Why are my teeth getting shorter? Tooth wear, explained

If your front teeth look shorter than they do in old photographs, their edges have started to chip, or the tips look glassy and see-through, the most likely explanation is tooth wear: the slow loss of enamel and the softer dentine beneath it.

It is very common. In the last national survey that measured it, 77% of adults had some wear and 15% had moderate wear, and moderate wear was more than ten times as common at 75 to 84 as at 16 to 24. Most wear is slow and needs nothing more than recording and watching. It matters when it is happening quickly, when it hurts, or when it starts to change how your smile looks.

The three ways teeth wear

Tooth wear almost always has more than one cause, and the treatment depends on which one is doing most of the damage.

• Erosion: acid dissolving the tooth surface. The acid can come from what you eat and drink, or from your own stomach, through reflux or frequent vomiting.
• Attrition: teeth wearing against each other, usually through grinding or clenching, often at night.
• Abrasion: wear from something other than teeth, such as hard brushing, a very abrasive toothpaste, or habits like biting pens or nails.

Erosion softens the surface, and grinding or brushing then removes the softened layer faster, which is why a mix of causes can wear teeth surprisingly quickly.

Signs to look out for

• Front teeth that look shorter, flatter or more even than they used to
• Chipped or crumbling edges
• Tips that look glassy or see-through
• Teeth looking more yellow as the enamel thins and the dentine shows through
• Small hollows on the biting surfaces of back teeth
• Fillings that now stand proud of the tooth around them
• Sensitivity to cold, sweet or acidic food and drink
• Jaw ache, tight jaw muscles or headaches when you wake, which can point to grinding

What you can do now

• Keep acidic drinks such as fruit juice, fizzy drinks, squash, wine and fruit teas to mealtimes, and drink them rather than sipping or swishing them.
• Between meals, choose plain water, milk, or unflavoured sparkling water.
• Brush twice a day with a fluoride toothpaste, gently, and avoid very abrasive "whitening" pastes. Your dentist may suggest a higher-fluoride paste.
• If you often have heartburn, a sour taste in your mouth or a hoarse voice in the morning, talk to your GP. Reflux can wear teeth before it causes much discomfort.
• If you grind your teeth, a dentist-made splint worn at night protects them. It is often the most effective single step.

When to see a specialist

Most tooth wear can be monitored by your own dentist. A specialist assessment is worth considering when:

• the wear is visibly progressing, for example between photographs taken a year or two apart
• teeth have become sensitive, or edges keep chipping
• you are considering veneers, crowns or bonding and want to know whether the wear needs addressing first
• you have been advised to have many teeth crowned and would like another view

A tooth wear assessment records the starting point with photographs, scans and study models, so that later appointments can measure change rather than guess at it. It also works out which causes are involved, because rebuilding teeth without controlling the cause rarely lasts. You can read how this works on our tooth wear page.

How worn teeth are rebuilt

Worn teeth can usually be rebuilt without cutting them down. Modern adhesive materials bond to the tooth that remains, so tooth-coloured composite can be built back onto worn edges and surfaces, a few teeth at a time, restoring their length and shape. This is the same material used in composite bonding, applied as part of a planned reconstruction.

Where the bite has closed down as teeth have worn, it is rebuilt at a comfortable height and tested before anything permanent is committed to. Ceramic onlays or crowns are used selectively, where composite is not the right material. A protective splint usually follows, so the new surfaces last.

Our comprehensive tooth wear assessment, with records and a written, staged plan, is £550, and composite rebuilding starts from £400 a tooth. Full guide prices are on the fees page, and every stage is priced in writing before you decide.

Common questions

Can worn enamel grow back? No. Enamel does not regrow, but fluoride can harden the surface and slow further wear, and lost tooth can be replaced with composite or ceramic.

Is it just my age? Teeth do wear with age, but how fast is what matters. Wear that is quick for your age usually has a cause that can be found and controlled.

Will it keep getting worse? That depends on the cause. Once the main causes are controlled, many people find their wear slows or stops, and some need nothing more than monitoring.