Etiology
Extrinsic acids — dietary: carbonated soft drinks (pH 2.4-3.5), sports/energy drinks (pH 2.4-4.0), fruit juices and citrus fruits (pH 2-4), white wine and alcohol (pH 2.8-3.8), pickled foods and vinegar.
Intrinsic acids — gastric: gastroesophageal reflux disease (GERD) — acid reflux exposes teeth to gastric acid (pH 1-2); eating disorders (anorexia nervosa with purging, bulimia nervosa) — self-induced vomiting brings gastric acid into the mouth; rumination disorder — habitual regurgitation of food.
Environmental/occupational: industrial exposure to acid fumes (battery manufacturing, wine industry, chemical plants); acid pools in competitive swimmers (improperly maintained pool water).
Behavioral and lifestyle factors: holding acidic beverages in the mouth before swallowing, 'swishing' technique, drinking without straw, mouth breathing (reducing saliva buffering).