Erosion

Erosion is the loss of tooth structure from a non-bacterial, chemical process.^9,16 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.^7,16,17 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.¹⁶ Regurgitated acids typically affect the palatal and lingual surfaces of the maxillary anterior teeth and the occlusal surfaces of maxillary and mandibular posterior teeth.^7,16,17 Clinically, the areas of erosion look smooth and shiny where the enamel has been removed and the dentin is exposed.^7,9,16,17 However, these exposed areas of dentin can subsequently take-up stain.⁷ Radiographically, these eroded coronal depressions appear radiolucent with smooth margins (Figure 47).

Figure 47.

Figure 47.

Periapical radiographs demonstrating erosion.