Why Teeth Wear Down, and Why It Speeds Up
Grinding and wear · 11 August 2026 · 6 min read
Teeth wear for three reasons: grinding tooth against tooth, acid softening the surface, and abrasion from brushing. Most people who have significant wear have some combination. Enamel does not grow back, and once it is worn through, the dentine underneath wears roughly seven times faster — which is why wear that took twenty years to become noticeable can become severe in five.
The three causes, and how to tell them apart
Attrition is tooth against tooth. It produces flat, polished, matching facets — the upper and lower wear patterns fit together like a key in a lock. It is the signature of grinding or clenching, most of which happens during sleep and most of which people do not know they do.
Erosion is chemical. Acid softens the enamel surface and it is then lost. It produces smooth, scooped, glassy hollows, often on the inner surfaces of the upper front teeth or as cupped depressions on molar cusps. The usual sources are reflux, frequent citrus or vinegar, sparkling water sipped through the day, sports drinks, wine, and vomiting.
Abrasion is mechanical wear from something other than teeth — usually a hard brush used with pressure, producing notched grooves at the gum line.
The distinction matters because the treatment for each is different, and rebuilding worn teeth without addressing the cause simply means the restorations wear too.
Why it accelerates
Enamel is the hardest tissue in the body. Dentine, immediately beneath it, is considerably softer — it wears at something like seven times the rate. So wear is not linear. There is a long, slow phase while enamel is being lost, and then a much faster one once it is breached.
This is what makes early recognition worth something. A patient in their thirties with flattened canine tips has a problem that is cheap to manage and expensive to ignore. The same mouth twenty years later may need full-mouth rehabilitation — rebuilding the bite as one planned sequence — because so much vertical height has been lost that individual repairs no longer fit together.
Signs worth noticing
- Front teeth that look shorter, or have become uneven or translucent at the edges.
- Flattened canine tips — canines should be pointed.
- Sensitivity to cold or to sweetness that was not there before.
- Chipping at the incisal edges, or fillings that stand slightly proud of the tooth around them.
- Jaw muscles that ache in the morning, or a partner who reports grinding noises.
- Cupped depressions on the biting surfaces of molars.
What can be done, by stage
Early. Identify and remove the cause. A night guard for grinding. Managing reflux with a doctor. Changing when and how acidic things are consumed — and not brushing for half an hour afterwards, because brushing softened enamel removes it. Monitoring with a 3D scan so change is measured rather than remembered.
Moderate. Rebuilding individual teeth as they need it, conservatively. Bonded onlays keep more natural tooth than crowns do, which matters a great deal in a mouth that will need more work later.
Advanced. Where the bite itself has collapsed, teeth are rebuilt as a planned sequence with a provisional stage worn and tested before anything definitive is made. This is slow, deliberate work, and it should never be started without records, photographs and a full understanding of the cause.
The point of measuring
Wear is difficult to notice in your own mouth because it happens across years. A digital scan taken at a first visit becomes a baseline: five years later the two can be overlaid and the change read off in millimetres, rather than argued about. That is the most useful thing we can offer someone who grinds — not a prediction, but a measurement.