Measuring erosion progression

A 6-year follow up of 55 patients showed that erosive lesions progress in the absence of preventive measures (Lussi & Schaffner 2000).
Progression correlates with increased daily consumption of acidic drinks or foods, a swishing and holding habit and a low buffer capacity of the saliva (Lussi & Schaffner 2000, O‘Sullivan & Curzon 2000).

The assessment of the progression of erosive processes is not standardised. The array of assessment methods range from using consecutive study casts, which are difficult to quantify, to accurate, but costly, computer-generated 3D pictures of superimposed images. A simple method involves the use of metal markers, which are applied to tooth surfaces and serve as a reference (Bartlett et al. 1997).

Amalgam-fillings and metal markers may help to monitor the erosion process. With tooth substance loss, the amalgam-fillings “elevate” above the tooth surface and metal markers become more visible.
Freshly applied metal markers to measure erosion progress
Occlusal erosion with exposure of dentine
The erosion with dentine exposure is well visible in this clinical image. With the tooth substance loss, the visible part of the amalgam-fillings has increased by several millimetres. Aetiology: strong reflux episodes
The same patient one year later
A year later, the amalgam-fillings have been lost. Due to persistent attacks, even the underlying defect has been practically levelled.
Unfortunately, simple, standardized procedures to monitor progression in the dental office are still not available.