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.

Score

Criteria

Image

No ETW

Initial loss of surface texture

2^a

Distinct defect; hard tissue loss involving <50% of the surface area

Photo of teeth with hard tissue loss involving 50% of surface area

3^a

Hard tissue loss involving ≥50% of the surface area

Photo of teeth with hard tissue loss involving greater than 50% of surface area

^a Dentin often involved.

Table 7. Cumulative BEWE Scores and Management Guidelines.

Cumulative Score

General 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

Managing Dental Erosion: Current Understanding and Future Directions
The Basic Erosive Wear Examination (BEWE)