Your teeth are shorter than they used to be.
You might have noticed it in photos — a smile that looks different from how you remember it. Or your dentist has mentioned it and you’ve filed it away as one of those things to deal with later. Or you’ve simply noticed that your front teeth, which used to have a defined edge, are now flat and even.
Tooth wear is extremely common in patients over 60. Some degree of wear is a normal result of decades of use. But significant wear — the kind that affects your bite, your smile, and the structural integrity of your teeth — is a clinical problem with solutions.
This post explains what causes tooth wear, what it means for your dental health, and what can be done about it at Sunny Dental Buderim.
What Causes Teeth to Wear Down?
Tooth wear has three main causes, and in many patients, more than one is operating simultaneously.
Attrition — Tooth Against Tooth
Attrition is wear caused by teeth grinding against each other. It’s primarily the result of bruxism (grinding or clenching, usually during sleep) but can also result from a misaligned bite that causes teeth to meet at wrong angles during normal chewing.
The pattern of wear from attrition is distinctive: it tends to be flat and matching across upper and lower teeth. The biting edges of front teeth wear mirror images of each other, and the cusps on back teeth become flattened and smooth.
Many people who grind their teeth aren’t aware they do it — the grinding happens during sleep, and they wake up with a headache or sore jaw muscles without connecting it to the cause. A partner who notices the sound of grinding at night can be a useful early warning.
Left unaddressed, significant bruxism can wear teeth down substantially over years and decades. Combined with the other causes below, it can accelerate wear considerably.
Erosion — Acid Attack
Erosion is wear caused by acid dissolving the outer enamel of the tooth. Unlike attrition, acid erosion doesn’t require any mechanical contact — the enamel simply dissolves in the presence of acid.
Sources of acid include:
Dietary acid. Soft drinks, fruit juices, citrus fruits, wine, vinegar-based foods — all are acidic. Frequent exposure (especially sipping acidic drinks slowly over long periods) creates an acidic environment around the teeth that erodes enamel over time.
Gastric acid. Patients with chronic acid reflux, GERD (gastro-oesophageal reflux disease), or a history of conditions involving frequent vomiting can experience significant dental erosion. The acid from the stomach is considerably more aggressive than dietary acid, and even if the patient isn’t symptomatic (some reflux is “silent”), the dental erosion pattern can be an early indicator.
Dry mouth. Saliva is one of the mouth’s primary defences against acid — it buffers the pH and rinses away acidic substances. Many medications commonly taken by older patients (antidepressants, antihistamines, blood pressure medications, and others) cause dry mouth as a side effect, reducing this protective buffer and making erosion more likely.
The wear pattern from erosion is different from attrition: it tends to produce rounded, concave surfaces (cupped-out areas) rather than flat wear facets. In severe cases, the softer dentine layer beneath the enamel is exposed, appearing as a yellowish inner core surrounded by a rim of enamel.
Abrasion — Mechanical Wear from External Sources
Abrasion is wear caused by repeated mechanical contact with something other than teeth — most commonly toothbrushing with excessive force or a hard-bristled brush, but also habits like biting pens, using teeth to open packaging, or chewing on hard objects.
Abrasion from overly aggressive brushing typically shows as notching at the gumline, where the enamel is thinnest. It’s a common finding and, at mild levels, manageable — but combined with erosion and attrition, it contributes to the overall rate of tooth structure loss.
When Does Tooth Wear Become a Problem?
All adult teeth show some wear over a lifetime — that’s normal. The question is whether the rate and extent of wear is creating clinical problems.
Loss of Vertical Dimension
The “vertical dimension” refers to the height of your bite — the distance between your upper and lower jaws when your teeth are together. This is set partly by the height of your back teeth. When back teeth wear down significantly (or are lost and not replaced), the vertical dimension decreases. The face can take on a “collapsed” appearance — the distance between nose and chin reduces, the corners of the mouth turn down, and the lower face appears older than it should.
More importantly, loss of vertical dimension shifts load to the front teeth, which aren’t designed to handle it. The front teeth start to bear the brunt of every chewing movement, which accelerates their own wear.
Sensitivity and Discomfort
As enamel wears away, the dentine underneath is exposed. Dentine contains tiny tubules that connect to the nerve, making worn teeth sensitive to temperature, sweet foods, and acidic substances. Significant wear can also make teeth more susceptible to decay and structural fracture.
Fractures and Cracks
Worn teeth are mechanically weaker than intact ones. The enamel that protects the tooth from fracture is thinner or gone. Craze lines, chips, and splits become more common — and a tooth that chips or cracks in an area already compromised by wear may require significantly more treatment to restore than an intact tooth.
Aesthetic Change
The visual change from significant tooth wear is often what prompts people to seek treatment. Shorter front teeth, a flattened smile, yellowing as dentine is exposed — these are cosmetic concerns, but they’re also clinical ones, because the aesthetic change reflects genuine structural loss.
Diagnosing Tooth Wear at Sunny Dental
When Dr Louis George or Dr Jeremy Collins sees a patient with significant tooth wear, the first priority is understanding the cause — because the right treatment depends on addressing what’s driving the wear, not just restoring the surfaces.
We look at:
- The pattern of wear — which surfaces, which teeth, what the shape of the wear is
- Your medical history — particularly reflux, medications, and sleep habits
- Your dietary history — how often you consume acidic foods and drinks, and how
- Whether there are signs of jaw muscle tension or jaw joint dysfunction that suggest bruxism
- Whether the wear is active (still progressing) or historical (slow and stable)
Where reflux is suspected and not yet diagnosed, we may suggest you speak with your GP about investigation. Treating the wear without addressing ongoing acid exposure will produce restorations that fail prematurely.
Treatment Options for Worn Teeth
Treatment depends on the extent of wear, its cause, and what your functional and aesthetic goals are.
Addressing the Cause First
Before any restorative work, we need to manage what’s driving the wear.
For bruxism, this typically means a custom-fitted night splint (occlusal splint) — a hard acrylic device worn over the teeth during sleep that prevents the grinding surfaces from contacting each other. This doesn’t stop the grinding reflex, but it protects the teeth from its effects.
For acid erosion from diet, we provide specific guidance on reducing acid exposure and improving saliva flow. For reflux-related erosion, treatment of the underlying medical condition (with your doctor) is essential before dental restoration begins.
Composite Bonding — For Mild to Moderate Wear
For teeth with mild to moderate wear, composite resin can be bonded directly to the worn surfaces to restore lost tooth structure. This is a conservative approach — minimal preparation of the tooth is needed — and it’s reversible if future treatment needs change.
Composite bonding is less durable than ceramic or zirconia restorations and will need periodic maintenance or replacement. But as a first-line treatment, or as a trial of the proposed bite position before committing to more permanent restorations, it’s a useful option.
Crowns — For Moderately to Severely Worn Teeth
For teeth with significant wear — particularly posterior teeth that have lost substantial height — crowns are the most durable and predictable restoration. The crown replaces the lost enamel and dentine with a ceramic or zirconia shell that is matched to the correct bite position and can withstand the forces of chewing and, with a night splint, moderate grinding.
In cases of widespread wear affecting many teeth, multiple crowns may be placed as part of a full mouth rehabilitation plan. Dr Jeremy Collins, who has particular experience with crowns and bridges, works closely with patients to plan and test the bite position before final crowns are placed. For patients who prefer sedation during longer crown appointments, our Registered Nurse and Practice Manager Dwi George is present to monitor the process.
Rebuilding the Vertical Dimension
Where the bite has collapsed — the back teeth have worn down to the point that the face height has reduced — treatment involves incrementally restoring the vertical dimension. This is done carefully, usually starting with temporary restorations at the proposed new bite height to allow the muscles and jaw joints to adapt, before final restorations are placed.
This is one of the more complex aspects of full mouth rehabilitation, and it requires careful planning and patient cooperation over several months of treatment.
Living in Buderim and Managing Wear
The Sunshine Coast lifestyle — outdoor dining, frequent smoothies, wine in the evening — has some dietary elements that are worth being aware of if you’re managing tooth wear. That doesn’t mean avoiding them, but it does mean being thoughtful about how and when you consume acidic foods and drinks.
Simple habits that help:
- Drink acidic drinks (juice, wine, kombucha) with meals rather than sipping throughout the day
- Follow acidic food or drink with water or milk to neutralise the pH
- Wait at least 30 minutes after acidic exposure before brushing — acid softens enamel temporarily, and brushing too soon accelerates abrasion
- Use a soft-bristled toothbrush with a gentle technique
- Stay hydrated — saliva is your first line of defence
These habits don’t reverse wear that’s already occurred, but they reduce the rate at which it continues.
Part of the Full Mouth Rehabilitation Series
Worn teeth are one of the most common presentations we see in patients from Buderim, Maroochydore, Mooloolaba, and across the Sunshine Coast hinterland who go on to need full mouth rehabilitation. If you’re dealing with wear alongside other dental concerns, our hub guide has the full picture: Full Mouth Rehabilitation: A Complete Guide.
For more on what to do when multiple teeth need work at once, see: What to Expect When Multiple Teeth Need Work.
If you’ve noticed your teeth looking shorter, feel increased sensitivity, or have been told you grind — a proper assessment is the place to start. Call us on (07) 5445 8400 or get in touch here. Sunny Dental Buderim is at 2/64 King St, Buderim.
All dental treatments carry risks. Outcomes vary between individuals. The information on this page is general in nature and does not replace personalised advice from a registered dental practitioner.