[7] Multiple indices have been developed in order to assess and record the degree of tooth wear, the earliest was that by Paul Broca.

[2] It tends to present as rounded ditching around the cervical margins of teeth, commonly described as ‘shallow’, concave or wedge shaped notches.

[1] Causative factors have been linked to this condition and include vigorous, horizontal tooth brushing, using toothpaste with a relatively high RDA value (above 250),[11] pipe smoking or nail biting.

It has also been shown that improper use of dental floss or Toothpicks can lead to wear on the interproximal (in-between) surfaces of the teeth.

[12] Dental erosion is rarely seen in the archaeological record, but certain cases have been described which suggested acidic fruits and/or plants were regularly consumed.

[2] Abfraction presents as triangular lesions along the cervical margins of the buccal surfaces of the teeth where the enamel is thinner and therefore, in the presence of occluding forces, is prone to fracture.

The management includes steps which identify and eliminate main aetiological factors, preventative treatment and also any operative and symptomatic intervention required by the patient.

[16] Once the cause of tooth wear has been identified and a preventative regime has been put in place, the patient should be reviewed for 6–12 months to establish that the intervention has been successful before any active management is carried out.

A decision is made after full occlusal assessment including assessment of contacts in intercuspal position (ICP) and retruded contact position (RCP) as well as analysing casts articulated in a semi-adjustable articulator to use for a diagnostic wax up of any proposed restorative work.

This makes things difficult as there is no room to build the teeth back up to their original height without increasing the OVD.

[29] The options for restoring this loss in tooth height are: [30] Pulp vitality must also be taken into consideration prior to treatment, when teeth have severe wear it is possible that they have become non-vital.