Dra. Cléo Salustiano In this article
SummaryWhat causes tooth wear, and when is it more than normal?How is oral rehabilitation for worn teeth planned?FAQRead nextWorn or short teeth: when it's a case for full-mouth rehabilitation
Book your general dentistry assessment on WhatsAppPrefer not to wait for a reply? Book online now, no phone call needed: see the open times and pick yours, any time (booking page in Portuguese).
Quick summary of this article+
Worn or short teeth are a case for oral rehabilitation when wear affects several teeth, changes the shape of your smile, causes sensitivity or alters your bite, especially if the cause is still active. The most common causes are bruxism, acid erosion (reflux, vomiting, sodas, juices), abrasion from aggressive brushing and overload from missing teeth — often combined. Rehabilitation is planned in stages: diagnosing the cause, controlling it, planning shape and bite, rebuilding with composite, veneers or crowns, and protecting with a night guard and check-ups. Rebuilding without controlling the cause leads to new wear. In Mooca, São Paulo, Dr. Cléo Salustiano (CRO-SP 170844) sees patients every day, 8 a.m. to 10 p.m.
Worn or short teeth become a case for oral rehabilitation when the wear affects several teeth, changes the shape of your smile, causes sensitivity or alters your bite — and, above all, when the cause is still active. Oral (or full-mouth) rehabilitation is treatment that rebuilds the function and appearance of the mouth as a whole, rather than one tooth at a time. It first identifies and controls what's wearing the teeth down, then restores shape, height and protection with fillings, veneers, crowns or other options.
In clinical practice, many patients come in saying their teeth have "gotten smaller," flat at the tips, see-through at the edges or yellowish, and that their smile looks older. Others come in because of sensitivity to cold or fillings that keep breaking. Behind this there's usually bruxism, acid erosion, aggressive brushing or a combination of these.
Below, Dr. Cléo Salustiano (CRO-SP 170844), a dentist in Mooca, São Paulo, with a focus on cosmetic dentistry and oral rehabilitation, explains the causes of tooth wear, how to tell when it's gone beyond normal and how rehabilitation is planned.
This article comes from Dr. Cléo Salustiano's dental office in Mooca, São Paulo (care in English, Portuguese and Spanish). See the general dentistry page to learn how the treatment is done here and book your assessment.
What causes tooth wear, and when is it more than normal?
Tooth wear goes beyond normal when it's faster than expected for your age, when it reaches the dentin — the yellowish layer under the enamel — or when it starts causing sensitivity, changes in shape or fractures. Everyone's teeth wear somewhat over time; the concern is accelerated wear, which has an identifiable cause and tends to continue if nothing is done.
The most common cause of accelerated wear is bruxism, the habit of grinding or clenching your teeth. It leaves the front teeth flat and smooth at the tips, the canines flattened and sometimes small cracks in the enamel. Many people don't realize they grind in their sleep and only find out from the wear or from jaw pain when they wake up.
The second major cause is erosion, chemical wear caused by acids. Acid reflux (GERD), frequent vomiting, sodas, citrus juices, energy drinks and some medications soften the enamel, which then wears away more easily. Erosion usually leaves teeth looking smooth and shiny, with translucent edges and fillings that seem to "stick out" from the tooth.
There's also abrasion, caused by brushing too hard, a stiff toothbrush or abrasive toothpastes, which mainly wears the tooth near the gum; and missing teeth, which overload the ones that remain. In most people, causes add up: someone with erosion who also grinds their teeth, for example, wears them down much faster.
Advanced wear has consequences beyond appearance: sensitivity, fractures, fillings that keep failing, teeth that keep getting shorter and, in some cases, loss of bite height. This changes how the upper and lower teeth meet and can make the lower part of the face look older. That's the point where oral rehabilitation comes in as whole-mouth treatment.
| Type | Main cause | How it usually looks |
|---|---|---|
| Attrition (bruxism) | Grinding or clenching | Flat, smooth tips, flattened canines, small cracks |
| Erosion | Acids: reflux, vomiting, sodas, citrus juices | Smooth, shiny surface, translucent edges |
| Abrasion | Brushing too hard, stiff brush, abrasive toothpaste | Step-like wear near the gumline |
| Overload | Missing teeth, unbalanced bite | Wear concentrated on a few teeth |
How is oral rehabilitation for worn teeth planned?
Oral rehabilitation for worn teeth is planned in stages: diagnosing the cause, controlling what's wearing the teeth, planning shape and bite, rebuilding and protecting. Rebuilding without controlling the cause usually means the new work wears down the same way. That's why the first step is understanding why, not just how much.
Diagnosis includes a conversation about habits, diet, reflux and sleep, an exam of the teeth and bite, photographs and, when needed, X-rays and models or a digital scan. When reflux or a sleep disorder is suspected, the dentist may suggest a medical evaluation, because treating the cause protects the teeth. Small routine changes, such as not brushing right after acidic drinks, also make a difference.
Rebuilding can use composite resin applied directly to the teeth, veneers, crowns or a combination, depending on the amount of wear and the strength of the bite. In many wear cases, composite is a conservative option, because it adds material without removing more tooth structure. When the bite has lost height, the plan may include restoring part of that height gradually and in a controlled way.
Protection completes the treatment. People with bruxism are usually advised to wear a custom-made night guard. People with erosion receive guidance on diet and hygiene. Regular check-ups monitor wear, polish and repair small spots before they grow. Oral rehabilitation isn't a one-time procedure but long-term care.
In Mooca, Dr. Cléo Salustiano treats tooth wear and oral rehabilitation cases and explains, based on your case, what can be done and in what order. Any existing issues, such as cavities, inflamed gums or missing teeth, become a stage of the plan. No result is guaranteed — planning shows what's realistic to expect before you start.
What is oral rehabilitation?
+
It's treatment that rebuilds the function and appearance of the mouth as a whole, not one tooth at a time. It includes finding and controlling the cause of the problems, planning shape and bite, and using fillings, veneers, crowns, dentures or implants as needed, with maintenance over time.
Why are my teeth getting shorter?
+
The most common causes are bruxism, which wears down the tips through grinding or clenching, and acid erosion from reflux, vomiting, sodas and citrus juices. Brushing too hard also contributes. Often the causes add up. An assessment identifies which ones apply to you.
Can worn teeth go back to their normal size?
+
Teeth don't grow back, but their shape and length can be rebuilt with composite, veneers or crowns. Before that, it's important to control the cause, so the new material doesn't wear down the same way. Planning determines how much can be safely restored.
Does tooth wear cause sensitivity?
+
Yes, often. When wear removes the enamel and exposes the dentin underneath, the tooth becomes sensitive to cold, sweets and touch. Sensitivity toothpastes help, but when wear is extensive, protecting the tooth with a restoration is usually needed.
Can acid reflux damage my teeth?
+
It can. Stomach acid reaching the mouth softens the enamel and causes erosion, especially on the inner surfaces of the upper teeth. Many people don't feel their reflux. When a dentist sees this pattern, they may suggest a medical evaluation, because treating reflux protects the teeth.
Should I brush right after drinking soda?
+
It's better to wait a bit. Right after acidic drinks, enamel is temporarily softer, and brushing immediately can increase wear. Rinsing with water and brushing later with a soft toothbrush is a way to reduce the risk.
Can composite resin rebuild worn teeth?
+
In many cases, yes. Composite applied directly to the teeth restores shape and length by adding material, without removing more tooth, and it can be repaired at the dental office. For very extensive wear or very strong bites, veneers in other materials or crowns may be recommended.
Can tooth wear change my face?
+
In advanced cases, it can. When teeth lose a lot of height, the bite closes more than it should, and the lower part of the face may look shorter, with thinner lips and an older appearance. Rehabilitation can restore part of that height in a planned, gradual way.
Do I need a night guard after rehabilitation?
+
If you have bruxism, usually yes. A custom-made night guard protects the new work and your natural teeth from grinding forces. It doesn't cure bruxism, but it reduces wear and the risk of fractures. Its use and fit are monitored at check-ups.
Is oral rehabilitation done in one session?
+
Rarely. Because it involves diagnosing the cause, planning shape and bite, any preliminary treatment and rebuilding several teeth, it's usually done over several sessions. The order and number of stages depend on the case and are explained in the treatment plan.
Is tooth wear related to stress?
+
It can be. Bruxism, the main cause of wear from attrition, often gets worse during periods of stress, anxiety or poor sleep. Addressing these factors, with support from other professionals when needed, helps control the habit, along with protecting the teeth with a night guard.
When should I see a dentist about worn teeth?
+
When you notice your teeth are shorter or flat at the tips, see-through edges, sensitivity to cold, fillings that break often, jaw pain when you wake up or a change in your smile. The sooner the cause is controlled, the less wear there is and the simpler the rebuild.
Where can I get oral rehabilitation in Mooca?
+
In Mooca, Dr. Cléo Salustiano (CRO-SP 170844) assesses worn teeth and plans oral rehabilitation in stages, starting with the cause. The office is at Rua Hipódromo, 1141, near Bresser-Mooca station (Metro Line 3-Red), open Monday to Sunday, 8 a.m. to 10 p.m. She sees patients in Portuguese, English and Spanish. WhatsApp: (11) 97409-7834.
