Erosion

Erosion is the loss of tooth structure from a non-bacterial, chemical process.^9,39 Typically, the chemical agent is acid from acid reflux or regurgitation, frequent vomiting (e.g., bulimia-associated), excessive home tooth-whitening, high acidic dietary intake, or occupationally related acid exposure.^5,39,40 The location and pattern of erosion is a key to the likely causal agent. Erosion affecting the facial surfaces of the cervical aspect of maxillary anterior teeth often is indicative of dietary acid from habits such as lemon-sucking.³⁹ Regurgitated acids typically affect the palatal and lingual surfaces of the maxillary anterior teeth and the occlusal surfaces of maxillary and mandibular posterior teeth.^5,39,40 Clinically, the areas of erosion look smooth and shiny where the enamel has been removed and the dentin is exposed.^5,9,39,40 However, these exposed areas of dentin can subsequently take-up stain.⁷ Radiographically, these eroded coronal depressions appear radiolucent with smooth margins (Figure 62A and 62B).

Figure 62A and 62B.

Figure 62A and 62B.

Periapical radiographs demonstrating erosion of anterior (A) and posterior (B) teeth.