Tooth wear is classified into four types: attrition, caused by teeth rubbing together; erosion, caused by acid; abrasion, caused by objects such as toothbrushes rubbing the teeth; and abfraction, caused by unbalanced chewing forces. Bruxism, an acidic diet, hard brushing, reflux and bite problems are the main causes. Treatment includes night guards, composite bonding, porcelain veneers and crowns.
- Worn tooth enamel cannot regenerate and will progress if untreated.
- Sensitivity to hot and cold is one of the earliest signs.
- Wait at least 30 minutes after acidic food before brushing.
- A soft brush and circular movements are recommended.
- Whitening with baking soda can cause permanent abrasion of enamel.
Tooth wear is a problem many of us share. The rush of daily life, eating habits and some routines we follow without realizing can damage tooth enamel, the hardest tissue in our body. Beyond aesthetic concerns, tooth wear is a serious dental problem that can lead to severe tooth sensitivity and loss of function over time.
In this guide, we cover tooth wear, one of the most common conditions seen in modern dentistry, in full detail, from its types to how to prevent it.
What Are the Types of Tooth Wear?
Tooth wear is examined in 4 main groups according to how it develops and the structural damage it causes:
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Attrition (Natural Wear): This is wear caused by teeth rubbing against each other. It can be a natural part of aging, but in people with bruxism (clenching and grinding) it can become severe enough to cause a loss of vertical dimension.
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Erosion (Chemical Wear): This is the dissolving of tooth enamel through purely chemical and acidic processes that do not involve bacteria. It is seen especially with acidic drinks, a citrus-heavy diet and conditions in which stomach acid reaches the mouth, such as reflux / bulimia.
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Abrasion (Mechanical Wear): This occurs when objects other than teeth rub against the teeth. Using hard-bristled toothbrushes, brushing with too much pressure, nail biting or chewing on pens are the clearest causes of this type.
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Abfraction (Stress Wear): These are micro-cracks and V-shaped lesions that form at the junction between the tooth and gum (the cervical area) when teeth receive chewing forces unevenly. They are usually triggered by a faulty bite and clenching.
The Main Causes of Tooth Wear
The factors that lead to loss of tooth structure are multifactorial; in other words, more than one cause is usually present at the same time:
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Parafunctional Habits: Clenching the teeth, whether at night or during the day (bruxism).
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Dietary Mistakes: Heavy consumption of carbonated and acidic drinks, energy drinks and excessive citrus fruits.
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Incorrect Oral Care: Brushing hard and carelessly with highly abrasive toothpastes in an effort to whiten the teeth.
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Systemic Conditions: Chronic reflux, stomach disorders involving frequent vomiting and conditions that reduce saliva flow (causing dry mouth).
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Anatomical Bite Problems: Excessive load on certain teeth because the jaws meet incorrectly.
What to Do About Tooth Wear and Treatment Options
As soon as tooth wear is noticed, the process should be slowed down with measures taken at home, and a dentist should be consulted to plan personalized treatment.
Measures You Can Take at Home
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Switch to a Soft Brush: Choose soft or ultra-soft toothbrushes and adjust your brushing technique to circular and sweeping movements.
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Wait After Acidic Foods: Do not brush your teeth immediately after eating something acidic. Because acid softens enamel, brushing right away increases wear. Rinse your mouth with plenty of water and wait at least 30 minutes before brushing.
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Adjust Your Diet: Drink fizzy and acidic beverages through a straw (to reduce contact with the teeth) and limit how often you consume them.
Clinical Treatment Options
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Night Guard (Splint) Treatment: Custom clear night guards are made to prevent attrition caused by bruxism.
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Composite Restorations (Bonding): Worn areas are restored with tooth-colored composite fillings, restoring aesthetics and preventing tooth sensitivity.
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Porcelain Veneers and Crowns: In cases of very advanced wear where the teeth have become shorter, porcelain crowns or veneers are preferred to restore aesthetics and function.
Frequently Asked Questions (FAQ)
Does tooth wear go away or reverse on its own?
No. Because worn tooth enamel is not living tissue, it cannot regenerate or grow back. Untreated wear progresses over time. However, the damage can be fully repaired with restorations done in the clinic.
Are tooth sensitivity and twinges a sign of tooth wear?
Yes, sensitivity to hot and cold in particular is one of the earliest signs of tooth wear. When the protective enamel layer wears away, the sensitive dentin beneath is exposed and starts to react to external stimuli.
How much does teeth grinding wear down the teeth?
In severe cases of bruxism, the teeth can be worn down to half their height and the chewing surfaces become completely flat. This also leads to jaw joint (TMJ) pain.
Does whitening teeth with baking soda cause wear?
Yes. Baking soda and similar coarse-particle substances have a high abrasiveness (RDA) value. Instead of whitening the teeth, they create microscopic scratches in the enamel, causing permanent abrasion and making teeth stain more quickly.
In summary, tooth wear is a process that leads to aesthetic and functional losses if not treated in time, but it can be fully brought under control with the right diagnosis. If you notice sensitivity or changes in the size of your teeth, you should see a dentist without delay to learn about personalized treatment options and take a step toward a healthy smile.
