Why are My Teeth Getting Smaller? Understanding the Types of Tooth Wear and What to Do About it!

We’re often asked by our patients that why is their teeth appear to be getting shorter or more yellow. Most often, the culprit is tooth wear. Much like how our car tires sustain wear over time and get thin, our enamel is under constant physical and chemical forces that add up over time and result in thinning enamel and loss of tooth structure. Sounds scary, but really by understanding how it happens we can help slow the damaging process down and prevent the worst of it.

There are three types of tooth wear:

1. Attrition: When the chewing surfaces of the teeth rub against each other, it causes gradual loss of enamel over time. Enamel is the strongest material in our body, but even it can wear itself down, especially in individuals who grind their teeth.
2. Abrasion: When other objects or external materials rub off the enamel or exposed roots of teeth. Examples included too-gritty toothpaste (like whitening toothpaste!), aggressive brushing, or using your teeth to rip open a bag.
3. Erosion: Unlike the first two types of wear, which are mechanical, erosion is chemical in nature. Simply put, acids soften the enamel and “melt away” tooth structure. This is not the same as decay! Decay is caused by bacteria. Acids could be from foods and drinks we tend to enjoy or from gastrointestinal issues like acid reflux or frequent vomiting.

We can see the signs of tooth wear during your regular dental exam. Attrition causes flattened chewing surfaces and the edges of front teeth. Abrasion commonly affects the outsides of teeth along the gum line, where we see the concave-shaped loss of tooth structure. Erosion can be seen on either the chewing surfaces or along the outsides of teeth. The results are usually shorter teeth, more yellow teeth (because of the loss of enamel and the naturally more yellow dentin shows through), and thinner or flatter edges of front teeth. This makes teeth smaller and weaker, thus making them more prone to other problems like fractures or sensitivity.

How to Protect Your Pearly Whites:

Treating tooth wear begins with finding the source of it and treating that first, like acid reflux disease. Replacing lost tooth structures could involve fillings, veneers, onlays, or crowns. Preventing tooth wear is easier than you may expect.

1. Don’t brush immediately after eating. This provides an opportunity for your saliva to neutralize the acids in your mouth first and your enamel time to rebuild with the good minerals from saliva before the toothbrush comes along and abrades the surface. Waiting at least 30 minutes prior to brushing can really help! When you do brush, slow down and gently use a soft-bristled brush in a circular motion. Be sure to avoid any whitening toothpastes that are too abrasive.
2. Limit any acidic foods or beverages (citrus, soda, wine, etc.) to meal times instead of snacking or sipping throughout the day. If you suspect you have acid reflux, please talk with your doctor about it. Avoid swishing wine, soda, or juice around in your mouth. To help neutralize your mouth a bit faster, you could try rinsing with water or a mouthwash to clear out any remaining acids lingering around. Or using sugar-free chewing gum, especially ones with xylitol, to help stimulate more saliva flow.
3. A night guard or day guard can protect our teeth from clenching or grinding.
4. How teeth are aligned and positioned in your mouth can cause certain areas to wear down faster than others. Some people close their front teeth edges, which can cause attrition slowly over time, similar to grinding. Talking with your dentist about correcting any crowding or unhealthy bite patterns can make a big difference down the road.

We hope you found this information helpful! The key to remember is to try to take care of your enamel as much as you can. Once it’s gone, it’s gone for good. Dentists can restore the lost tooth structure most of the time, but preventing the loss of enamel is so much better! If tooth wear is a concern for you, please talk with one of our lovely dental team members about it and we can help!