Erosion

Etiology • Acid dissolution of enamel and dentin • Loss of enamel and, less commonly, dentin secondary to chemical
(usually acids) action/demineralization • Intrinsic sources relate to stomach acid presence within the
oral cavity. • May be due to the following:
• Occupational exposure to acids • Diet with acid exposure (phosphoric acid– containing
beverages; sucking on lemons) • Chronic regurgitation/gastroesophageal reflux • Bulimia-related vomiting
Clinical Presentation • Loss of enamel initially along lingual surfaces of anterior teeth

(bulimia, reflux) • Labial enamel loss (beverage related, occupation related) • Cupped dentin noted to occur more rapidly than adjacent
enamel loss on occlusal surfaces • Existing metallic restorations (inlays, amalgam fillings) and any
protected enamel may be above the surrounding dentin, creating a “ledge” effect.
• Smooth to polished appearance of maxillary incisors in chronic, high-volume consumers of beverages (phosphoric or citric acid–containing)
Diagnosis • Correlation of appearance with diet, habits, environmental
exposure, underlying eating disorder, or chronic acidic reflux
Differential Diagnosis • Amelogenesis imperfecta • Factitial injury
Treatment • Identification and elimination of cause • Treatment of underlying etiology

• Dental restorative treatment subsequent to complete functional evaluation, vertical dimension, and esthetics
Prognosis • Excellent