Changing patterns of tooth wear have been used extensively to obtain information about the lifestyle and culture of pre-historic and modern humans. The assessment of tooth wear in previous anthropological studies has been largely based on quantitative analysis of wear indices and qualitative analysis of micrographs. Wear indices are simple to use and can be sensitive tools, but there is a lack of international standardization in their use. Micrographic assessment of pits and scratch marks on the worn surfaces of teeth can assist in dietary reconstruction of humans, but this approach has low reliability and high observer error. This review will provide an update on a new wear index and novel nano-techniques that hold promise for improving the analysis of tooth wear. Recently, a new wear index, termed the Basic Erosive Wear Examination index, has been proposed as a standardized universal tool for diagnosing erosive tooth wear. However, its value seems to be limited when assessing the dentitions of populations, in whom tooth wear occurs predominantly by attrition and abrasion. Optical techniques involving scanning confocal microscopy combined with fractal analysis can provide an objective assessment of the worn surface. Other nanotechnology-based methods, such as nanohardness measurements, nano-computed tomography and mass spectrometry, can be also useful in physical and chemical characterization of both sound and worn teeth, but these techniques are limited to use in vitro. A combined assessment of the worn dentition using all of these techniques promises to provide the best holistic approach to analyse tooth wear.