One issue that I commonly see in patients is the loss of tooth structure as a result of wear. Teeth have been worn down to the point that they can no longer function correctly, and complex dental work must be completed to address this problem.
Let me start by saying that all teeth will undergo some wear and tear during your lifetime. However, a patient could live to the age of 100 with normal tooth wear and never experience any pain, or notice a change in the look of their teeth.
The type of wear I’m referring to is a pathological wear, where the tooth is no longer sustainable in its current state. This wear can be a result of a number of stimuli, including:
- Tooth grinding: Either as a result of a nervous habit, or an effect of the teeth being used outside of their normal function. For instance, chewing on straws or toothpicks, or holding things between your teeth.
- Acids: These include both acids from both your stomach and your diet (i.e. citrus, mints or sodas).
- Tooth loss: Loss of teeth in one area of the mouth can cause you to chew differently, placing extreme stress on the remaining teeth and creating friction that results in tooth loss.



These three photos are examples of pathological wear due to excessive grinding and acid erosion. This patient required full mouth reconstruction to rebuild lost enamel and reduced vertical dimension.
Unfortunately, the wear that these stimuli cause to teeth can occur without the patient noticing. It is a slow wear that occurs over a long period of time, gradually reducing the tooth structure until it becomes an issue of pain or aesthetic.
Determining the cause of this wear and treating issues early can go a long way in improving patients’ dental health. That is because the treatment for this wear is often complex dentistry, which will only become more involved as the wear continues.
However, if caught early, wear can be addressed with a bite guard or bonding and crowns only to the teeth that are affected. As it gets worse, restorative dentistry will be needed to address changes to the bite, and require a combination of crowns, veneers and orthodontics to treat the problem.
The consequence of not treating this is ultimately tooth loss. While your teeth will not fall out, they will wear down until a root canal is needed. That is why it is so important to address tooth wear at its earliest sign.
If your teeth have shortened in the last 5 years, or your smile has changed, talk to your dentist about how you can prevent and mitigate the loss of tooth structure. Other signs of wear include jagged edges or translucency around the tooth structure.
If you suspect that your teeth are wearing, or have questions about the treatment for this problem, call us at (813) 689-4226 to schedule a consultation today.