Worn and eroded teeth

What wear looks like

Worn teeth may look shorter, flatter or more yellow, with edges that chip or look translucent. They can also be sensitive to cold, and the bite can feel different from how it used to. The change is usually gradual, so many people notice it only when comparing old photographs.

What causes it

• Grinding and clenching (bruxism). Teeth wear flat against each other, often during sleep.
• Acid erosion. Stomach acid from reflux or vomiting, and frequent acidic food or drink, dissolve the enamel surface.
• Abrasion. Hard brushing or habits such as biting objects wear the teeth in specific places.
• A combination. Wear is often several causes at once, which is why a diagnosis comes before a restoration.

Why the cause comes first

Rebuilding worn teeth without dealing with the cause means the new restorations wear or break in the same way. Depending on the findings, the plan can include a night guard, advice on diet or a referral to a physician for reflux, and bite adjustment alongside restorative treatment.

Options

• Monitoring with records, when the wear is mild and not progressing.
• Bonded restorations to rebuild small areas conservatively.
• Onlays, veneers and crowns to restore shape and protect weakened teeth.
• Full-mouth rehabilitation when wear is widespread and the bite itself needs to be re-established. See the guide to full-mouth rehabilitation.

Planning how much to restore

Deciding how much length and shape to restore is the central question. Dr. Lal’s approach is to design the proposed result digitally and, where appropriate, let the patient try it with provisional restorations before the final work is made, so appearance and bite can be checked and adjusted first.