Indices for assessing erosive wear are expected to deliver more than is expected of an ideal index: simple with defined scoring criteria so that it is reproducible, reflective of the aetiology of the condition and accurately categorizing shape, area and depth of affect, both at a point in time (prevalence) and longitudinally (incidence/increment). In addition, the differential diagnosis of erosive wear is complex, as it usually co-exists with other types of tooth wear. Therefore, a valid recording of erosive wear at an individual as well as at a population level without a thorough history with respect to general health, diet and habits is a challenge. The aims of this chapter are to describe the potential methodological challenges in assessing erosive wear, to critique the strengths and limitations of the existing erosion indices and to propose the adoption of a validated erosion index for the purpose for which it is intended.
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