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

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