Challenges in Assessing Erosive Tooth Wear.

Assessing erosive tooth wear (ETW) using qualitative, semiquantitative, and quantitative measurements is a challenging process. Indices as semiquantitative tools must have simple, clearly defined scoring criteria to ensure reproducibility, accurately reflect the condition's etiology, and categorize the shape, area, and depth of the wear both at a single point in time (prevalence) and over time (incidence/increment). New technologies, such as direct three-dimensional image capture from intraoral scanners and automated monitoring using artificial intelligence, may offer more reliable quantitative methods for assessing and monitoring ETW; however, they still have limitations. Additionally, the differential diagnosis of ETW is complex, as it often coexists with other types of tooth wear. While new technological achievements hold promise, reaching a valid assessment of ETW at both the individual and population levels remains challenging without a comprehensive history of general health, diet, and habits. This chapter aims to describe the potential methodological challenges in assessing ETW, discuss recent developments in addressing these challenges, critique the strengths and limitations of existing ETW indices and other assessment systems, and propose the adoption of a validated ETW assessment system suited to its intended purpose.