Is it possible your teeth have become worn over time? It’s fairly common, and most people don’t even realize it’s happening - for many people, their dentist is the first one to tell them they have signs of tooth wear. Many other people aren’t sure how serious the problem really is.

Unfortunately, it’s not just a cosmetic issue. After dental decay and gum disease, many dentists consider tooth wear to be the third significant dental “disease” that we diagnose and treat every day. In this post, I’ll talk about what those risks are and how you can protect your teeth, as well as how teeth get worn down in the first place.

How Do Teeth Get Worn Down?

There are a number of reasons why teeth become worn over time. Normal function (eating and speaking), and some diets promote tooth wear at varying rates. Outside of normal function, the most common cause of wear on teeth is clenching or grinding (upper and lower teeth touching or teeth rubbing against each other at times other than when you’re eating or swallowing). This can happen during the day (like maybe when you’re concentrating hard on a task, or faced with a stressful situation) or at night (which most people do not even realize they’re doing, so it can be harder to identify and control).

The result of that kind of repeated tooth-to-tooth contact is called “attrition,” or wear. If you think you may have worn teeth, and you don’t know why the most likely cause is attrition related to clenching or grinding.

A few other reasons your teeth might appear worn are:

Other habits, like biting and chewing on hard objects (like pens, fingernails, or ice)
Erosion from long-term exposure to acidic substances (like soda, energy drinks, juice, coffee, etc.) or from acid reflux
Severe tooth decay - but this is a whole other problem

What Do Worn Teeth Look Like?

Mild tooth wear isn’t always obviously visible, which is why people often aren’t aware of it. Severe wear can be much more apparent, and sometimes painful. With severe wear, you’ll notice shorter, flat-looking teeth with sharper edges, that may appear more yellow (if the inner layers of the tooth are exposed, which have a more yellow color).

Often you’ll notice a slight unevenness or jaggedness to the ends of teeth, as a result of chipping. Other times teeth start to look more rounded (the same way sand wears away at a rock and makes it smoother). You might also feel soreness, or tightness in your facial muscles, especially when you first wake up in the morning.

Here’s a list of the most common symptoms of wear:

Teeth that look unusually jagged or unusually smooth
Cracks or chips in teeth
Shorter teeth
Tooth sensitivity or pain (especially with hot or cold foods)
Yellowing of teeth, due to worn enamel
Problems with dental restorations like crowns or fillings.
A bite that seems to change

The Consequences of Wear Over Time

Increased risk of decay: Worn teeth don’t just look different, they’re actually more vulnerable to cavities and decay. That’s because worn teeth are missing some of their tooth enamel -- the hard, protective layer that covers your teeth and keeps bacteria from getting into the rest of the tooth. The layer below enamel, dentin, isn’t as strong, is more porous, and is much more susceptible to decay if exposed.

Uneven bite: When teeth lose their natural shape, your bite can change, and as a few teeth become worn, more will follow and become worn down over time too - because all of our teeth work together as a system, rarely is just a single tooth affected. A bad bite can cause even more grinding and clenching while you sleep, which only makes the wear worse. A bad bite can also lead to jaw popping, headaches, and other facial and neck muscle pain.

Facial changes: If teeth get so badly worn that a significant portion of tooth is missing, it can actually make the lower half of your face appear shorter, especially when your mouth is closed.

Solutions for Severely Worn Teeth

If you have worn teeth or wonder if you do, take the first step by talking to your dentist about it. Depending on the severity of your situation, you may have several treatment options available to you. The right solution depends on how your teeth became worn in the first place and how extreme the wear is.

A Night Guard

If you have tooth wear related to clenching or grinding your teeth at night, or if you have wear and you’re not really sure why, a bite guard to wear at night can be a great treatment. Depending on the type of guard your dentist recommends, it can protect your teeth from damage caused by coming into contact with each other while you sleep, and it can even protect your jaw joint and jaw muscles from the stress of constant clenching and grinding. A night guard is also a great supplement to other treatment options - in some cases it might be mandatory!

Dental Crowns and Other Restorations

If you already have more significant loss of tooth structure due to attrition, your dentist may recommend attempting to replace that lost tooth structure, with options like bonded composite restorations, crowns, or porcelain veneers to cover and protect worn teeth and rebuild the worn teeth back up to their natural, healthy form.

Depending on how worn your teeth are, this may be simple, or it can be very complex in more severe cases of wear. Look for a dentist with lots of experience treating cases of severe attrition, if you’re in that situation - it can mean rebuilding most or all of your teeth, which takes training and skill.

How to Prevent Worn Teeth

Veneers and crowns are good solutions for worn teeth, but if you can prevent wear on your teeth in the first place, that’s even better. If you’re concerned you might be damaging your teeth from grinding or clenching during sleep, here’s my advice:

Know the symptoms of tooth grinding. Have you noticed headaches, sore facial muscles, jaw pain, insomnia, general stress, or tooth soreness or sensitivity (especially when you wake up in the morning)? Those are all common signs of sleep bruxism (clenching and grinding teeth in your sleep).

Identify the cause. If you can figure out why you are grinding and clenching at night, you’ll have a better chance of stopping it from happening. Your dentist may have good advice here. Common causes include:

Stress
Anxiety or depression
Chronic body pain
Bad posture, neck, or back problems
A bad bite or abnormal bite
Sleep apnea

Find a treatment that works. A night guard can be a good preventative measure even if you’re not seeing signs of tooth wear yet. Many stores carry night guards you can try, although one that’s custom-made for you by a dentist will be more comfortable and effective. Talk to your dentist about other treatment options. You may decide to make other lifestyle changes too.

Don’t Wait Too Long for Treatment

Unfortunately, if your teeth are worn now, they’re probably going to continue to wear as time goes by. I urge you not to wait too long before calling your dentist.

With the right treatment, you’ll have your smile back and you won’t have to worry about damaging your teeth even more.

If you want to find a solution for your worn teeth, or just have some questions, I’d love to help. Give my office a call at 540-298-6696 to set up an appointment.

Photos: Itdent, BruceBlaus

Should I Be Worried about my Worn Teeth?