As modern societies increase their acidic food and beverage consumption, erosive tooth surface loss is an increasing cause of tooth destruction among young people. The primary causes can be exacerbated by hyposalivation, which can be induced by dehydration, several systemic diseases, or any of a number of drugs. Initial preventive treatments are directed at eliminating extrinsic acids, reducing the sensation of xerostomia and other cofactors, and increasing the teeth-resistance to acid. Initial restorative treatments should be conservative, using adhesive materials. Treatment of advanced tooth tissue loss is difficult, and preventive management is emphasized.