Tooth Wear

All teeth wear throughout the life of an individual. Usually tooth wear is very slow and, despite the fact nature does not provide the means of repairing or applying new material to replace parts worn or damaged, most teeth will survive the lifespan of that person.

Sometimes tooth wear becomes excessive and the appearance of the teeth deteriorates or discomfort in eating and sometimes pain can result.

Excessive tooth wear can be caused by rubbing teeth together (Attrition), by the softening and dissolving of the surface of acids (Erosion), by something hard or rough removing the surface (Abrasion), or by a flexing of the tooth under excessive load (Abfraction). Usually combinations of all factors are present.


The cause of teeth grinding together and causing excessive tooth wear, might simply be a habit or as a means of relieving stress or of wearing down something which Pprevents the teeth fitting together properly when chewing (E.G. A filling which is too Large or a tooth which has grown into an odd position in the mouth).

Such wear occurs, for example, ehen someone waits impatiently at a red traffic light, tensed up, with jaw set and teeth grinding together. Others grind their teeth together when asleep and are unaware of their habit. The first group can reduce such wear by altering their habit and attempting to stop or seduce it. Those in the second group are obviously unaware of their habit and are not able to stop. Sometimes a plastic mouth guard which is worn at night can help reduce the wear.


Tooth wear by erosion is caused by acids, softening and dissolving the surface. The acids may be present in the mouth either from the diet or from the stomach

Acid in the diet typically arises from the excessive intake f cola-type drinks and carbonated, fizzy drinks with high acid content. many people who wish to adopt a healthy, natural diet, drink daily, large amounts of fresh fruit juices most of which are very acidic. This is harmful since in a truly natural diet, fruit fnd fruit juices were very seasonal and the yearly intake by humans was quite modest. Nowadays, with modern farming and industrial methods, vast quantities of pure juice from a wide variety of fruits, worldwide, (pineapples, oranges, lemons, apples, kiwi fruit etc) are available all year round from the local supermarket. Some people consider that 1 litre per day can’t do harm, but this would certainly harm not only the teeth but could irritate the stomach. If you must consume fruit juice, Try to reduce the frequency and protect your teeth by using a drinking straw (which will direct the acidic juice past the teeth) or gulp it down rather than wash it around the mouth and teeth.

Other sources ofaAcid in Yyur diet would be wine drinking (particularly white) and yoghurt. Again moderate amounts are acceptable; excessive amounts are unacceptable. odd habits such as frequently sucking raw lemon slices are obviously harmful.

Acid from the stomach can arise from:

  • A hiatus hernia or oesophageal reflux
  • Anorexia nervosa and bulimia
  • Alcoholism and narcotic addiction.

Oesophageal reflux occurs when the acid contents of the stomach are allowed to run back from the stomach into the mouth typically when lying down or asleep. Pregnancy may also give rise to such conditions. This can be reduced by avoiding eating a large meal or consuming a large amount of drink just before bedtime. Those who suffer from a hiatus hernia or heartburn may reduce their symptoms with antacid tablets prescribed by their doctor.

Those Wwho suffer from anorexia nervosa or bulimia (the slimmer’s diseases) vomit regularly, exposing their teeth to acid each time.

Those who suffer from alcoholism and narcotic addiction also have recurrent vomiting and reflux of acid from the stomach to the mouth.

People who suffer from these conditions will rarely admit that they are unwell and will certainly not accept advice from a dentist. Tooth wear in such cases is difficult to control and will only be possible once the individual accepts medical treatment and advice.

Extra damage is done to these patients’ teeth by immediately brushing their teeth after vomiting or taking acidic foods. Always allow at least half an hour for your saliva to neutralise the acid before brushing.


Tooth wear by abrasion is often caused by an aggressive tooth brushing technique, or by using an abrasive toothpaste or tooth powder (typically a “smoker’s toothpaste”), or by brushing too frequently or by using a hard brush.

To clean the teeth and gums effectively it is only necessary to brush twice daily, using a gentle, meticulous technique with a soft or medium nylon toothbrush. The well known brands of toothpaste are acceptable but avoid any which are recommended for removing stains from smoking since invariably these are too rough and gritty

Tooth wear will result if teeth are used against hard unyielding objects – supporting pipe stems, stripping wire, holding sails/hairgrips, opening beer bottles, cutting string – you name it, it’s been done.

Tooth wear is often only recognised by the dentist and hence the importance of regular attendance for check-ups. Since the changes are fairly small, impressions are taken on successive visits to make stone models, which are then compared.


Usually occurs on pre-molar or canine teeth and is characterised by a well defined notch at the gum level.