AbstractBackgroundIn an ageing population, tooth wear is likely to increase. It is increasing in prevalence in the younger population and a greater number of patients are retaining their teeth into old age.MethodsThis paper is a narrative review of the clinical presentation, the epidemiology and the restorative intervention for erosive tooth wear. The dilemmas in managing this common condition with the aging dentition in mind are described. The paper discusses evidence‐based prevention methods and highlights how preventive intervention may be preferable over extensive restorative care and high maintenance needs. Patient wishes, expectations and commitment to treatment and maintenance require consideration during clinical decision making.ConclusionSuccessful management of erosive tooth wear in an ageing population depends on effective diagnosis, preventive intervention and holistic advice regarding restorative intervention.