Background: Tooth wear is a multifactorial condition, leading to the loss of dental hard tissues. Physiological tooth wear is a slow process that normally does not lead to any subjective symptoms. When the condition progresses, it can become pathological, and several signs and symptoms may occur. The Tooth Wear Evaluation System (TWES) was described to implement a systematic diagnostic and management approach. Recently, management guidelines were presented in a European Consensus Statement (ECS) as well.Objectives: To evaluate the TWES in practice and to integrate the principles described in the ECS in order to compose a renewed TWES 2.0 and a new taxonomy. Methods:The TWES and the recommendations of the ECS were used by dental clinicians, in order to test its applicability in practice.Results: Agreement was reached that the TWES 2.0 will use a stepwise approach, with a straightforward Tooth Wear Screening part and a more detailed Tooth Wear Status part. Also, the assessment of pathology from the ECS is incorporated in the TWES 2.0 (both classification and taxonomy). Conclusions:In the TWES 2.0 is described that tooth wear is pathological if moderate/severe/extreme tooth wear is present, in combination with one or several described signs and symptoms. Aetiology can be assessed by findings that indicate a chemical and/or a mechanical cause. The taxonomy may help to identify situations in which preventive (restorative) interventions in early stages of tooth wear can be indicated. The reliability and validity of the adapted parts must be proven. K E Y W O R D S classification, diagnosis, European Consensus Statement (ECS), management, pathological, physiological, taxonomy, tooth wear, Tooth Wear Evaluation System (TWES) How to cite this article: Wetselaar P, Wetselaar-Glas MMJ, Katzer LD, Ahlers MO. Diagnosing tooth wear, a new taxonomy based on the revised version of the Tooth Wear Evaluation System (TWES 2.0). J Oral Rehabil. 2020;47:703-712. https://doi.

Tooth wear is a multifactorial condition, leading to the loss of dental hard tissues. Many grading scales are available to assess the amount of tooth wear, one of which is the tooth wear evaluation system (TWES). A grading scale can be used chairside, on casts and on photographs. The aim was to test whether the grading scales of the TWES, used on casts and on photographs, resulted in comparable scores. In addition, it was tested whether these scales can be used to assess tooth wear reliably on photographs. Of 75 tooth wear patients, sets of casts and series of photographs were obtained and graded. Comparison of the grading on casts and on photographs revealed equal median values and percentiles for both occlusal/incisal grading and non-occlusal/non-incisal grading. The grading on casts and on photographs showed a high correlation for the occlusal/incisal grading and a low correlation for the non-occlusal/non-incisal grading (Spearman's rho = 0·74 and rho = 0·47; P < 0·001). Concerning the grading on photographs, the interexaminer reliability was fair-to-good (ICC = 0·41 to ICC = 0·55) while the intra-examiner reliability was fair-to-good to excellent (ICC = 0·68 to ICC = 0·86) for the occlusal/incisal grading. For the non-occlusal/non-incisal grading, the interexaminer reliability was poor to fair-to-good (ICC = 0·22 to ICC = 0·59), while the intra-examiner reliability was fair-to-good to excellent (ICC = 0·64 to ICC = 0·82). It was concluded that the scores obtained with the grading scales of the TWES on casts and on photographs are comparable. The grading scales can be used in a reliable way on photographs, which is especially the case for occlusal/incisal grading.

No abstract

No abstract

No abstract

A 30-year-old woman appeared at the gnathology department of a centre for special dentistry complaining of migraine attacks which were preceded each time by severe odontalgic pain. Furthermore, she suffered from an autoimmune disease as well as from tension headaches. The oral health care provider in charge suspected that the episodes of odontalgic pain, which lasted for several hours or even several days, were caused by bruxism. Treatment of the bruxism resulted in reduced pain as well as reduced severity of the migraine attacks.