Tooth wear: when to treat, why, and how. Part two.

Tooth wear has been described in the literature as physiologic--that is, normal, expected over the life span of an individual, and not creating a pathologic condition. It has also been described in pathologic terms as caused by stress, corrosion, and friction, utilizing a variety of mechanisms and affected by a host of endogenous and exogenous factors. From a clinician's point of view, when should we decide to restore a tooth or change the conditions in the mouth to protect the teeth; and what should we consider using to either prevent or restore abnormal--i.e, pathologic--tooth wear? This review in Part One (Northwest Dentistry, September-October 2009) looked at what is normal, non-pathologic tooth wear and etiologies associated with all forms of tooth wear. Part Two will discuss the effects of tooth wear in enamel and dentin, when it may be advisable to intervene in the wear processes diagnosed on specific patients, and what methods of prevention and restoration can be utilized to restore or maintain the dentition. This review will not look at the need for full mouth reconstruction due to wear.