AtlasDentalDental Erosion

Dental Diseases

Dental Erosion

aka Acid Erosion · Chemical Erosion

Loss of tooth structure by chemical dissolution from non-bacterial acids.

Extrinsic
Dietary acids
Intrinsic
GERD/bulimia
Index
BEWE

§ figuresFigures (2)

Fig. 1(Gastroesophageal Reflux Disease and Tooth Erosion 2012)

“Tooth erosion caused by GERD” · Dr. A. Dickson · CC BY 2.5 · Wikimedia Commons

Fig. 2Некариозные поражения зубов. Пример зубной эрозии, яркий случай, связанный с гипоэстрогенией, фотография 2011 года, сделана в клинике во время работы над книгой: Г.Е.Соловьёва-Савоярова, "Эстрогены и некариозные поражени

“Dental erosion (hypoestrogenia) no211” · Финитор · CC BY-SA 3.0 · Wikimedia Commons

Verified open-access images only, reproduced for education under their stated licences · no AI-generated or illustrative artwork · Dental Erosion figures pending faculty review.

§ overviewOverview

Irreversible loss of dental hard tissues caused by extrinsic or intrinsic acid exposure without bacterial involvement.

§ icdICD Classification

K03.2

§ etiologyEtiology

  • 01Extrinsic: dietary acids (citrus, carbonated drinks, wine)
  • 02Intrinsic: GERD, bulimia, chronic vomiting

§ riskRisk Factors

  • 01High acidic beverage intake
  • 02Eating disorders
  • 03GERD
  • 04Reduced salivary flow

§ epidemiologyEpidemiology

Increasing prevalence, especially in young adults with high soft drink consumption.

§ pathogenesisPathogenesis

Acid demineralises enamel surface layer; saliva cannot remineralise faster than dissolution.

§ clinicalClinical Features

  • 01Smooth, silky-shiny enamel surface
  • 02Cupping of cusps and incisal edges
  • 03Palatal erosion of upper anteriors (intrinsic)
  • 04Facial erosion (extrinsic)
  • 05Restorations standing proud ('amalgam islands')

§ differentialDifferential Diagnosis

  • 01Attrition
  • 02Abrasion
  • 03Abfraction

§ investigationsInvestigations

  • 01Dietary history
  • 02Medical history (GERD, bulimia)
  • 03BEWE (Basic Erosive Wear Examination)

§ treatmentTreatment

  • 01Identify and reduce acid source
  • 02Dietary counselling
  • 03Fluoride/CPP-ACP remineralisation
  • 04Restore with composite/crowns if severe

§ complicationsComplications

  • 01Sensitivity
  • 02Pulp exposure
  • 03Aesthetic concerns

§ prognosisPrognosis

Good if behaviour modified early; irreversible once lost.

§ preventionPrevention

  • 01Limit acidic beverages
  • 02Use straw
  • 03Rinse with water after acid exposure
  • 04Avoid brushing immediately after acid challenge

§ examKey Examination Points

  • 01Palatal erosion of 16, 26 = GERD/bulimia
  • 02Cupping of cusps
  • 03Restorations standing above tooth surface

§ revisionQuick Revision Summary

  • 01Non-bacterial acid = erosion
  • 02Intrinsic = palatal maxillary anteriors
  • 03BEWE scoring system

§ vivaBDS Viva Questions

  • 01How do you differentiate erosion from attrition?
  • 02What is the BEWE index?
  • 03What dietary advice would you give?

§ mcqsMCQs — Assessment (3)

Question 1

Perimylolysis refers to erosion from:

Question 2

Characteristic distribution of intrinsic erosion:

Question 3

Why avoid brushing immediately after acid exposure?

§ evidenceReferences & Evidence

Current Classification

WHO Classification of Tumours Online — Head and Neck

IARC / WHO · 2022

Continuously updated online edition of the WHO head and neck tumour classification.

View official source

Evidence summary

Highest level of evidence linked to this page: WHO / Official Classification.

  • L1 · Classification — 1
  • L6 · Textbook — 3

1 linked source was published from 2024 onwards. Where guidance is limited or contested, rely on the higher-level sources above rather than this summary. Educational use only — not a substitute for clinical judgement.

Content last reviewed

September 2026

Evidence last reviewed

September 2026

Next scheduled review

September 2027

Review status

EVIDENCE REVIEWED

Search latest PubMed evidence

Last literature search: 7 September 2026

Open PubMed

Current Classification

Reference #1L1 · ClassificationWHO / Classification Verified
WHO Classification of Tumours Online — Head and Neck

IARC / WHO. IARC · 2022

Continuously updated online edition of the WHO head and neck tumour classification.

DOI: Identifier not availablePMID: Identifier not available
View source

Histopathology References

Reference #4L6 · TextbookHistopathology References Unverified
Surgical Pathology of the Head and Neck3rd Edition

Barnes L. CRC Press · 2008

Detailed histopathological reference for head and neck diagnostic criteria.

DOI: Identifier not availablePMID: Identifier not available

Textbook References

Reference #2L6 · TextbookTextbooksRecent Verified
Oral and Maxillofacial Pathology5th Edition

Neville BW, Damm DD, Allen CM et al.. Elsevier · 2024

Standard reference textbook of oral and maxillofacial pathology used throughout this atlas.

DOI: Identifier not availablePMID: Identifier not available
View source
Reference #3L6 · TextbookTextbooks Unverified
Shafer's Textbook of Oral Pathology9th Edition

Rajendran R, Sivapathasundharam B. Elsevier · 2020

Undergraduate and postgraduate oral pathology textbook widely used in BDS and FCPS curricula.

DOI: Identifier not availablePMID: Identifier not available

Additional sources cited on this page

  1. Lussi A. Erosive Tooth Wear, 2e
  2. Neville BW. Oral & Maxillofacial Pathology, 4e

Browse the full evidence library →

Draft — pending faculty review. Educational use only; verify against current guidelines and primary sources before clinical application.