An introduction to the Basic Erosive Wear Examination (BEWE)

The campaign to improve understanding and monitoring of erosive tooth wear

Erosive tooth wear is the 3rd most commonly observed oral condition,1 however many professionals are not actively recording signs in patient notes.

During 2018 GSK sponsored a meeting of key representatives from associations within dentistry, chaired by the Erosive Tooth Wear Foundation to highlight the requirement for monitoring and patient discussion to form part of every clinical examination.

A series of educational tools for professionals have been developed as outputs from this session which can be accessed on this page. These tools are designed to help protect your patients and your practice by identifying signs of the condition early and providing preventative advice to patients.

How you can make a difference

  • Questions to ask about diet

    Ask patients about diet choices and snacking habits

    1. How many dietary acids are consumed daily; fruits, anything with a fruit flavouring, acidic drinks, acidic sweets and medications?
    2. How many of these are between meals?
    3. Do you spend more than 10 minutes consuming any dietary acid at a single sitting?
    4. Do you sip, swish, hold or rinse acidic drinks before swallowing?
  • Advise patients on diet modification

    Provide dietary modification advice

    Diet advice to minimise the risk of erosive tooth wear includes:

    • Advise patients that it is important to follow a healthy diet and get your “5 a day” but it is important that acidic fruits and juices are consumed WITH meals
    • Try not to have fizzy drinks or fruit juices everyday and if you do have them occasionally then consume with meals
    • Try to eat acidic foods/drinks quickly – avoid sipping slowly or swilling drinks

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  • Use the BEWE to protect your patients and your practice

    BEWE

    Protect your patients and your practice from the effects of erosive tooth wear by following these steps:

    • ETW examination should form part of every routine oral health assessment to avoid a missed diagnosis
    • Routinely record ETW using the BEWE & document that preventative advice is given
    • Patients are fully informed about:
      • the extent of the condition in order to be able to provide valid consent for treatment options (preventative and restorative)
      • any early areas of ETW that are being monitored
    • Ensure that patients understand the importance of looking after their own oral health and managing their risk factors

Other ways to make a difference

Saoirse interview image

A practical introduction to the BEWE

This video provides a practical demonstration of the BEWE examination for everyday practice and features Professor David Bartlett and Dr Saoirse O’Toole from Kings College London.

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How to perform bewe with bpe image

Conducting a BEWE examination alongside the BPE

The BEWE was developed to share many characteristics of the BPE and the 2 examinations can be completed simultaneously, using the same equipment to optimise clinical time.

In this video Diane Rochford of the BSDHT shares a practical demonstration of completion of the BEWE and BPE together.

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David interview image

Why should I use the BEWE?

In this video Professor David Bartlett discusses the importance of using the BEWE for patients at risk of erosive tooth wear.

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Erosive Toothwear presentation

Erosive Tooth Wear education module

This auto play module includes a voice over from Professor David Bartlett and provides an introduction to erosive tooth wear, patient management and the use of the BEWE.

Learning objectives:

  • Definition of erosive tooth wear and clinical signs
  • Prevalence of the condition
  • Identification of risk factors
  • Using the BEWE as part of clinical examinations
  • Prevention and progression

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BEWE module CPD Questions

Test your knowledge of erosive tooth wear

Download this quiz to test your knowledge of erosive tooth wear and the BEWE. If you would like to find out more access the learning module for a full introduction.

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BDJ BEWE Article

Find out more about the need to monitor erosive tooth wear

This article written by members of the expert working party outlines the need to take practical steps to record and monitor erosive tooth wear in daily practice and highlights the potential risks if signs are ignored. It was originally featured in the British Dental Journal.

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Pronamel Patient Leaflet

Patient leaflet on erosive tooth wear

Download, share and print this A4 leaflet on erosive tooth wear for patients including prevention advice.

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Pronamel children's patient leaflet

Children’s leaflet on erosive tooth wear

Download, share and print this leaflet on erosive tooth wear for parents including prevention advice.

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BDJ BEWE Article

Find out about the recommendations and guidelines for dentists using the BEWE

This article explains how to screen tooth wear in general practice using the Basic Erosive Wear Examination (BEW). Is was originally featured in the British Dental Journal.

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