Objective The aim of this study was to evaluate changes in speech characteristics and self-perceived quality of speech in tooth wear patients, after occlusal rehabilitation. Materials and methods Patients with tooth wear were included in this study after informed consent. The amount of tooth wear was scored with Tooth Wear Evaluation System (TWES). To assess the perspective of the patient, the Dutch Speech Handicap Index was used (SHI). Acoustic analysis was performed to evaluate changes with the use of voice recordings. These were made before treatment, T 0 ; directly after treatment, T 1 ; 1 month after treatment, T 2 . With the use of PRAAT software, the spectral characteristic centre of gravity (COG) was evaluated for the sounds /s/, /f/, /v/, /d/, /t/, /m/. Results Recordings of 17 patients (14 men, 3 women, mean age 41.2 ± 10.4 years) were included. SHI scores did not change significantly between T 0 and T 2 ( p  = 0.054). A multiple regression model showed that for all sounds the intercept was negative, but statistically significant only for /s/ and /f/ between T 0 and T 1 . The effect of the initial change (between T 0 and T 1 ) on the change between T 1 and T 2 was clearly negative for all sounds ( p  < 0.001), showing a rebound effect ranging between 29 and 68% of the initial change. Conclusion Tooth wear patients perceive improvement in speech function after treatment. Clinical significance Clinicians may explain to patients that speech is likely to alter for a short period due to treatment but that there will be a good adaption to the new situation.