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Basic Erosive Wear Examination (BEWE): a new scoring system for scientific and clinical needs

, 1 , 2 , 3

Clinical Oral Investigations


Erosion, Tooth wear, Diagnosis, Examination, Index, Epidemiology

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      A new scoring system, the Basic Erosive Wear Examination (BEWE), has been designed to provide a simple tool for use in general practice and to allow comparison to other more discriminative indices. The most severely affected surface in each sextant is recorded with a four level score and the cumulative score classified and matched to risk levels which guide the management of the condition. The BEWE allows re-analysis and integration of results from existing studies and, in time, should initiate a consensus within the scientific community and so avoid continued proliferation of indices. Finally, this process should lead to the development of an internationally accepted, standardised and validated index. The BEWE further aims to increase the awareness of tooth erosion amongst clinicians and general dental practitioners and to provide a guide as to its management.

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      Most cited references 13

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      An index for measuring the wear of teeth.

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        Dental erosion -- changing prevalence? A review of British National childrens' surveys.

        To investigate the change in the prevalence of dental erosion, over time, by a review of the data from the published national dental surveys of young people in the UK. A subsidiary objective was to investigate the relationship between erosion and possible associated risk factors. The review was based on cross-sectional prevalence studies incorporating a clinical dental examination and structured interviews. The data were collated from the 1993 UK childrens' dental health survey and the dental report of the two National Diet and Nutrition Surveys (NDNS) of children aged 1(1/2)-4(1/2) in 1992/3 and 4-18 years in 1996/7. The criteria used for data collection were comparable between the three different studies. Comparing the data from the different studies, the prevalence of erosion was seen to increase from the time of the childrens' dental health survey in 1993 and the NDNS study of 4-18-year-olds in 1996/7. There was a trend towards a higher prevalence of erosion in children aged between 3(1/2) and 4(1/2) and in those who consumed carbonated drinks on most days compared with toddlers consuming these drinks less often. Drinks overnight were associated with an increased prevalence of erosion. More 4-6-year-olds with reported symptoms of gastro-oesophageal reflux had erosion compared with symptom-free children. On multivariate analysis, the strongest independent association with erosion was geography, with children living in the North having twice the odds of having erosion compared with those in London and the South-east. Comparing prevalence data from cross-sectional national studies indicates that dental erosion increases between different age cohorts of young people over time. Dietary associations with erosion are present but weak. Similarly, there is an association apparent between erosion, symptoms of gastro-oesophageal reflux and socio-demographic variables such as region of domicile, social class, and receipt of social benefits.
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          Dental erosion in children and adolescents--a cross-sectional and longitudinal investigation using study models.

          To investigate the prevalence and incidence of dental erosion in children and adolescents. Lesions were registered for all tooth surfaces of primary and permanent teeth using pre-orthodontic study models. A total of 1,000 individuals (mean age 11.4+/-3.3 years) were included; 265 of them were followed over a 5-year period using their final orthodontic casts. In the primary teeth, 26.4% of the individuals had no erosive lesions, 70.6% had at least one tooth with grade 1 erosion and 26.4% had grade 2 erosion. Grade 1 erosion was found in 44% of the occlusal surfaces of molars (36% of the incisal surfaces of the canines) and grade 2 erosion in 11% (9%). Lesions affecting oral or vestibular surfaces were negligible. In the permanent teeth, 11.6% of individuals had at least one tooth with grade 1 erosion but only 0.2% had at least one tooth with grade 2 erosion. The most affected teeth were the mandibular first molars (7% with grade 1 lesions). Lesions affecting oral or vestibular surfaces were negligible. Mandibular first molars were identified as possible marker teeth for the onset of erosive lesions. Within the last two decades, the percentage of subjects with at least one tooth with a grade 1 or 2 erosive lesion significantly increased for primary and with grade 1 for permanent teeth (P< or =0.001). The longitudinal observation revealed that subjects with erosive lesions in their primary dentition had a significantly increased risk for erosion in their permanent teeth (P< or =0.001). In Germany, dental erosion seems to be a significant, but not a serious, problem for dental health in adolescents.

            Author and article information

            [1 ]Department of Prosthodontics, King’s College London Dental Institute, Floor 25, Guy’s Tower, London Bridge, SE1 9RT London, UK
            [2 ]Department of Conservative and Preventive Dentistry, Dental Clinic, Justus-Liebig-University, Giessen, Germany
            [3 ]Department of Preventive, Restorative and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
            +44-01207-1885390 ,
            Clin Oral Investig
            Clinical Oral Investigations
            Springer-Verlag (Berlin/Heidelberg )
            29 January 2008
            March 2008
            : 12
            : Suppl 1
            : 65-68
            © Springer-Verlag 2007
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            © Springer-Verlag 2008


            examination, tooth wear, index, diagnosis, epidemiology, erosion


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