Diagnosis
Clinical examination using the BEWE (Basic Erosive Wear Examination) index to score all sextants (0-3 per sextant) and guide treatment. Cumulative score guides recall interval and treatment planning.
Dietary analysis: 4-7 day diet diary to identify frequency and timing of acidic food and drink consumption.
Medical history: GERD symptoms (heartburn, regurgitation, morning hoarseness), eating disorder screening, medication review (antacids, bisphosphonates, Vitamin C supplements).
Pattern of erosion guides etiology: palatal surfaces of upper anterior → intrinsic acid (GERD, bulimia); buccal and occlusal surfaces of lower posterior → extrinsic acid (dietary); generalized smooth erosion → multiple acid sources.
Study models or intraoral scans at diagnosis and 6-12 monthly intervals to monitor progression quantitatively.