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Recent epidemiological data shows that the prevalence of tooth wear (TW) is increasing. Current available assessment tools are either too complicated to carry out on every patient or inadequate in identifying the nature of the condition. Moreover, early onset or localized lesions may be overlooked. This article describes a screening tool which may overcome these problems. This tool involves using the existing Basic Erosive Wear Examination scoring system and a proposed age-related grid. This will lead to an associated pathway, which indicates the recommended level of further investigations and management.
CPD/Clinical Relevance: Early identification and prevention of pathological tooth wear in the primary care setting is the key to slowing down the disease progression.
Article
Tooth wear (TW) or Tooth Surface Loss (TSL) is used to describe the progressive loss of dental hard tissue by chemical and mechanical actions other than those caused by caries or trauma. It is a multifactorial process comprised of erosion, attrition, abrasion and abfraction.1
In England, Wales and Northern Ireland, improved dental health awareness and dental services in the last 30 years have reduced edentulous adults from 28% in 1978 to 6% in 2009. Compared with 30 years ago, the percentage of adults aged 45–50 who have over 20 natural teeth increased nearly two-fold (Figure 1).2 Because natural teeth now survive for longer, the impact of TW is critical to the ageing population. The overall prevalence of tooth wear has increased since 1998.3 The increase of anterior TW in the younger group, aged 16 to 24, was significantly higher than the older groups.3 Fortunately, the prevalence of TW-related dentine and pulp exposure for children aged 12 to 15 remains at a low level.4 This supports the fact that TW is not aggressive, but rather a slow process. Therefore it requires long-term preventive and monitoring strategies. The earlier the disease or potential risk is identified, the more likely a well-designed management regimen would be successful.
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