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BEWE Score 12 Management — ORE Part 1 MCQ

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ModerateDental Public Health & EpidemiologyBEWE Score 12 ManagementORE Part 1

A 30-year-old patient has generalised erosive tooth wear. A diet diary identifies consumption of approximately 2 litres of cola daily. The cumulative BEWE score is 12. Which management plan is most appropriate?

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Correct answer: C — Reduce acidic-drink exposure, reinforce fluoride toothpaste use, record baseline photographs or study models, review for intrinsic acid risks, and consider restoration only if indicated

The best answer is **A**. BEWE 12 represents substantial erosive wear requiring active risk-factor management. In this case, the major identified risk is daily cola consumption, so advice should focus on reducing acidic-drink frequency and limiting intake to mealtimes, alongside fluoride toothpaste use. Baseline photographs or study models help detect progression, and the history should also assess intrinsic acid exposure such as reflux or vomiting. Restorative care may be needed if there is functional, aesthetic, symptomatic or structural indication, but prevention and stabilisation come first. **B** and **C** under-treat established generalised wear. **D** is unjustifiably invasive before controlling risk and establishing need. **E** incorrectly substitutes referral for appropriate primary-care prevention and monitoring.

Reference: Department of Health and Social Care et al. Delivering Better Oral Health: An Evidence-Based Toolkit for Prevention, Chapter 7: Tooth wear, updated 10 September 2025. https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention/chapter-7-tooth-wear