With Teeth sold more than 270,000 copies in the USA in its first week. This was a significant increase on the already impressive 228,000 sales of its predecessor. The album replaced Bruce Springsteen's Devils & Dust and was a document of frontman and songwriter Trent Reznor's personal situation during the making of the album. The themes of addiction and recovery once again resonated with NIN fans. The album stayed in the charts for 43 weeks and was certified gold by the RIAA just two months after its release.

Critics were generally positive about With Teeth, few more so than Stylus Magazine, who called it "current yet already potentially classic sounding." E! Online spoke of "dark, frightening and paranoid gut-punches", while the New York Times noted that "almost every song thrills and excites".

Entertainment Weekly, meanwhile, made an apt observation: "Reznor seems to have finally realized that listening to a NIN album shouldn't be as torturous as the artistic ordeal that preceded its creation."