Overview

Worn, chipped, and misshapen teeth affect both function and aesthetics. Tooth wear can result from attrition (tooth-to-tooth grinding), abrasion (physical wear from brushing or habits), or erosion (acid dissolution). Chipped or misshapen teeth may be congenital or acquired from trauma, decay, or wear. As tooth structure is lost, teeth become shorter, more sensitive, and weaker — and the bite collapses if severe wear is left untreated.

Symptoms

• Teeth that appear shorter or flatter than before
• Chipped or jagged edges on front teeth; uneven tooth lengths
• Teeth that are pointed, peg-shaped, or malformed (congenital)
• Sensitivity from exposed dentine; a worn or aged appearance
• Bite feels different or jaw tires when chewing

Causes & Risk Factors

• Bruxism (tooth grinding) — causes attrition; common in Kuwait due to stress
• Aggressive brushing — causes abrasion at the gum line
• Acid erosion from diet or acid reflux
• Trauma: falls, accidents, or sports injuries
• Congenital: amelogenesis imperfecta, peg lateral incisors
• Excessive wear of large aged fillings

Complications

• Further tooth loss if wear continues without intervention
• Bite collapse causing overclosure and facial changes
• TMJ disorder from altered bite
• Pulp exposure requiring root canal treatment in advanced wear

Diagnosis

Clinical examination and study models assess degree of wear using the BEWE index. Identifying the primary cause guides treatment. X-rays check for pulp proximity before restorative planning.

Treatment

• Address the underlying cause first: night guard for bruxism, dietary advice for erosion
• Composite bonding: minimally invasive restoration of chipped or worn front teeth
• Porcelain veneers: aesthetic long-term solution for front teeth
• Crowns for structurally compromised back teeth
• Full-mouth rehabilitation for generalised severe wear affecting the entire bite

Prevention

• Wear a custom night guard to prevent grinding wear
• Use correct brushing technique and a soft-bristled toothbrush
• Reduce acidic foods and treat acid reflux; wear mouthguard during sports
• Ask your dentist about monitoring wear at each check-up

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