This paper does not set out to describe the reasons why a new concept of dental care should be deemed as acceptable and recognised as mainstream. Rather, the starting point of this paper ibelief that some dentists who are increasing the overall vertical dimension for worn dentition patients are not using the protocols of the traditional ‘re-organised approach’. If adhesive direct restorations are used, there seems to be anecdotal indication that despite not restoring in the terminal hinge axis, it can have a successful outcome.

So, while not criticising this approach simply because it does not follow orthodoxy, the paper has two objectives. It hopes to stimulate some debate and research on this subject. Furthermore, by suggesting some parameters for what might be considered a new approach, it aims to improve patient outcome.