Written and reviewed by: Dr Delon Cheng Di Lun, BDS (VINAYAKA MISSION’s UNIVERSITY]), 14 years in clinical practice, Hello Dental Clinic.
Last reviewed: [22nd Oct 2026].
Tooth abrasion is the gradual wearing away of tooth surfaces caused by repeated friction, often from brushing too hard, using a hard-bristled toothbrush, or habits such as biting your nails. It commonly appears as small notches or grooves near the gumline. Lost tooth structure does not grow back naturally, but the damage can be prevented from worsening and worn areas can be repaired by a dentist.
The frustrating part is that abrasion often happens to people who are trying hard to look after their teeth. If you brush twice a day with a firm hand and still feel a twinge when you drink something cold, this article is for you.
Abrasion is caused by something physically rubbing away at the tooth again and again. The most common culprit is the toothbrush, but everyday habits play a part too.
Abrasion is more likely if your gums have already receded. The root surface below the gumline has no enamel covering it, so it wears down much faster than the crown of the tooth.
What Our Dentists Commonly See
The most common cause we see is brushing too hard with a medium- or hard-bristled toothbrush. We also see patients using home whitening remedies, such as baking soda mixed with lemon juice or charcoal powder, which can contribute to tooth surface wear.
Early abrasion is easy to miss because it rarely hurts at first. Here’s what to look out for:
A 2020 systematic review of 24 studies involving 14,628 adults found that 46.7% had at least one non-carious cervical lesion. These lesions involve tooth structure loss near the gumline and can have multiple contributing causes (Teixeira et al., 2020).
These four terms all describe tooth wear, but each has a different cause, so the fix is different too. In real life, teeth often show more than one type at the same time.
| Type | What Causes It | Where It Shows Up | What It Looks Like |
|---|---|---|---|
| Abrasion | Friction from an external object, such as a toothbrush, abrasive toothpaste or nail biting | Outer surfaces near the gumline | Smooth, shiny V-shaped or rounded notches |
| Erosion | Acid dissolving enamel from sources such as soft drinks, citrus, vinegar, acid reflux or frequent vomiting | Can occur anywhere, often on the inner surfaces of upper front teeth and chewing surfaces | Smooth, glassy, thin-looking teeth, sometimes with cupped dips on the biting surfaces |
| Attrition | Tooth-to-tooth contact from grinding or clenching (bruxism) | Biting edges and chewing surfaces | Flat, worn-down edges and shorter-looking teeth |
| Abfraction | Thought to be associated with biting forces that may cause stress near the tooth’s neck; the mechanism remains debated | At the gumline, sometimes affecting individual teeth | Wedge-shaped notches |
Abrasion and abfraction can look similar because both may cause notches at the gumline. A dentist assesses the shape and location of the wear, which teeth are affected, and whether there are signs of grinding to help identify possible contributing factors.
No, enamel can’t grow back once it’s worn away. Unlike skin or bone, enamel has no living cells, so the body can’t rebuild it. What you can do is stop the wear from getting worse and repair the areas that have been lost.
Fluoride toothpaste and fluoride treatments can strengthen the enamel you still have and make it more resistant, and catching abrasion early usually means simpler, cheaper treatment. Ignoring it can let a small notch deepen until it reaches the nerve or weakens the tooth.
Treatment depends on how deep the wear is and whether it’s causing pain. Small, painless notches sometimes only need monitoring and a change in brushing habits.
We recommend treatment once you start noticing the notch or it begins causing symptoms such as sensitivity. Treating it at this stage is generally quicker and more affordable than waiting until the wear becomes severe.
Deeper notches are filled with tooth-coloured composite resin, which is shaped to match the tooth and bonded in place. This helps protect the exposed dentine, reduce sensitivity and restore the tooth’s surface, making it easier to keep clean. The procedure usually takes one visit and requires little or no drilling.
If sensitivity is the main problem, your dentist can apply a fluoride varnish or desensitising agent to seal the exposed dentine. Using a desensitising toothpaste at home also helps over a few weeks.
Where gum recession has left a lot of root exposed, a gum graft can cover the root again, protect it from further wear and improve the look of the gumline. This is usually only needed in more advanced cases.
No repair will last if the cause continues. Your dentist will check your brushing technique and toothbrush, and look at habits like nail biting or grinding. If grinding is part of the problem, a night guard may also be recommended.
The good news is that prevention is simple and costs very little. Most of it comes down to how you brush.
No. A cavity (caries) is caused by bacteria and acid that create a hole in the tooth. Abrasion is wear caused by friction. They can look similar near the gumline, which is why a dentist should check any notch or dark spot.
Any brush can cause abrasion if you press too hard. Many electric toothbrushes have a pressure sensor, which can actually help prevent it. Let the brush do the work and guide it gently.
Some whitening toothpastes are more abrasive than regular ones. They’re generally safe for healthy teeth, but if you already have abrasion, sensitivity or receding gums, a gentler toothpaste is a better choice.
Often not at first. As the notch deepens and dentine is exposed, many people notice sensitivity to cold, sweet or touch. Deep notches near the nerve can cause more lasting pain.
A filling repairs the damaged area and protects the tooth, but it can wear or come loose if the cause continues. Changing your brushing technique is what keeps the repair lasting.
If you’ve noticed notches near your gums, teeth that look longer, or a sharp twinge with cold drinks, it’s worth getting them checked. Our dentists will find the cause, show you a gentler way to brush, and repair any worn areas so your teeth stay strong and comfortable.
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