Dental Erosive Wear Examination: BEWE Index
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Questions and Answers

What percentage of the tooth surface must be affected by erosion to score a BEWE 3?

  • 100%
  • 75%
  • 25%
  • 50% (correct)
  • What is a common characteristic of a BEWE 3 score?

  • Presence of a single concavity
  • No involvement of dentine
  • Erosion affecting less than 50% of the tooth surface
  • Complete loss of the occlusal surface (correct)
  • If a tooth has a restoration covering more than 50% of the surface, can it be scored as a BEWE 3?

  • Yes, if the wear affects more than 50% of the surface, regardless of the restoration
  • No, because the restoration prevents accurate assessment of the erosion (correct)
  • No, only if the restoration is less than 50% of the surface
  • Yes, because wear adjacent to the restoration can contribute to the score
  • What is the primary focus of the BEWE 3 score?

    <p>The extent of enamel loss on the occlusal surface (A)</p> Signup and view all the answers

    Which of these accurately describes the BEWE 3 score?

    <p>Significant enamel loss with dentine involvement (D)</p> Signup and view all the answers

    What is the maximum BEWE score that can be achieved for a single sextant?

    <p>3 (A)</p> Signup and view all the answers

    When examining teeth for BEWE, what should be discarded?

    <p>Restorations covering more than 50% of the tooth surface (B)</p> Signup and view all the answers

    Which of the following conditions is NOT a sign of tooth wear?

    <p>Fluorosis not affecting the shape of the tooth (D)</p> Signup and view all the answers

    What is the recommended time interval for repeating the BEWE examination in high-risk cases?

    <p>Every 6 months (A)</p> Signup and view all the answers

    What is the BEWE score for a tooth with initial signs of wear, including rounding of cusps?

    <p>1 (D)</p> Signup and view all the answers

    Which of these is NOT a component of the BEWE assessment?

    <p>Root surface (C)</p> Signup and view all the answers

    What is the main purpose of the Basic Erosive Wear Examination (BEWE)?

    <p>To identify and manage early signs of tooth wear. (A)</p> Signup and view all the answers

    What is the significance of the BEWE score?

    <p>It helps track tooth wear progression over time (D)</p> Signup and view all the answers

    What is the preferred term for tooth wear in the UK and other countries?

    <p>Tooth wear (A)</p> Signup and view all the answers

    How is the BEWE assessment applied to children with a mix of primary and permanent teeth?

    <p>Both primary and permanent teeth are assessed using the same scoring system (A)</p> Signup and view all the answers

    What role does acid play in tooth wear?

    <p>Acid is a contributing factor in severe tooth wear. (A)</p> Signup and view all the answers

    Where can dentists find resources and information about the BEWE?

    <p>The Erosive Tooth Wear Foundation website (D)</p> Signup and view all the answers

    What is one of the main benefits of using the BEWE?

    <p>It helps dentists to identify early signs of tooth wear that may otherwise be missed. (B)</p> Signup and view all the answers

    What is the recommended approach to using the BEWE, according to the text?

    <p>It should be used for all causes of tooth wear, including abrasion and attrition. (A)</p> Signup and view all the answers

    What is the main purpose of the toolkit for practitioners mentioned in the text?

    <p>To promote the use of the BEWE in dental practice. (B)</p> Signup and view all the answers

    What does the information provided in the text suggest about the impact of the BEWE?

    <p>The BEWE has become a widely accepted tool for assessing tooth wear. (A)</p> Signup and view all the answers

    What BEWE score indicates a discrete area of wear with no other signs of wear?

    <p>BEWE score 1 (A)</p> Signup and view all the answers

    What condition qualifies as a grade three in tooth wear assessment?

    <p>More than 50% of the surface affected (C)</p> Signup and view all the answers

    What is typically noted for patients over the age of 20 with regards to dentition wear?

    <p>Complete wear is rare (A)</p> Signup and view all the answers

    What should be chosen when there is doubt between BEWE scores?

    <p>The lower score should be chosen (B)</p> Signup and view all the answers

    What diameter signifies a concavity on cusps that qualifies as cupping?

    <p>Diameter ≤ 0.5 mm (A)</p> Signup and view all the answers

    What does a sextant score of 1 indicate regarding wear on the canines?

    <p>Slight wear is visible on the incisal surface. (B)</p> Signup and view all the answers

    Which score would be assigned if wear involves the whole incisal edge of the two central incisors?

    <p>A score of 3. (B)</p> Signup and view all the answers

    What is the clinical crown height measured from?

    <p>The gingival margin to the incisal edge. (D)</p> Signup and view all the answers

    What does a BEWE score of 0 indicate?

    <p>No signs of wear on the buccal/palatal/lingual surface. (D)</p> Signup and view all the answers

    What is considered concave wear on cusps known as?

    <p>Cupping. (B)</p> Signup and view all the answers

    What is the minimum diameter for considering wear as cupping?

    <p>≥0.5 mm. (B)</p> Signup and view all the answers

    When scoring enamel developmental defects, what is the important consideration?

    <p>They must cause changes to the tooth shape. (A)</p> Signup and view all the answers

    What would be the appropriate score for wear that is classified as severe with complete loss of incisal edge?

    <p>Score 3. (A)</p> Signup and view all the answers

    What is the primary purpose of the BEWE score in assessing tooth wear?

    <p>To assess the severity of tooth wear (D)</p> Signup and view all the answers

    What should be recorded for each sextant when using the BEWE?

    <p>The worst affected surface in that sextant. (A)</p> Signup and view all the answers

    In the BEWE scoring system, what does a score of 2 indicate?

    <p>Wear covering just less than 50% of the tooth surface (D)</p> Signup and view all the answers

    What is indicated if a tooth has a BEWE score of 3?

    <p>Erosive wear covers more than 50% of the tooth surface (A)</p> Signup and view all the answers

    Why might a BEWE score not be assigned to a restored tooth?

    <p>If the restoration covers more than 50% of the tooth surface. (D)</p> Signup and view all the answers

    What is the main feature distinguishing BEWE scores 0 and 1?

    <p>Presence of visible wear (B)</p> Signup and view all the answers

    How is an overall BEWE score for the mouth determined?

    <p>By taking the highest score from any sextant (D)</p> Signup and view all the answers

    What is a critical feature of the BEWE system regarding clinical assessments?

    <p>It should be used in conjunction with the BPE scoring system. (A)</p> Signup and view all the answers

    Flashcards

    BEWE Score 3

    Indicates hard tissue loss with >50% surface area affected, dentine often involved.

    Concavities merging (cupping)

    Visible indentation on tooth surfaces due to erosion.

    Occlusal surface loss

    Loss of the chewing surface of a tooth covering over 50% of the area.

    Restoration impact on scoring

    Restorations covering >50% of surface affect BEWE scoring; adjacent wear is counted.

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    Dentine involvement in erosion

    When erosion extends to the dentine layer beneath the enamel, indicating severe wear.

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    Tooth wear

    The loss of tooth structure due to erosion, abrasion, or attrition.

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    Erosive tooth wear

    Tooth wear caused by chemical processes, often from acidic substances.

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    Clinical assessment

    A systematic evaluation of tooth wear during dental examinations.

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    BPE

    Basic periodontal examination, assesses gum health.

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    BEWE Index

    A scoring system for tooth wear based on clinical examination.

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    Sextant

    A division of the dental arch for assessment purposes, typically 6 segments.

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    Score 0

    Indicates no signs of tooth wear on the assessed surface.

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    Score 1

    Indicates initial tooth wear, such as rounding of edges present.

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    Score 2

    Indicates tooth wear affecting less than 50% of the surface area with hard tissue loss.

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    Good lighting for assessment

    Adequate lighting is crucial for accurate visual examinations of teeth.

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    Third molars

    Typically excluded from assessment unless they replace a second permanent molar.

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    Tooth wear risk factors

    Factors influencing the progression of tooth wear phenomena over time.

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    Acidic Aetiology

    The underlying cause of tooth wear often related to acidic substances.

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    Prevention in Dentistry

    Strategies and tools implemented to avoid tooth wear signs in patients.

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    Practitioner Toolkit

    Resources created for dental professionals to address tooth wear.

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    Erosive Tooth Wear Foundation

    An organization providing information and support regarding tooth wear.

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    Index Scores for Tooth Wear

    Measurements evaluating the extent of tooth wear irrespective of cause.

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    Dental Public Health

    The branch focusing on the prevention of dental diseases and promoting oral health.

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    Clinical Crown

    The visible portion of a tooth above the gums, regardless of periodontal health.

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    Sextant Score

    A scoring system used to evaluate wear on teeth, with scores ranging from 0 to 3.

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    Incisal Edge Wear

    The wear observed on the biting edges of anterior teeth, particularly canines and incisors.

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    Cupping

    Concave wear patterns found on cusp surfaces of teeth, indicating wear.

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    Diameter Assessment

    Using a WHO probe to measure the width of wear defects on teeth.

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    Enamel Defects

    Conditions like opacities and fluorosis that affect tooth enamel but do not indicate wear.

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    Tooth Shortening

    Reduction in the height of teeth due to wear and other factors.

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    Grade 3 Tooth Wear

    More than 50% of the tooth surface is affected by wear.

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    Cusp Concavity (Cupping)

    A small concavity on the cusp indicating early wear, diameter ≤0.5 mm.

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    Study Notes

    Basic Erosive Wear Examination (BEWE) Index

    • BEWE is a simple screening tool for tooth wear in general practice.
    • Similar procedure to the Basic Periodontal Examination (BPE).
    • Designed for routine dental examinations.
    • Stakeholders in the UK endorsed recording BEWE alongside BPE.
    • Ideally, all new patients should have BEWE recorded.

    BEWE Index Assessment (Table 1)

    • Score 0: No erosive tooth wear.
    • Score 1: Initial surface texture loss (brightness, opaque, 'frosted glass').
    • Score 2: Distinct defects and hard tissue loss (less than 50% of surface area). Dentin involvement possible.
    • Score 3: Hard tissue loss (more than 50% of surface area). Dentin involvement possible.
    • Sextant cumulative assessment (maximum 18) guides clinical management.

    BEWE and BPE Procedure

    • BEWE and BPE use similar procedure and scoring systems.
    • Can be performed at the same time to save practitioner time.
    • Facilitates early recognition and prevention of tooth wear.

    Tooth Wear in Children and Mixed Dentition

    • Same BEWE protocols apply to children and mixed dentition.
    • Sextants categorized into anterior and posterior.
    • Deciduous teeth are more prone to wear than adult teeth.
    • Examination interval should be reduced to 6-12 months for high-risk cases.

    Assessment of Molars and Premolars (Occlusal Surfaces)

    • BEWE Score 0: No tooth wear, restorations don't show wear
    • BEWE Score 1: First signs of wear, rounded cusps/grooves
    • BEWE Score 2: Distinct defects, less than 50% surface loss, dentin often involved, concavities ≥0.5mm
    • BEWE Score 3: Hard tissue loss more than 50%, dentin often involved, concavities merging

    Assessment of Anterior Teeth (Buccal, Palatal/Lingual)

    • BEWE Score 0: No tooth wear on buccal, palatal, or lingual surfaces.
    • BEWE Score 1: Initial surface texture loss, minimal incisal edge loss.
    • BEWE Score 2: Distinct defect, less than 50% surface or clinical crown height loss.
    • BEWE Score 3: Hard tissue loss more than 50% of surface area.

    Differential Diagnosis with Other Conditions

    • Differentiate BEWE from gingival recession, root caries.
    • Caries lesions appear as brown-orange, non-carious wear matches tooth structure color.
    • Caries lesions might have a friable surface, while non-carious wear is hard.
    • Assess tactile sensation and look for plaque stagnation.
    • Consider caries if in doubt.

    Conclusion

    • BEWE is a simple, validated assessment tool for primary dental care.
    • Reproducibility and consistent use crucial to reliable results.

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    Related Documents

    BEWE Guidance 2020 PDF

    Description

    Explore the BEWE Index, a vital screening tool for assessing tooth wear in dental practice. This quiz covers its scoring system, procedure, and the significance of recording BEWE alongside the BPE. Perfect for dental professionals looking to enhance their understanding of tooth wear management.

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