Tooth wear is the gradual loss of tooth structure caused by erosion, abrasion, or attrition. Digital analysis can help clinicians visualize tooth wear patterns, review enamel wear and dentin exposure, and monitor changes over time.
Tooth erosion is one of the most common forms of tooth wear and is a frequent reason for investigating changes to the tooth surface. Traditionally, clinicians assess tooth erosion through visual examination and clinical assessment. However, because tooth wear can also result from abrasion and attrition, the broader pattern of wear often needs to be evaluated during a clinical examination.
Digital workflows provide another way to assess and monitor tooth wear. By combining intraoral scans with software-based visualization, clinicians can review wear patterns, compare scans from different visits, and monitor changes over time as part of a digital workflow.
For tooth wear assessment, a TRIOS intraoral scan displayed within Dx software provides a view of the tooth surfaces for review. This can include visible wear patterns on the enamel surface and areas where dentin exposure may be present. The scan creates a 3D record that clinicians can review, compare across visits, and use as input for software-based visualization.
To understand the scanning process, see how intraoral scanners work.
Deep dive
Collapse
A scan used for tooth wear assessment follows the standard recommended scanning protocol for the intraoral scanner and Dx software.
Scan time can vary depending on the operator’s experience, the clinical situation, and the quality of data needed for software-based review. No additional scanning steps are required beyond following the manufacturer’s recommended scanning protocol.
Collapse
Digital tooth wear assessment combines intraoral scan data with software-based visualization and analysis. The workflow moves from scan capture to 3D visualization, AI-assisted review, and comparison of scans over time.
The following steps explain what the clinician sees and how tooth wear findings can be reviewed within the software environment.
The workflow begins with an intraoral scan of the teeth. For tooth wear assessment, the scan captures the surface shape and topography of the tooth structure, including areas where enamel wear or dentin exposure may be visible.
This scan data provides the basis for software-based visualization and comparison over time.
Once the scan has been captured, the scan data is processed to create a 3D digital model of the teeth. The clinician can then review the scanned surfaces within the software and prepare the data for visualization, comparison, and AI-assistive analysis.
The resulting 3D model provides the foundation for reviewing tooth wear findings and monitoring changes over time.
Once the scan has been processed, Dx software displays tooth wear findings directly on the 3D model using a color-coded visualization. This allows clinicians to review the location and extent of wear patterns on the scanned teeth.
The software distinguishes between enamel wear and dentin exposure using different colors: yellow indicates enamel wear, while red indicates dentin exposure. The visualizations can be examined from different angles and used together with other clinical findings to support assessment.
One of the key advantages of digital monitoring is the ability to compare scans taken at different visits. Dx software displays scans chronologically and allows clinicians to select and compare scans from different dates.
Using a comparison view, clinicians can review changes in tooth surfaces over time and assess whether tooth wear has progressed since the previous scan. This creates a visual record that can support monitoring and patient communication.
Dx software uses AI-assistive analysis to highlight areas that may require further clinical examination. Detected findings are displayed within the software and can be reviewed individually by the clinician.
For more on how AI-assistive tools can support dental checkups, read the AI-powered dental diagnostics article.
The clinician can inspect each finding, review the AI confidence score, and modify or remove findings if they do not align with their clinical judgment. The software supports the assessment process, but the final diagnosis remains the responsibility of the clinician.
This workflow is part of 3Shape Dx software, which supports AI-assistive analysis and helps clinicians review tooth wear findings as part of the overall clinical assessment.
Digital tooth wear assessment follows a scan → visualization → comparison workflow. The software highlights tooth wear findings on the 3D model, distinguishing between enamel wear and dentin exposure using color-coded visualizations.
Scans from different visits can be compared to monitor changes over time. AI-assistive analysis supports the review process by highlighting areas that may require further clinical examination, while the final diagnosis remains the responsibility of the clinician.
To see this workflow in practice, watch the How to detect Tooth Wear with Dx Plus video.
Traditional scoring systems such as BEWE are used to assess and record erosive tooth wear. Dx software takes a different approach by visualizing tooth wear findings on the 3D model instead of displaying a clinical score.
Traditional indices such as BEWE give clinicians a structured way to record tooth wear severity during clinical assessment and monitor findings over time.
Dx software does not calculate or display BEWE scores, assign a BEWE stage, or replace clinical scoring. Instead, it highlights tooth wear findings visually on the scan, so clinicians can review the location and extent of enamel wear and dentin exposure as part of their overall clinical assessment.
Dx software displays tooth wear findings directly on the 3D model using color-coded visualization. The software distinguishes between enamel wear and dentin exposure, helping clinicians review the findings in context. Yellow indicates enamel wear, while red indicates dentin exposure.
These findings can be examined from different angles and used alongside other clinical information to support assessment and monitoring.
Visual tooth wear findings can help clinicians review where wear is present, and whether enamel wear or dentin exposure is visible on the scan. Because the findings are shown on the 3D model, clinicians can review them alongside the clinical exam, patient history, and other relevant information.
When sans from different visits are compared, the visual record can also help clinicians monitor changes over time and support patient conversations about the findings and possible next steps.
Visual assessment remains an important part of evaluating erosive tooth wear. Digital monitoring provides an additional way to document, visualize, and track changes over time using intraoral scan data and software-based analysis.
Research comparing clinical assessment, scan-based assessment, and AI-derived assessment suggests that digital workflows may present sensitivity compared to clinical assessment, and reproducibility in tooth wear detection.2 However, digital monitoring is intended to support clinical judgment, not replace it.
The accuracy of digital tooth wear detection can be affected by several factors, including scan quality, the visibility of surface changes, the level of tooth wear present, and how findings are reviewed by the clinician.
Because digital methods may highlight more possible wear than visual assessment alone, findings should be interpreted carefully alongside the clinical examination.
Digital scanning may help clinicians identify and monitor subtle tooth surface changes that can be difficult to assess through visual examination alone. By comparing scans from different visits, clinicians can review how tooth surface changes over time and decide whether further clinical assessment or action is needed.
These findings should be interpreted as part of the overall clinical assessment, not as a standalone diagnosis.
Research comparing clinical visual assessment, scan-based assessment, and AI-derived assessment found differences in how tooth wear was identified and assessed across the three methods.2
The study also reported strong repeatability for AI-derived assessment and good performance in detecting dentin exposure. These findings suggest that digital monitoring can provide useful additional information for reviewing tooth wear, especially when changes need to be tracked over time.
Digital findings should be interpreted in their clinical context. Differences between assessment methods mean that scan-based and AI-derived findings should support the clinician’s assessment, not replace it.
Deep dive
Collapse
No. Digital scanning is intended to support, not replace, clinical assessment and visual examination.
Digital monitoring can provide additional information by documenting tooth surfaces, visualizing findings, and comparing scans from different visits. However, clinical judgment remains essential, and the final diagnosis and treatment decisions remain the responsibility of the clinician.
Collapse
Tooth wear can involve irreversible loss of tooth structure, including enamel loss that cannot regenerate. For this reason, identifying and monitoring changes early is important for understanding progression and supporting preventive care.
Digital monitoring may provide a way to document tooth surfaces over time, helping clinicians review changes, communicate findings, and track progression between visits.
AI-assisted identification of tooth wear may support preventive treatment planning by helping clinicians review changes before significant tooth structure is lost. Structured assessment of tooth wear can also help inform decisions around monitoring, prevention, and ongoing management.3
Dx software does not provide BEWE scores or treatment recommendations. It visualizes tooth wear findings using AI masks, which the dentist reviews and interprets alongside the clinical examination, patient history, and risk factors.
Digital visualization can help make tooth wear findings easier to review and discuss with patients. By displaying findings directly on the scan and comparing scans from different visits, clinicians can show patients how tooth surfaces have changed over time. To explore this broader shift, read more about changing dental diagnostics.
This visual approach may support patient understanding and provide additional context when discussing preventive measures and ongoing monitoring.Digital workflows can help document tooth wear findings within the same digital environment used for scanning and analysis. Findings can be reviewed, shared with patients, and included in PDF reports generated from the software.