How to fix worn down front and back teeth (2 steps with pictures)

The do's and don'ts of treating worn-teeth
Do you think your teeth are wearing down?

If so, you're not alone. Tooth wear is a common problem caused by a variety of factors. But don't worry, there are ways to manage the damage and prevent it from getting worse.

In this article, we'll cover the two main steps to fix worn down teeth permanently: managing the risk factors and repairing the damage.

The three most common causes of tooth wear:

Worn down teeth can be caused by a variety of factors. Sometimes they can act in combination and lead to further damage to the teeth. Three primary causes of tooth wear are Attrition, Abrasion, and Erosion.

Attrition happens when teeth rub against each other excessively, resulting in shiny, smooth surfaces called wear facets. It is often associated with a condition known as bruxism, which is involuntary grinding and clenching of the teeth.
tooth attrition

Abrasion occurs when teeth are rubbed repeatedly with abrasive objects such as a hard-bristled toothbrush or hard foods. The damage is typically located in the area of the tooth near the gum line. tooth abrasion and agressive toothbrushing Erosion, on the other hand, is caused by a chemical process, and it's the primary cause of tooth wear due to our modern diet's high sugar and acid content. When the acidity of our mouth increases, the minerals in our teeth start dissolving. Over time, this process can damage the protective teeth layers, causing them to shrink. Dental erosion can be the result of two main factors:

  • Internal Factors: These come from inside our bodies. Internal factors include repeated vomiting, acid reflux, gastroesophageal disorder, and eating disorders.
  • External Factors: These involve all the acidic substances you put in your mouth. They can include acidic foods and beverages (soda, citrus fruits, energy drinks, and vinegar) or certain medications (vitamin C, aspirin).

tooth erosion

Tooth erosion

The two steps you need to know to fix worn down teeth:

There are two main steps for treating worn down teeth: managing the risk factors by preventive measures and repairing the damage. Here are the essential steps involved in fixing worn down teeth:

1. Identifying and managing the root cause:

Your dentist will assess the type and cause of tooth wear to help you address the underlying risk factors. These measures will help you stop the wear progression, strengthen your teeth, and prevent further damage.

1. Attrition:

Your dentist may recommend a mouthguard to protect your teeth from further damage. They may also suggest an orthodontic treatment to correct any problems with tooth alignment that may be contributing to the problem. This will help to distribute the chewing forces evenly over your teeth and reduce overload.

2. Abrasion:

Switching to a soft-bristled toothbrush and adjusting your brushing technique to be gentler are recommended. You should also avoid chewing or biting on food or hard objects, such as pens, ice, or your fingernails.

3. Erosion:

You should make dietary changes and improve your oral hygiene. This includes drinking at least 1.5 liters of water a day, avoiding acidic foods and drinks, and not consuming anything after brushing in the evening and at night. Also, it's important to use toothpaste with remineralizing active ingredients (such as Fluoride or Hydroxyapatite).

The do's and don'ts of treating worn down teeth

2. Repair of worn teeth:

Once the causes of tooth wear are under control and the lesions are stabilized, you can consider a solution to repair and restore your teeth. There are different treatment options. The choice depends on the extent and location of the damage. Here are the solutions available to repair worn down teeth:

1. Front Teeth:

The solution for restoring worn front teeth depends on the location and extent of the damage.

1. When only the front visible surface of the teeth is worn out: Veneers

If the front surface of your teeth is affected, veneers can restore their height and shape. These are thin tooth-colored shells made of porcelain that cover the front surface of the teeth, creating a more even and aesthetically pleasing appearance.

veneers for worn down front teeth before and after: Restoring the front surface of teeth
2. Wear on the back of the front teeth: Composite Bonding or Palatal Veneers

When the wear is limited to the back of the front teeth, rebuilding the destroyed tissue is crucial. This can be accomplished through either composite bonding or palatal veneers.

  • Composite Bonding: This involves applying tooth-colored material to the affected tooth area to rebuild it. This option is ideal for minor damage.

  • Palatal Veneers: Also known as onlays, these are just like regular veneers, but instead of covering the front visible surface, they are bonded to the back side of the front teeth. Palatal veneers are an alternative option to composite bonding if the damage is more significant, involving the top portion of the teeth.

palatal veneer for worn down front teeth before and after: Restoring the back side of damaged teeth
3. The damage extends to all sides of the teeth: Crowns

When the front teeth are severely damaged, dental crowns may be the only option. These caps cover the entire visible part of the teeth, restoring both the teeth's appearance and function, resulting in a straighter, healthier smile.
Like veneers, they are custom-made from porcelain. This means they can also give long-lasting and highly aesthetic results for your front teeth.

2. Back Teeth:

Depending on the extent of the damage, there are a few options available to restore worn down back teeth:

  • Onlay: This is a type of restoration that covers the chewing surface of the tooth, providing support and stability. It is a more conservative approach than a full crown because it requires less tooth preparation.

  • Overlay: Similar to an onlay, an overlay covers the chewing surface of the tooth but extends over the cusps (the pointed parts of the teeth). It is a good option for teeth that have significant wear or damage but still have a good amount of healthy tooth structure.

  • Dental crown: When the damage to a back tooth is extensive, a dental crown may be the best option. A crown is cemented in place and covers the entire tooth, providing strength, stability, and protection. Crowns for back teeth can be made from a variety of materials, including porcelain, metal, or a combination of both.
overlays for worn down back teeth: Restoring the chewing surfaces

Complications if worn down teeth are left untreated:

If worn down teeth are left untreated, several complications can arise. These include:

  • Tooth sensitivity: As the protective enamel layer wears away, the underlying dentin layer becomes exposed, causing sensitivity to hot, cold, sweet, or acidic foods and drinks.

  • Change in the appearance of your teeth: Your teeth may look yellow and discolored. This is because dentin is naturally darker and duller than enamel. You may also notice cracks and chips as the protective layers break down.

  • Tooth decay: The exposed dentin is also more susceptible to decay, leading to cavities and potential tooth loss.

  • Gum recession: Worn down teeth can lead to gum recession, where the gum tissue pulls away from the tooth, exposing the root surface. This can cause tooth sensitivity, as well as an increased risk of decay and gum disease.

  • Jaw pain and headaches: When teeth are worn down, the jaw muscles have to work harder to compensate for the loss of tooth structure. This can lead to jaw pain and even headaches.

  • Malocclusion: Worn down teeth can alter the alignment of the teeth, causing a misaligned bite or malocclusion. This can lead to further wear and tear on the teeth, as well as difficulty chewing and speaking.

How to prevent tooth wear after treatment?

Here are some tips to prevent further wear on your teeth:

  • Use a soft-bristled toothbrush: Using a hard-bristled toothbrush or brushing too vigorously can damage tooth enamel and cause wear. So, it's best to use a soft-bristled toothbrush and brush gently.

  • Correct brushing technique: Brushing with a circular motion and not applying too much pressure can help prevent further wear.

  • Ask your dentist about fluoride supplements and remineralizing treatment: These can help strengthen your teeth, increase their resistance to acid attack, and prevent further damage. Ask your dentist if you can introduce a fluoride gel or a remineralizing toothpaste into your oral hygiene routine.

  • Limit acidic foods and drinks: Acidic foods and drinks such as citrus fruits, sodas, and sports drinks can erode tooth enamel, leading to wear. Limiting these in your diet can help prevent further damage.

  • Wear a mouthguard: If you grind your teeth or clench your jaw, wearing a mouthguard while sleeping can protect your teeth from further wear.

  • Correct your bite: If your teeth are not aligned correctly, it can cause uneven wear on your teeth. Correcting your bite through orthodontic treatment can distribute the chewing forces evenly and prevent further wear.

  • Visit your dentist regularly: Regular dental checkups can help detect wear on teeth early on and prevent further damage. Your dentist can recommend appropriate treatment or preventive measures to protect your teeth.

  1. Composite palatal veneers to restore a case of severe dental erosion http://www.dentalmedjournal.it
  2. The prevalence, etiology and management of tooth wear in the United Kingdom https://pubmed.ncbi.nlm.nih.gov/9338867/
  3. Tooth wear https://www.gov.uk/government/