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Sources of dental damage
Chemically-derived erosion can be divided into extrinsic and intrinsic factors. The main sources of extrinsic acids are dietary.
The most common intrinsic compound is gastric acid. Gastric reflux or gastro-esophageal reflux disorder (GERD) are likely reasons for gastric acid entering the mouth, but dental erosion can also be a manifestation of eating disorders such as anorexia or bulimia nervosa.30 Dry mouth or altered pH as a result of medication or disease may also impact on tooth surface quality.
TSL can also be due to physical damage such as chipping the tooth, or long-term wearing down of the surfaces, for example toothbrushing technique31 or bruxism.32
As caries result from microbial fermentation of sugars in foods, they are not considered within the subject of TSL, although certain dietary advice will be beneficial in both cases.