If there are concerns around aesthetics or clinical consequences such as dentinal hypersensitivity, a dental restoration (white filling) may be a suitable treatment option. Aside from restoring the lesion, it is equally important to remove any other possible causative factors. Adjustments to the biting surfaces of the teeth alter the way the upper and lower teeth come together, this may assist by redirecting the occlusal load. The aim of this is to redirect the force of the load to the long axis of the tooth, therefore removing the stress on the lesion. This can also be achieved by altering the tooth surfaces such as cuspal inclines, reducing heavy contacts and removing premature contacts. If bruxism is deemed a contributing factor an occlusal splint can be an effective treatment for eliminating the irregular forces placed on the tooth. Controversy
Abfraction has been a controversial subject since its creation in 1991. This is due to the clinical presentation of the tooth loss, which often presents in a manner similar to that of abrasion or erosion. The major reasoning behind the controversy is the similarity of abfraction to other non carious lesions and the prevalence of multiple theories to potentially explain the lesion. One of the most prevalent theories is called "the theory of non-carious cervical lesions" which suggests that tooth flexion, occurring due to occlusion factors, impacts on the vulnerable area near the cementoenamel junction. This theory is not widely accepted among the professional community as it suggests that the only factor is occlusion.
The observations of the following may indicate lower estrogen levels: little pubic hair, loss of the labial fat pad, thinning and resorption of the labia minora, and the narrowing of the vaginal opening. An internal exam will reveal the presence of low vaginal muscle tone, the lining of the vagina appears smooth, shiny, pale with loss of folds. The cervical fornices may have disappeared and the cervix can appear flush with the top of the vagina. Inflammation is apparent when the vaginal lining bleeds easily and appears swollen. The vaginal pH will be measured at 4.5 and higher. Treatment
Symptoms of genitourinary syndrome of menopause (GSM) will unlikely be resolved without treatment. Women may have many or a few symptoms so treatment is provided that best suits each woman. If other health problems are also present, these can be taken into account when determining the best course of treatment. For those who have symptoms related to sexual activities, a lubricant may be sufficient. If both urinary and genital symptoms exist, local, low-dose estrogen therapy can be effective. Those women who are survivors of hormone-sensitive cancer may need to be treated more cautiously. Some women can have symptoms that are widespread and may be at risk for osteoporosis. Estrogen and adjuvants may be best.Topical treatment with estrogen is effective when the symptoms are severe and relieves the disruption in pH to restore the microbiome of the vagina. When symptoms include those related to the urinary system, systematic treatment can be used.