Prosthetic rehabilitation of worn teeth: a conservative approach
Assessing causes, deciding when to intervene and considering additive restorations.
On this page
Does wear automatically mean crowns?
No. Assessment considers severity, progression, symptoms and everyday impact. The European consensus recommends prevention and monitoring, with restorative intervention when indicated. Visible wear alone is not a reason to crown every tooth. [1]
Why investigate the causes?
Chemical and mechanical mechanisms can combine in tooth tissue loss. Acid exposure and individual factors need assessment. Restoring shape alone does not remove the cause; prevention continues alongside treatment. [3]
What is additive restoration?
It rebuilds shape by adding material while conserving tissue where feasible. The Radboud approach describes conservative adhesive options and maintenance through repair. It is not a universal protocol and does not remove the need for follow-up. [2]
What is occlusal vertical dimension?
It is a vertical jaw relationship when the teeth are in contact. Shortened, worn teeth alone do not prove that it has decreased. Any proposed change requires planning and clinical evaluation. Rehabilitation should not be presented as a guaranteed cure for joint pain. [NIDCR]
Clinical sources
- Loomans B et al. Severe Tooth Wear: European Consensus Statement on Management Guidelines. 2017.
- Loomans B, Opdam N. A guide to managing tooth wear: the Radboud philosophy. 2018.
- Carvalho TS et al. Consensus report: European Federation of Conservative Dentistry — erosive tooth wear. 2016.
Further reading
- Rosenstiel SF, Land MF, Walter R. Contemporary Fixed Prosthodontics. 6th ed. Elsevier, 2023.
- Shillingburg HT Jr et al. Fundamentals of Fixed Prosthodontics. 4th ed. Quintessence, 2012.
Selected editions published from 2012 onwards. Books are recommended for further reading; clinical explanations reference the accessible sources above.
The information on this page is general and educational. It does not replace a medical consultation, and a treatment recommendation can only be made after examining each patient. Results differ from one case to another.
A plan for your situation
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Every treatment begins with a diagnosis: clinical examination, photographs, radiographs and, where relevant, an occlusal analysis. Only then do we discuss options.