Basic Erosive Wear Examination (BEWE)

Basic Erosive Wear Examination (BEWE)

Basic Erosive Wear Examination

✅ Objectives

By the end of these revision notes, you should be able to:

  • Understand the basics of why the BEWE was introduced
  • Describe the principles and scoring system of the BEWE indext
  • Interpret the BEWE score and create an appropriate management strategy

What is the BEWE?

Tooth surface loss can be caused by erosion, attrition, abrasion or abfraction.

The Basic Erosive Wear Examination (BEWE) is a simple, reproducible and validated screening tool aimed at recording and monitoring erosive tooth surface loss. Bartlett et al. (2008) introduced the BEWE to help with recording this information in a similar fashion to the BPE. 

The BEWE quantifies the severity of erosive tooth surface loss across the dentition. This will also provide a summary score that can be used to categorise patients in to various risk levels and, therefore, guidance on management. 

How to carry out the BEWE

Like the BPE, the mouth is divided in to sextants.

All tooth surfaces are then examined in each sextant and the most severely affected surface is identified. 

Only the worst lesion in each sextant is scored. 

Score
Description
Example of clinical features
0
No erosive wear
Enamel intact and no loss of contour
1
Initial loss of surface texture
Enamel appears dull/matt but no dentine exposure
2
Distinct defect, hard tissue loss <50% of surface area
Dentine visible on <50% of the surface
3
Hard tissue loss ≥50% of surface area
Dentine visible ≥50% of surface, extensive wear, pulpal exposure may be present
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