Accuracy of Different Methods for Assessing Erosive Tooth Wear

The detection of exposed dentine caused by erosive tooth wear is difficult. To the authors' knowledge, there are no studies available on the impact of magnification and/or dye on the detection of erosive lesions. Therefore, the aim of this study was to investigate if the accuracy of assessing exposed dentine by the naked eye could be improved by using a microscope, dyeing, or a combination of both. The collected data were compared with the assessment of histological sections, which was considered the gold standard. A total of 70 teeth (24 teeth with slight erosion and 46 teeth with dentine involvement) showing different grades of erosive tooth wear were assessed 4 times by 17 examiners (9 aged <40 y, 8 aged ≥40 y). The first assessment was performed without magnification and without dye, the second assessment with magnification and without dye, the third assessment without magnification and with dye, and the fourth assessment with magnification and with dye. The examiners decided if dentine was exposed in the area of interest (positive test result) or not (negative test result). Subsequently, the teeth were histologically evaluated. Enamel was still present in 6 teeth and dentine was exposed in 64 teeth. Microscope magnification without dye performed the best, with 86% of all assessments being correct. The use of microscope magnification had a significant impact for dentists older than 40 y ( P = 0.02). The authors conclude that the assessment of exposed dentine was best when a microscope was used alone and that an additional dyeing of the samples did not improve performance. Knowledge Transfer Statement: Clinicians can use the results of this study when they assess erosive tooth wear. It will help clinicians to detect erosive tooth wear correctly, particularly the involvement of dentine. Using a microscope in the diagnostic process has a direct impact on the right assessment and consequently on prevention and/or minimally invasive treatment.