A patient with a severely worn dentition can be one of the most challenging clinical conditions a general dentist faces. The author updated this guide for a fourth edition to assist the clinician with all aspects of managing a patient with a worn dentition. Following a comprehensive discussion of possible etiologic factors, the Guide systematically walks through the steps necessary to adequately evaluate and create plans for therapy options. Photos of a case supplement discussion of the sequencing of treatment. Finally, maintenance care is outlined to assist the patient and the clinician to protect the investment.