Enamel wear: Diagnosis
How to diagnose enamel wear
Enamel wear is gradual and can be hard to detect during the early stages. Explore the tools that can help you identify enamel wear.
Early diagnosis of enamel wear is important to prevent further, lasting damage1
Common features of enamel wear2,3
Clinical appearance is critical to identifying enamel erosion. Over time, the wear caused by enamel erosion can lead to reduced thickness of tooth enamel and a change in the texture, shape, and appearance of the teeth, which may also cause teeth to become sensitive.2,3
These include 2,3:
- Yellowing (advanced sign)As erosion becomes more severe, enamel thins, exposing the dentin underneath and causing teeth to appear yellow or discolored.
- Thinning and translucencyTeeth that appear thin and translucent are a sign that tooth enamel erosion may have already begun.
- Surface changes (smoothing)One sign of dental erosion is the loss of the surface of the tooth, leading to a smooth, shiny appearance.
- Loss of structural features (rounding)Dental erosion, if untreated, can lead to the progressive loss of the surface of the tooth. The loss of tooth structure can require complex and lengthy treatment involving fillings, veneers, crowns, and potentially root canals.
Other signs of enamel wear2,3
These include:
- Palatal erosive tooth wear
- Occlusal cupping
The Basic Erosive Wear Examination (BEWE)
The BEWE is a quick, effective, validated tool for assessing enamel wear4 and was a key tool in the ESCARCEL study; the first pan-European epidemiology study on non-carious cervical lesions (NCCL) and associated risk factors, and the largest and most comprehensive study of its kind.
The BEWE in practice
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Step 1 – Talk to your patient
How to identify tooth erosion
Your patient’s diet or dietary habits may increase their risk of erosive tooth wear.3,6 Ask them the following questions to help determine their risk:
- How many times do you consume acidic foods or drinks in a day?
- Do you have a history of gastric reflux?
- Do you swish or hold acidic drinks in your mouth?
- Do you frequently take liquid medication (which may be acidic)?
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Step 2 – Assign BEWE scores
BEWE scores describe how severely each sextant of your patient’s dentition is affected by enamel wear. Each sextant should be assigned a score of 0 to 3:
0. No erosive wear 1. Initial loss of enamel surface texture 2. Distinct defect, hard tissue loss extending over less than 50%* of the surface area 3. Hard tissue loss extending over 50%* or more of the surface area
Once assigned, the scores from each sextant can be used to calculate a cumulative BEWE score.
*In scores 2 and 3, dentine is often involved
Sensodyne - helping your patients manage dentine hypersensitivity due to enamel wear
Impact on patient quality of life
Find out about the impact enamel wear has on patients’ daily lives.
The Sensodyne range
Find out how the Sensodyne range can help your patients with dentine hypersensitivity due to enamel wear.
