Worn Teeth: Why They Are Getting Shorter
Worn teeth are losing their surface to acid, grinding or brushing, and some wear is normal with age. The wear pattern can hint at a cause but is not a diagnosis, and rebuilding worn teeth without controlling the cause can fail. If you notice sensitivity, changes in how your teeth look, or think you may have dental erosion, the Oral Health Foundation advises speaking to your dental team.
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Clinically reviewed by Dr Ibraheem Ijaz, dentist · GDC 301711
Medical disclaimer: This page is for general information only. It does not replace an examination or treatment by a dentist.
Dr Ibraheem Ijaz, principal dentist at Deepcar Dental Care, reviewed this page. He is a General Dental Practitioner, GDC 301711, with a BDS, BSc (Hons), MSc (Leeds) and postgraduate qualifications in implant, restorative and aesthetic dentistry.
What are worn teeth?
Worn teeth have lost hard tissue, enamel or dentine, to acid or physical wear rather than decay. UK guidance calls this tooth wear, a cumulative loss of tooth substance from chemical or mechanical factors, or both.
Teeth look shorter when wear on their biting edges and surfaces reduces crown height. Worn teeth are looked after within restorative dentistry, which focuses on keeping and repairing natural teeth, and other changes, such as a hole in a tooth, are covered among the options in this section.
Is tooth wear normal, or is it accelerated?
Some tooth wear is normal. UK guidance, Delivering Better Oral Health, calls it a natural part of ageing and judges its seriousness against age.
In a 2009 national survey of adults in England, Wales and Northern Ireland, 77% had some wear, and moderate wear, exposing a large area of dentine, was found in 44% of those aged 75 to 84 against 4% of 16 to 24-year-olds, because the damage builds up. The guidance uses the terms accelerated and non-age-related tooth wear, and says most people, although prevalence may be increasing, do not have accelerated wear.
What are the four causes of worn teeth?
Erosion, attrition, abrasion and abfraction are the four causes commonly listed, although UK guidance says clinical evidence that abfraction is a separate cause is lacking.
In the guidance, erosion is wear from acids not made by plaque bacteria, as our page on dental erosion and acid wear explains. Attrition is wear from tooth-to-tooth contact, as in teeth grinding and clenching (bruxism), and abrasion is wear from objects such as a toothbrush. Abfraction, a term the guidance does not recommend, describes notches at the gumline. The guidance says wear normally has several causes.
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How can the wear pattern point to the cause?
Where and how a tooth has worn can suggest a cause, but it is a clue rather than a diagnosis, because the patterns overlap.
| Possible cause | Wear pattern described | What the sources caution |
|---|---|---|
| Grinding or clenching (attrition) | Among grinding symptoms, the NHS lists worn-down or broken teeth, which can cause increased sensitivity, and loss of teeth and fillings. A 2015 study described attrition-type wear as wear into the dentine on biting edges and surfaces, with matching wear facets on opposing front teeth. | A 2024 review found mostly no or weak links between wear and grinding, except at the gumline, and called the evidence inconclusive; wear alone should not be taken as grinding. The exploratory 2015 study found more reported sleep grinding but no significant difference in measured sleep jaw-muscle activity. |
| Acid from food, drink or medicines (erosion) | Reviews describe loss of shine, flattened rounded surfaces, shallow hollows with a rim of intact enamel next to the gum, cupping and grooving on biting surfaces, and fillings standing proud. | One review says these signs came from clinical experience and small-group observations, not systematic research, and that cupping and grooving may also come from abrasion, making them doubtful for diagnosing erosion. |
| Stomach acid from reflux disease (erosion) | Wear on the inner (tongue and palate) sides. A consensus quoted in a 2012 review agreed that erosion, especially there, is more common with reflux disease. | The review concluded the link is clear though variable, with relatively few controlled trials; one large study found no significant link. |
| Brushing (abrasion) | Notches at the gumline, which UK guidance links to vigorous brushing. | A review found no single brushing factor can be shown to be the main cause; brushing may act with acid and, possibly, biting forces. |
The Oral Health Foundation advises that if you notice sensitivity, changes in how your teeth look, or think you may have dental erosion, you speak to your dental team, who can help identify the cause and advise how to protect your teeth. For reflux or an eating disorder, UK guidance advises seeking medical advice and support.
The NHS advises seeing a dentist if you grind your teeth and have tooth damage or sensitive teeth, or pain in your jaw, face or ear, if your partner says you grind in your sleep, or if you are worried about your child grinding their teeth.
Why must the cause be found before any worn teeth are rebuilt?
Rebuilding worn teeth without controlling the cause can fail.
A 2018 British Dental Journal guide concluded that restorations, even ones considered definitive, may have a limited lifetime in severe tooth wear because of grinding and erosion. It also concluded that restorative treatment is not always indicated, even for patients with severe tooth wear. A 2015 European consensus on erosive tooth wear says restorative treatment should only be used together with prevention. Our page on tooth wear explains treatment.
What happens if worn teeth keep wearing?
Continuing wear removes more tooth, and lost tooth tissue does not come back, although UK guidance says wear does not inevitably progress.
The guidance describes worn areas on back teeth exposing dentine, which can merge into wider, deeper hollows that reduce crown height. On front teeth, flattening of the outer surface can, without prevention, shorten the tooth if it merges with wear on the edge. Severe wear may affect appearance and shorten the lifespan of the teeth involved.
Exposed dentine can make teeth sensitive to heat, cold or sweetness, the Oral Health Foundation explains, though UK guidance says sensitivity is not necessarily a sign of progression. The Foundation advises that if you notice sensitivity, changes in how your teeth look, or think you may have dental erosion, you speak to your dental team.
Frequently asked questions
Can worn enamel grow back?
No, enamel that has worn away does not grow back. UK guidance says remineralisation is possible only in enamel, and only where there has been no physical loss. Once tissue is lost, tooth wear is irreversible. The guidance treats finding non-age-related wear early, and preventing its causes, as key.
Why do worn teeth look thin or yellow?
The Oral Health Foundation says that when enamel wears away, the dentine underneath becomes exposed and teeth may look thinner or more yellow. If you notice sensitivity, changes in how your teeth look, or think you may have dental erosion, it advises speaking to your dental team.
Is tooth wear the same as tooth decay?
No, they are different processes. The Oral Health Foundation says that, unlike tooth decay, erosion does not involve bacteria and is caused by acid alone. UK guidance describes attrition and abrasion as physical loss. Our page on diet and tooth decay explains how diet affects decay.
Can children's teeth wear down?
Yes. In a 2013 national survey, 33% of 5-year-olds had some wear on the outer surfaces of their upper front baby teeth, but only 4% had wear into the dentine or pulp. UK guidance says screening younger children matters, so early preventive advice can be given. Show a dentist any wear that worries you.
How quickly do teeth wear down?
Usually slowly. UK guidance says tooth wear is generally a slow process and may happen in episodes. It also says there are not yet accurate methods for measuring tooth wear over time. National survey figures show more wear with age, as the damage builds up.
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