Aim: To develop a reproducible method for the assessment of tooth wear in vivo using a laser profilometer. Design: A controlled study to measure tooth wear. Subjects and methods: Wear was measured over a 6-month period in 13 patients with unexplained palatal dental erosion and compared with a group of 7 controls without any evidence of abnormal wear. Main outcome measures: Metal disks were cemented to the tooth surface and impressions taken at 6-month intervals. Wear was estimated by scanning the impressions with a contacting laser profilometer and measuring a change in depth around the disk over a 6-month period using fixed reference points on the metal disks. Results: A statistically significant difference was observed between patients with palatal erosion and the controls. Patients with erosion had a median of 36.5 μm of wear over 6 months (range 17.6-108.2) and the controls had a median of 3.7 μm (range (0.5-15.8). Conclusions: This paper presents a novel method for measuring erosion using fixed reference points cemented to the palatal surfaces of upper incisor teeth.