Managing Dental Erosion: Current Understanding and Future Directions

Course Number: 517

The Basic Erosive Wear Examination (BEWE)

The BEWE, introduced by Bartlett, Ganss and Lussi in 2008,68 is used to assess the level of erosion. For this examination, the mouth is divided into six distinct areas for evaluation. Table 6 shows the criteria for sextant scores from 0 to 3, which are summed to obtain a cumulative score that is the basis for determining interventions (Table 7). The BEWE is a simple, quick index for screening a patient’s erosion status.

Table 6. BEWE Scores and Criteria.

ScoreCriteriaImage
0No ETWimage
1Initial loss of surface textureimage
2aDistinct defect; hard tissue loss involving <50% of the surface areaimage
3aHard tissue loss involving ≥50% of the surface areaimage

a Dentin often involved.

Table 7. Cumulative BEWE Scores and Management Guidelines.

Cumulative ScoreGeneral guidelines for management
No ETW: 0 - 2
  • Routine maintenance and observation
  • Repeat at 3-year intervals
Low: 3 - 8
  • Oral hygiene, dietary assessment
  • Routine maintenance and observation
  • Repeat at 2-year intervals
Medium: 9 -13
  • Oral hygiene, dietary assessment
  • Routine maintenance
  • Fluoride measures
  • Avoid restorations
  • Repeat at 6-12 month intervals
High: ≥14
  • Oral hygiene, dietary assessment
  • Routine maintenance
  • Fluoride measures
  • Repeat at 6-12 month intervals
  • Consider restorations