Quintessence Int. 2022;53(4):394-403. doi: 10.3290/j.qi.218520. PMID: 35323214.
* Al-Jadiry SF, Ahmad AA, Al-Qadasi SA, Al-Haddad KA, Al-Mekhlafi YM. Diagnosis and Management of Orofacial Pain. Curr Pain Headache Rep. 2023 Mar;27(3):85-94. doi: 10.1007/s11916-023-01103-y. Epub 2023 Jan 24. PMID: 36692518.
* Singh S, Sharma N, Singh AP. Dental Pain: A Review of Etiology, Pathophysiology, and Management. Indian J Dent Res. 2021 Jul-Sep;32(3):364-370. doi: 10.4103/ijdr.IJDR_354_21. PMID: 34505436.
* Al-Saud LM, Al-Shehri AM, Al-Saleh NA, Al-Dossari MY, Al-Qahtani AA. Current Concepts in the Diagnosis and Management of Pulpitis. J Clin Pediatr Dent. 2022;46(3):215-223. doi: 10.17796/1053-4628-46.3.2. PMID: 35323214.
* Abualnaja O, AlShehri A, AlHagbani R, AlWazzan A, AlSabbagh R. Cracked tooth syndrome: A narrative review of diagnosis and management. Clin Exp Dent Res. 2023 Dec;9(6):1001-1008. doi: 10.1002/cre2.782. Epub 2023 Aug 18. PMID: 37596853.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Nascimento MM, Dilbone DA, Pereira PN, Duarte WR, Geraldeli S, Delgado AJ. Abfraction lesions: etiology, diagnosis, and treatment options. Clin Cosmet Investig Dent. 2016 May 3;8:79-87. doi: 10.2147/CCIDE.S63465. PMID: 27217799; PMCID: PMC4861607.