Non Carious Crvical Lesions Essay

Non carious cervical or class V lesions (NCCL) are associated with loss of hard tissue, at the cementoenamel junction (CEJ) of the cervical third of the tooth structure. It is also referred as cervical abrasion or cervical erosion (Wood, Jawad et al. 2008). These lesions are commonly presented in a variety of forms to the general dental practitioners; varying from shallow grooves to broad dished-out lesions or large wedge-shaped defects, with sharp internal and external line angles (Sarode and Sarode 2013).
Restoring these lesions with predictable success is a restorative challenge, faced by the general dentist and requires knowledge and understanding of the aetiology of these lesions.
History
Miller in 1907 was amongst the first to relate non-carious cervical lesions, with chemical and mechanical factors in his experimental studies, and observations on the tooth wear (Levitch, Bader et al . 1994).
In early 1980, McCoy associated these lesions with bruxism as a primary cause of cervical erosion (Litonjua, Andreana et al.
2003).
Prevalence
Prevalence of non carious cervical lesions (NCCL) can vary from 5% to 85% (Levitch, Bader et al. 1994). The prevalence has been recorded as low as 2% by Shulman and Robinson, and as high as 90% by Bergstrom and Eliasson (Wood, Jawad et al. 2008). This wide variation in the prevalence of NCCL is due to the difference population age group range in the studies. Studies also showed that the prevalence of lesion is higher in older patients. The severity and prevalence increases with age, as patients are retaining more number of teeth nowadays (Levitch, Bader et al.1994). The older patient population has a greater percentage of NCCL. Older patient population are also associated with numerous, larger and deeper sized lesions (Wood, Jawad et al.
2008).
It is more prevalent in patients with good oral hygiene, as Levitch et al noticed prevalence is significantly higher in people brushing twice daily, when compared with those who brush less frequently.
Xhohga (1977) reported higher prevalence of NCCL in bruxist patients; as he reported that 87% of bruxists have NCCL, while only 20% of non-bruxists showed similar lesions (Wood, Jawad et al. 2008).
Aetiology
The aetiology of NCCL is complex and multifactoral. Most common aetiological factors associated with non carious cervical lesions are dental erosion, abrasion and tooth flexure (Levitch, Bader et al. 1994).
Dental erosion is defined as loss of dental hard tissue by chemical action not involving bacteria (Perez Cdos, Gonzalez et al. 2012). It can be caused by extrinsic and intrinsic factors (Levitch, Bader et al. 1994).
• Extrinsic factors are like; airborne acid, chlorinated swimming pool acid, acidic food and beverages such as citrus fruits, carbonated soft drinks and sucking on sour candies.
• Intrinsic factors are like; gastro oesophageal reflux disease (GORD) gastrointestinal problems, alcoholism, anorexia nervosa and bulimia.
Erosive cervical lesions caused by extrinsic factors are mainly seen on the labial surface of the anterior teeth, whereas intrinsic factors are associated with the