Signs Of Tooth Abrasion & How To Prevent It

Signs Of Tooth Abrasion & How To Prevent It

 Whitney DiFoggio BS, RDH
Written by Whitney DiFoggio BS, RDH
Medical Reviewed on Oct 15, 2023
byDr. Matthew Hannan DDS
🔬 Evidence Based
Signs Of Tooth Abrasion & How To Prevent It

Dental abrasion or tooth abrasion is where enamel gets worn away by some type of outside force. Yes, tooth enamel is the hardest substance in your entire body. Not to be morbid, but that’s just one reason why dental records are frequently used in forensic cases. So, when it comes to tooth abrasion, it’s important to know what causes it and how to get it to stop.

Tooth abrasion is a slow, microscopic process where your enamel erosion gets worn down for some reason or another. And not just because of normal biting and chewing. There’s something else at play. 

We don’t want dental abrasion to occur because once tooth enamel is gone, you’re not getting it back. That protective outer layer of your tooth structure is essential for a balanced diet (and of course great aesthetics.) If it wears down, teeth are more likely to develop tooth decay, tooth sensitivity, complete failure of your existing dental work or even lead to tooth loss.

Dental abrasion isn’t tooth-on-tooth dental wear, like where you see flat, worn-down teeth on the chewing surfaces from clenching them all the time. It’s usually isolated in specific parts of your mouth because of something you’re putting in your mouth. 

Signs Of Tooth Abrasion

Common warning signs of dental abrasion include things like:

  • Notch-like shapes in the edges of your front teeth
  • Receding gums
  • Wedges that appear “cut into” the sides of teeth

Sometimes you’ll even be able to see the yellower layer of tooth—the dentin—because of how much the whiter enamel has worn away. 

Since the tooth abrasion process is slow and gradual, those teeth are rarely sensitive. It might even be that the nerve inside of the tooth has slightly crept back away from the area of abrasion as a defense mechanism.

What Causes Dental Abrasion?

Dental abrasion can come from subconscious habits we’ve developed over our lifetime. Maybe you chew on a toothpick after every meal (ok you probably don’t, but you get the idea). They’re little everyday things that we do, that you probably don’t even think about. People who have dental abrasion usually fit one of the following categories:

1. Brushing too hard or using too stiff of a toothbrush.

One of the biggest offenders when it comes to tooth abrasion is your toothbrush. You could either be scrubbing too hard whenever you’re brushing your teeth or you could be using a medium to firm or extra-stiff bristled toothbrush. Even worse, maybe you’re doing both. All of that aggressive scrubbing usually causes visible dental abrasion next to your gums. One side of your mouth might be worse than the other, depending on which hand is your dominant. Always use a soft brush and only enough pressure to allow gentle blanching in your gums. Or better, use an electric toothbrush that you can just hold there and it will do all of the work for you, no pressure needed. 

2. Biting your nails. 

It can be really challenging to not bite your nails. Those of us who happen to chew, bite, or “trim” our nails with our front teeth almost always have abrasion on the biting edges. Plus, every time you chew your nails, you’re putting whatever germs there are from anything you’ve touched straight into your mouth. And then you’re spreading your own saliva onto things other people are touching (we definitely don’t want to do that when there are viruses floating around!)

3. Chewing on pens.

When you’re at work or focusing on a project, you might be tempted to put your pen in your teeth and chew on it. Maybe it’s a coping mechanism, maybe it’s just something to do because you’re bored. Who knows. But having that hard piece of plastic between your front teeth will, day after day, start to wear them down. 

Speaking of chewing on pens, hair stylists who are always opening bobby pens with their teeth tend to see the same effects!

Dental Attrition vs. Abrasion

Tooth abrasion is not the same thing as attrition. Attrition also causes tooth enamel to wear away, but it’s caused by excessive clenching and grinding (bruxism.) Repeated teeth grinding, heavy tooth-on-tooth wear is usually done subconsciously out of stress or even from a sleeping disorder. Even some medications can cause people to clench and grind their teeth. Whereas abrasion is from wear caused by a non-tooth object. 

As the months and years go by, unmanaged bruxism will gradually lead to severe attrition. At that point, the teeth appear flattened and may have sharp or jagged edges. If you have dental work like fillings or crowns, they will likely break under all of that pressure. 

Can You Reverse Damaged Teeth? 

Unfortunately, no. That’s why it’s so important to catch tooth abrasion or abrasion-causing habits early. Enamel doesn’t grow back on its own, but dentists can repair areas of abrasion with restorations when needed. If the area is structurally sound and there are no aesthetic issues, no treatment is necessary. 

How To Treat Dental Abrasion?

When tooth abrasion is severe enough that it’s compromising your tooth, causing major aesthetic issues, or you’re experiencing sensitivity, your dentist will need to go ahead and treat it. 

Common treatments:

The best dental treatments will depend on the severity of your enamel abrasion. Sometimes dental bonding over abrasion near the gumlines is most appropriate, as a dental crown would be excessive and it’s not possible to place a gingival graft in that space. On the other hand, if the biting edge of the tooth is severely damaged, full dental crowns may be the only restoration that’s strong enough to offer long-term results. Minor areas of abrasion can often be masked with dental veneers. 

How To Prevent Dental Abrasion

If you see your dentist regularly, they will be able to tell if you’re showing signs of dental abrasion. Chances are, they will probably ask about oral hygiene habits like how hard you’re brushing, are you using an abrasive toothpaste, are you holding hair pins in your teeth ,or biting your nails. Once you identify what it is that’s causing the dental abrasion, it’s just a matter of eliminating it from your daily activities. But for habits like nail biting, that can be easier said than done. On the other hand, always using your teeth to hold a comb every time you’re staying your hair can be corrected with a little old fashioned “mind over matter.”

Is your abrasion from brushing too hard? Consider switching to an electric toothbrush with soft bristles when managing and preventing dental abrasion. Or hold your soft bristled toothbrush with your thumb and only 2-3 fingers to lessen the pressure you’re putting on your mouth. 

Talk With Your Dentist About Tooth Abrasion Concerns

Your dentist will probably bring up any visible dental abrasion during your exam if they haven’t already. But if you already know you struggle with brushing too hard or biting your nails, your dental team is a great resource. You’re not alone, and they’ll have the tips and tricks you need to put dental abrasion to a halt and treat any areas that need attention. 

Overcoming Tooth Abrasion

Dental abrasion is a type of tooth damage that we usually bring upon ourselves. Either by chewing our nails, brushing too hard, or physically wearing against or tooth enamel with a foreign object. Teeth are strong, but they’re not invincible! It’s best to get ahead of tooth abrasion habits before complex dental work is the only option left to help. 

 Whitney DiFoggio BS, RDH
Written by Whitney DiFoggio BS, RDH"Teeth Talk Girl," is a registered dental hygienist. She started her dental health journey on YouTube, educating the public through videos.
Dr. Matthew  Hannan DDS
Medical Reviewed byDr. Matthew Hannan DDSDr. Matthew Hannan is a board-certified dentist and graduate of UT Health San Antonio School of Dentistry.
Last updated onOctober 18, 2023Here is our process

Related Articles

Recommended reads