BEWE Assessment Quiz for Dental Students

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What does the BEWE screening tool primarily assess?

Patient's overall oral hygiene habits

Signs of hard tissue wear (correct)

Risk factors for gum disease

Patient's pain levels during dental examinations

Which of the following factors is essential in the clinical detection of tooth wear?

Patient's personal history of treatments

Use of high-powered dental lights

Thorough examination of both clinical signs and patient factors (correct)

Patient's age and gender

In the context of tooth wear, which of the following is emphasized as a detection tip?

Patient reports should be disregarded if they seem exaggerated

Evaluate changes in tooth morphology, especially subtle ones (correct)

Focus only on the buccal surfaces for examination

Always look for obvious signs of wear first

What does a BEWE score of 2 indicate?

Distinct defect with hard tissue loss less than 50% of the surface area Signup and view all the answers

Which of the following conditions could lead to a BEWE score of 3?

Notable dentine involvement with loss of more than 50% of the surface area Signup and view all the answers

In the BEWE index, what score would be assigned for no erosive wear?

0 Signup and view all the answers

What is the maximum cumulative BEWE score for a patient?

18 Signup and view all the answers

Which characteristic defines a BEWE score of 1?

Initial loss of surface texture, such as brightness loss Signup and view all the answers

What is the indication of BEWE 2 related to tooth wear?

Less than 50% loss with signs of erosive wear Signup and view all the answers

Which description is associated with BEWE 3?

More than 50% of the tooth surface affected Signup and view all the answers

Which of the following best describes the changes seen in healthy cusps?

Pointy with steep inclines resembling a mountain Signup and view all the answers

What characteristic is visible when more than 50% of the palatal surface is affected?

Sensitive areas due to dentine hypersensitivity Signup and view all the answers

What clinical condition is represented by BEWE 0?

Molar with no signs of erosive wear Signup and view all the answers

What does a cumulative BEWE score of 3 indicate regarding patient interventions?

Some level of intervention may be required. Signup and view all the answers

Which of the following factors should be included in the risk assessment of a patient?

Occupation and habits Signup and view all the answers

What is the main purpose of using fluoride toothpaste for patients with moderate to severe tooth wear?

To maximize fluoride exposure and reduce wear. Signup and view all the answers

What is a recommended dietary recommendation for patients at risk of erosive tooth wear?

Limit acidic drinks to meal times. Signup and view all the answers

Which technique should patients be advised to avoid to minimize tooth wear?

Brushing immediately after consuming acidic foods Signup and view all the answers

Study Notes

Tooth Wear 2

Lectures: Tooth Wear 1: Pre-recorded and workbook; Tooth Wear 2: Pre-recorded and quiz; Tooth Wear 3: Live lecture with case studies for applying theory.
Assessments: Formative assessments include a workbook, quizzes and case studies. Summative assessments are in the form of e-assessments or case studies.
Intended Learning Outcomes: Students should be able to describe and detect clinical signs and symptoms of tooth wear, describe the BEWE screening tool and outline preventative management strategies. The GDC learning outcomes 1.1.2, 1.1.4, 1.1.8, 1.7.7, 1.10.1, 1.10.2, 1.10.3, 1.10.4, and 1.10.6 are covered.
Clinical Detection (Signs and Symptoms): Clinical signs, BEWE screening tool and patient history are used for detection.

Detection

Clinical examination: Includes examination of clinical signs.
Patient factors: Patient complaints (how they noticed any changes), symptoms and medical history are considered.
Tooth wear risk assessment: Combines clinical examination findings and patient factors to assess risk.

Clinical Detection

Preparation: Mirror, dry surface, 3-in-1 or cotton rolls are used.
Systematic approach: Used throughout the clinical examination process.
Clinical signs examination: Examination of occlusal, incisal, palatal/lingual, and buccal/cervical areas.
BEWE (Basic Erosive Wear Examination): A systematic screening tool, similar to BPE, specifically used for hard tissues and its basic examination process is described.

Tips to Detect Clinical Signs

Normal tooth morphology knowledge: Students are advised to use their knowledge of normal tooth morphology.
Subtle changes: Early stages of tooth wear might not be obvious. Look for subtle changes to tooth morphology.
Physiological processes: Most adults show some signs of tooth wear due to normal physiological processes.
Patient age: Assess the rate of wear compared to the patient's age.

BEWE Index

BEWE score (per sextant): A scoring system from 0 to 3 representing different levels of erosive wear.
Description of each score: Detailed descriptions are provided for each score (0, 1, 2, and 3), outlining the type and degree of tooth wear observed.
Cumulative score calculation: Each score per sextant is added to obtain a cumulative BEWE score (maximum 18) for the patient.

Images of Various BEWE Scores

Different images show varying levels of tooth wear (0 to 3). These images are meant for illustrating the stages of erosive tooth wear and corresponding BEWE scores.
Each image is labelled with its corresponding BEWE score value

Cuspal Changes

Healthy cusp morphology: Healthy teeth have pointy cusps with steep inclines, resembling a mountain top.
Flattened morphology: Shows a flattened or rounded cusp, a sign of tooth wear.

BEWE 3

Palatal surface extent: More than 50% of the palatal surface is affected and exposed dentin is noticeable, particularly at the gingival margins and incisal edges.
Halo effect: A "halo effect" (visible exposed dentin) is apparent.
Possible sensitivity: Dentin hypersensitivity may be present, depending on the activity of the tooth wear process.
Diagnosis/Clinical Information (with images): Various images (f, c) are labeled accordingly to illustrate different stages and scores in the BEWE process. Specific information accompanies the images to explain the type and degree of tooth wear.

Patient Factors in Risk Assessment

Age: The rate of tooth wear relative to the patient's age.
Patient history: Includes verbal history of aetiological factors, exposures to internal and external acids (e.g., acidic foods/drinks, acid reflux) occupation, medical history (e.g., including seamstress pins), past and current fluoride exposure, habits (stress, habits), and dietary factors, including symptoms (e.g. due to exposed dentin and loss of smear layer) and noticing changes such as anterior teeth chipping or reports of grinding. Saliva is a key modifying factor.

Interventions

Preventive interventions: Include providing tailored advice on oral health, non-abrasive brushing, low abrasive toothpaste, avoiding brushing after acidic foods/drinks/vomiting/reflux, using fluoride toothpaste and spitting, and appropriate diet advice (identifying potential contributing factors to tooth wear, eliminating or reducing acidic foods/drinks, limiting acidic drinks to meal times, encouraging buffering with water).
Fluoride supplements/advice: Maximizing fluoride exposure through prescription fluoride toothpaste (2800/5000ppm) and/or mouthwash (0.05% fluoride).
Monitoring: Taking impressions for study models and clinical photographs at intervals helps monitor change over time.
Occlusal splint: Considered only when erosion is under control.

Restorative Options

Restorative interventions: Restorations may be necessary, depending on the severity and stability of tooth wear.
Bonding, veneers, or crowns: Possible restorative options include bonding, veneers, crowns, or complex build ups.
Referral: Referral to a specialist could be needed depending on complexity.

Referrals

Scope limitations: Severe tooth wear, bruxism, complex restorative care, query eating disorder, or GORD (Gastro-esophageal reflux disease) could potentially be outside the scope of the provided care. Referrals to a GDP or specialist would be required in these complex cases.

Summary

Detection elements: Risk assessment; patient history; clinical signs (including use of the BEWE).
Interventions: Preventive, Monitoring, and Restorative interventions.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on the BEWE (Basic Erosive Wear Examination) screening tool and its application in detecting tooth wear. This quiz covers scoring, assessment tips, and common outcomes related to tooth wear assessment. Perfect for dental students or professionals enhancing their understanding of dental erosion.