Some degree of tooth wear is normal with age, but excessive wear can affect how your teeth look and feel. Find out what causes it and how to protect your teeth.
Tooth wear is the gradual loss of tooth structure — the enamel and dentine that make up the visible part of your tooth. Some wear is a natural consequence of using your teeth over a lifetime, but excessive or accelerated wear is a clinical concern that requires investigation and management.
There are four recognised types of tooth wear, and they often occur together:
Erosion — tooth structure dissolved by acid (dietary or from stomach acid)
Attrition — wear caused by tooth-to-tooth contact — from chewing, or from grinding and clenching (bruxism)
Abrasion — wear caused by an external agent, most commonly over-vigorous toothbrushing
Abfraction — wedge-shaped notches at the gumline thought to result from the flexing forces of biting. Often appears alongside erosion and abrasion.
What causes tooth wear?
Tooth wear is usually caused by a combination of factors:
Diet — frequent consumption of acidic food and drinks (fizzy drinks, fruit juices, citrus fruits, vinegar-based foods, alcohol)
Acid reflux or GORD — stomach acid reaches the mouth, attacking teeth from the inside surfaces
Tooth grinding (bruxism) — creates significant attrition on biting surfaces
Aggressive toothbrushing — using too much pressure or a hard-bristled brush
Occupational exposure — certain jobs involving exposure to acidic environments (e.g., battery manufacturers, some food industry workers)
Dry mouth — saliva normally protects against erosion; less saliva means more risk
Signs and symptoms
Tooth wear develops slowly, and many people only become aware of it when it is already quite advanced. Signs include:
Teeth that look shorter, flatter, or more rounded than they used to
A change in your smile — particularly if front teeth look shorter or more yellow
Teeth that appear increasingly yellow as enamel thins and the darker dentine shows through
Sensitivity to cold, heat, or sweet foods
Roughness or sharper edges on teeth, noticed by the tongue
Cupping or dents on the biting surfaces of molars
Cracks, chipping, or broken fillings more frequently than expected
How is tooth wear managed?
The most important step is identifying and reducing the cause. Without addressing the cause, any restoration will itself be worn away.
Clinical management may include:
Dietary review and advice — identifying and reducing acidic food and drink triggers
Referral to your GP for management of acid reflux if this is a contributing factor
A custom nightguard or occlusal splint to protect teeth from grinding forces
Fluoride treatments — prescription-strength fluoride toothpaste or in-surgery fluoride application to help protect and desensitise the remaining tooth structure
Monitoring — regular clinical photographs and study models (or 3D scans) to track whether wear is progressing
Restoring lost tooth structure — once wear is stable, damaged teeth may be restored with composite bonding, veneers, or crowns depending on severity
What you can do at home
Simple daily habits make a significant difference:
Reduce acidic food and drinks — keep them to mealtimes only, not sipped throughout the day.
Use a soft-bristled toothbrush and gentle pressure — let the brush do the work.
Wait 30–60 minutes before brushing after acidic food, drink, or vomiting — enamel is temporarily softened and more vulnerable immediately after acid exposure.
Use fluoride toothpaste and do not rinse after brushing — leave the residue on your teeth.
Stay hydrated — good saliva flow protects teeth. Drink plenty of water throughout the day.
Discuss any concerns about heartburn or reflux with your GP — managing this medically can significantly slow dental erosion.
When to see your dentist
Make an appointment if you notice:
Visible changes to the shape or length of your teeth
Increasing sensitivity across multiple teeth
Frequent chipping or cracking of teeth or restorations
Regular check-ups are particularly important if you have tooth wear — your dentist will monitor for any progression and advise on the right time to intervene with restorative treatment.
This leaflet is for general information only and does not replace professional dental advice. Your dentist will discuss your individual circumstances and any risks and treatment specific to you. Treatment outcomes vary between patients depending on individual circumstances.
References
Aligned with guidance from: NICE, SDCEP, FGDP(UK), DBOH.