Whether an item is made from ivory or bone makes a huge difference in its value, and also the way you need to clean and take care of it. There are some clear cut ways to tell if an item is made of bone or ivory.
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Hold the suspected item under a magnifying glass in a brightly lit area. Sunlight is the best light for viewing.
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If an item is made of ivory, you will be able to see lines, or a grain. These lines are sometimes known as Schreger lines and occur when the tusks grow. These lines may appear V-shaped or look like cross hatching. Genuine ivory may also have the appearance of a wood grain or circular rings.
If the item does not appear to have grain, check for tiny black dots or small dark colored holes. These marks are present in bone and are the channels through which living bone receives its nutrients.
Check the color. Real ivory has slight variants in its color throughout the piece. Bone will have a consistent color throughout the piece unless it has been engineered to look like ivory through false coloring. In this case, the color variations will be more drastic.
Bone will usually look very dry and rough. Ivory is smooth and has a glossy shine to it.
If you're still not sure, take the piece to an antique dealer or jeweler. An expert will be able to tell very quickly whether the piece is ivory or bone.