Basic Erosive Wear Examination (BEWE)

The need for harmonisation of diagnostic tools and indices resulted in the definition of the BEWE-scoring system.

Background:
  • The wide range of indices and definitions used to identify and classify dental erosion impede comparison among trials and cases.
  • This lack of harmonisation among tools and indices for diagnosis triggered the organisation of a workshop of experts in 2007.
  • The outcome was a new scoring system based on common experience and knowledge.

Objective:
  • The Basic Erosive Wear Examination is a simple partial scoring system that evaluates the severity of erosion and guides the practitioner in case management (Bartlett et al. 2008).
  • The BEWE scoring system assesses lesions on all teeth and tooth surfaces. All teeth excluding the 3rd molars in a sextant are examined, but only the surface with the worst (highest) score per sextant is recorded.
  • Summed up, these six sextant scores result in the total BEWE score
  • The BEWE index also permits additional analysis and classification of studies allowing cross-comparison and assisting decision making for the management of erosion.

BEWE scores for the diagnosis of erosive lesions:

Score: 0   No surface loss
Score: 1   Initial loss of surface texture
Score: 2* Distinct defect, hard tissue loss of less than 50% of the surface area
Score: 3* Distinct defect, hard tissue loss of more than 50% of the surface area
* In scores 2 and 3, dentine is often involved

(Bartlett et al. 2008)

For further description of the stages of erosion and clinical pictures, please review the signs and symptoms of erosion.

Benefits:
  • Developed as a tool for general practitioners
  • Classifies clinical visual erosion defects
  • Matches clinical signs to risk levels
  • Gives guidance toward clinical management
  • Easy to integrate into daily office routine