Introduction 1 4 8 5 14 9 12 2 19 The Basic Erosive Wear Examination (BEWE) has therefore been designed to provide a simple scoring system that can be used with the diagnostic criteria of all existing indices aiming to transfer their results into one unit which is the BEWE score sum. The aim of the BEWE is to be a simple, reproducible and transferable scoring system for recording clinical findings and for assisting in the decision-making process for the management of erosive tooth wear. Basic Erosive Wear Examination (BEWE) 1 11 12 Table 1 Criteria for grading erosive wear Score   0 No erosive tooth wear 1 Initial loss of surface texture 2* Distinct defect, hard tissue loss <50% of the surface area 3* Hard tissue loss ≥50% of the surface area *in scores 2 and 3 dentine often is involved The examination is repeated for all teeth in a sextant but only the surface with the highest score is recorded for each sextant. Once all the sextants have been assessed, the sum of the scores is calculated as indicated on the grid that follows: Highest score Highest score Highest score   1. Sextant (17–14) 2. Sextant (13–23) 3. Sextant (24–27)   Highest score Highest score Highest score Score sum 4. Sextant (37–34) 5. Sextant (33–43) 6. Sextant (44–47)   2 Table 2 Risk levels as a guide to clinical management Risk level Cumulative score of all sextants Management None a Routine maintenance and observation Repeat at 3-year intervals Low a Oral hygiene and dietary assessment, and advice, routine maintenance and observation Repeat at 2-year intervals Medium a Oral hygiene and dietary assessment, and advice, identify the main aetiological factor(s) for tissue loss and develop strategies to eliminate respective impacts Consider fluoridation measures or other strategies to increase the resistance of tooth surfaces Ideally, avoid the placement of restorations and monitor erosive wear with study casts, photographs, or silicone impressions Repeat at 6–12-month intervals High a Oral hygiene and dietary assessment, and advice, identify the main aetiological factor(s) for tissue loss and develop strategies to eliminate respective impacts Consider fluoridation measures or other strategies to increase the resistance of tooth surfaces Ideally, avoid restorations and monitor tooth wear with study casts, photographs, or silicone impressions Especially in cases of severe progression consider special care that may involve restorations Repeat at 6–12-month intervals a The management would include identification and elimination of the main aetiological factor(s), prevention and monitoring, as well as symptomatic and operative intervention where appropriate. It does not provide guidance for the most appropriate prosthodontic or operative technique as there is too much variation at this level of decision making between clinicians. However, for the highest risk levels special care is suggested. 17 Discussion The need for a standardised and internationally accepted index is obvious, but there continues to be research needs which may not be fulfilled with a simplified index. Over the past 20 to 30 years, different researchers have developed indices which suit their own research needs but do not allow comparison to assess the prevalence of tooth wear between countries and regions. Therefore, this new scoring system has been designed to allow existing and hopefully future indices to be collapsed and re-analysed. It will be important that this proposed system is validated against existing data or in field trials. In time, it 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. 10 13 15 x x y 7 18 6 3 16 Conclusion The BEWE is a basic structure to initiate the development of an internationally accepted, standardised and validated index. This is to provide on one hand a clear and defined structure for scientific and clinical use, but on the other to be amenable for further development. It will encourage clinicians, students and GDPs to pay more attention to erosive wear and hence will be beneficial for patient care.