What are cupping lesions and how should dentists handle them?

C;upping  refers to concave erosions in teeth sometimes found on the biting surfaces of teeth. These result when enamel becomes perforated due to attrition (due to tooth wear from function) and erosive wear of the exposed dentin causes the small cup shaped depression in the dentin to form. These are opposed to wear from just attrition where exposed dentin remains at the same level as the enamel of the occlusal or incisal table.

Some dentists will leave these lesion alone but in my practice I suggest placing small minimally invasive composite restorations ( about .75 mm in depth) in order to prevent further errosion of these cupping lesion, since when they enlarge they tend to undermine adjacent enamel and gradually widen and deepen over time. The small composite filling that I place functions like artificial enamel since the protect the underlying dentin from further erosion.

These small filling take minutes to place and the restorations are mostly completed without the need for local anesthesia.  The only real drawback that I have found is that these small fillings can need to be replaced more often than regular fillings . This probably is due to the shallow depth of the preparation that I employ. The resulting restorations can wear sufficiently fast that my patients may need replacement restorations in four to seven years. That being the case, these restorations are quite worthwhile since they do help preserve teeth. When left unrestored these lesion grow in diameter and can in some cases even join up with other nearby cupping lesions to effectively remove all the occlusal or incisal enamel of a tooth, sometimes even resulting in the placement of   a crown to preserve the remaining tooth structure.

from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2019/10/what-are-cupping-lesions-and-how-should.html - http://lspindelnycdds.blogspot.com/

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