Tooth wear is different from tooth decay. It’s when your enamel is lost because of chemical and mechanical damage. While damage from tooth decay is localized to specific areas and can be treated with simple tooth-colored fillings, tooth wear is more likely to need treatment with dental crowns and possibly an entire smile makeover because of the widespread damage, including dental crowns, root canals, and maybe even dental implants.

woman holding her jaw in painSymptoms of Tooth Wear

Tooth wear can start subtly, and by the time symptoms develop, it might be well advanced and may require significant treatment. It’s best to identify the causes of tooth wear and stop them before you start to experience symptoms. However, it’s also important to know the symptoms of tooth wear. These include:

  • Tooth sensitivity
  • Chips and cracks
  • Tooth discoloration
  • Cupping and other changes in tooth shape
  • Shrinking teeth

Tooth sensitivity is one of the most noticeable symptoms of tooth wear, and it’s the one that brings people into our office most often. However, it’s also a nonspecific symptom, since sensitivity can be caused by many other aspects of poor oral health, such as cavities, infection, and receding gums.

Chips and cracks can happen at any time, especially due to trauma. But if you notice that your teeth are chipping a lot more than they used to in the past, it may be related to tooth wear. Once this process starts, it likely won’t stop until you identify the cause of tooth wear. In fact, it’s more likely to accelerate.

Tooth discoloration can also stem from many causes, such as staining beverages, tooth trauma, or tooth infection. However, unlike stains from foods and beverages, tooth wear doesn’t respond to teeth whitening treatments. And unlike trauma or infection, tooth wear affects many different teeth at once, causing widespread discoloration.

Cupping occurs when one tooth is essentially tunneling down into another tooth, creating an indentation that often looks like a cup. It doesn’t have to be a cup, but you’ll notice that your teeth are shaping to one another, fitting together perhaps a bit too precisely.

As your teeth get damaged by wear, they can start to look smaller. Note that this isn’t always the same as when you notice that you show less of your teeth when you smile now than in the past–that can be caused by other aging effects.

Types of Wear

In general, we divide tooth wear into three types: erosion, attrition, and abrasion. We go into this in more detail in another blog, but brief definitions will suffice here.

  • Erosion is destruction of teeth by chemicals, especially acids.
  • Attrition is when your teeth contact each other, causing wear.
  • Abrasion is when hard and rough materials rub against your teeth, removing enamel.

It’s possible to experience all three types of tooth wear at the same time, which can lead to extensive damage quite quickly.


Bruxism is involuntary teeth clenching and grinding. It may be related to stress, can be caused by some medications, may follow a jaw trauma, or it may have no clear inciting incident. Bruxism can be a cause of temporomandibular joint disorder (TMJ), but it can also be relieved with TMJ treatment. Bruxism primarily causes attrition.

Sugary, Acidic Drinks

Many of the beverages that we enjoy on a regular basis are actually acidic and can be highly damaging to teeth. Wine, for example, is highly acidic, as are some fruit juices. However, the most dangerous acidic drinks are sodas and sports drinks. The very low pH of these drinks, combined with a tendency to consume them in large quantities, makes these drinks a very potent source of tooth erosion. With this type of erosion, damage often starts in the front of the mouth.


Gastroesophageal reflux disease (GERD) can cause significant tooth erosion. GERD occurs when stomach acids bubble up in your throat during sleep. These stomach acids can be highly damaging for your teeth and gums. This type of erosion tends to start with the back teeth, but it can ultimately affect your entire mouth.


The purging behaviors of bulimia also expose your teeth to high quantities of stomach acid. As a result, they can also cause serious tooth erosion, resulting in significant tooth damage over a relatively short period of time. Damage often hits the back of the front teeth hardest at first, but will ultimately damage all your teeth.

Hard Foods

Our teeth can be abraded by exposure to hard foods. Treats like popcorn can be significantly erosive to our teeth, resulting in heavy tooth wear.

But healthy foods can also be damaging to our teeth. For example, hard vegetables like carrots, collards, and kale can all cause significant wear on our teeth when eaten regularly. Often it’s not the food itself that causes the abrasion, but grit in food that isn’t well washed, so if you eat a lot of vegetables from your garden or you get food from a farm co-op, make sure you are washing vegetables well.

Abrasive toothpaste

Even your oral hygiene may not be suitable for protecting your teeth. Make sure you are not using an abrasive toothpaste, and always remember to brush gently with a soft-bristled brush. Aggressive toothbrushing or the use of abrasive toothpastes can lead to tooth wear and receding gums.

Unfortunately, toothpastes aren’t generally labeled with their abrasiveness. It can be very hard to determine how abrasive toothpastes are. However, you should avoid most toothpastes marked either as “whitening” or “tartar control,” as these tend to be the most abrasive styles.

Have Your Teeth Eroded?

As we mentioned before, by the time you experience the symptoms of tooth wear, it’s likely quite advanced. However, if you are experiencing symptoms like sensitivity, cracking, discoloration, cupping, or shrinking teeth, it’s time to take action. First, track down the causes of your tooth erosion. The odds are good that at least one thing on this list stands out as a possible cause. Once you have a likely cause, do what you can to limit or stop the damage. Then please call (949) 551-5902 for an appointment with an Orange County cosmetic dentist at Rice Dentistry in Irvine.