① 自身防御功能不足：如牙釉质自身发育缺陷（图1）；引起唾液流量减少的临床常见疾病如干燥综合征患者，鼻咽癌患者放疗术后唾液功能降低以及一些抗抑郁药物的应用均可使唾液的流量和流速下降。而一些神经性暴食症患者往往因饮食过度，唾液来不及中和食物中的酸性产物并在牙齿表面形成保护膜，使得牙齿在机械摩擦作用下产生全牙列的磨损。

(1) lack of self defense functions: such as self development defects of enamel (Figure 1); clinical common diseases that cause a decrease in saliva flow, such as Sjogren's syndrome, the decrease of saliva function and the use of some antidepressant drugs in patients with nasopharyngeal carcinoma can decrease the flow and flow of saliva. Some patients with neurogenic binge often have too much food to neutralize the acid products in the food and form protective membranes on the surface of the teeth, making the teeth wear out under mechanical friction.

图1  牙釉质发育不全患者的前牙磨损     

Figure 1. Anterior teeth wear in patients with enamel hypoplasia.

② 不良的饮食习惯： 牙齿暴露在口腔环境内，表面硬组织受到饮食中酸的作用会发生脱矿软化现象（图2），如果酸性饮料或食物长时间与牙齿表面接触（“裹食症”患者）而没有去除，软化的牙釉质受到机械摩擦作用将极易损失。

(2) bad eating habits: teeth exposed to the oral environment, the surface hard tissue is affected by the effect of acid in the diet (Figure 2). If acid drinks or food are exposed to the surface of the tooth for a long time ("wrapping") without removal, the softened enamel will be easily affected by mechanical friction. Loss.

图2  饮用可乐饮料导致前牙酸蚀性磨损并有继发龋

Figure 2. Drinking cola beverages causes eroding wear of the front teeth and secondary caries.

③ 胃食管反流：这也是导致牙齿表面脱矿软化的常见原因，胃酸中的主要成分是pH值较小的盐酸,对牙釉质的侵蚀作用较大。酸蚀发生在牙齿的部位与患者睡眠时的头位姿势密切相关。如头仰着低位睡觉的患者，其上颌牙齿及双尖牙的腭侧易发生酸蚀性磨损；头趴着睡觉的患者，牙齿酸蚀部位常出现上颌前牙的唇侧及下颌前牙的切缘；右侧卧位睡眠者，牙齿发生的酸蚀性磨损部位在右侧上下后牙的咬合面及右上颌后牙的腭侧。

(3) gastroesophageal reflux: This is also a common cause of demineralization of the surface of the teeth. The main component of the gastric acid is a small pH value of hydrochloric acid, which has a greater erosion effect on the tooth enamel. Acid erosion occurs at the location of the tooth and is closely related to the head position of the patient during sleep. In patients with low position, the maxillary teeth and the palatine side of the bicuspid teeth are prone to erosion, and the patients with head lying on the bed often have the cutting edge of the labial and mandibular anterior teeth of the maxillary teeth, and the right side of the sleeping person and the occlusal surface of the teeth in the right upper and lower posterior teeth and the occlusal surface of the right upper and lower teeth. The palatine side of the right maxillary posterior teeth.

④ 药物和膳食的补充剂：一些治疗药物本身呈酸性，在口服或咀嚼其片剂时，如果不及时漱口也可能侵蚀牙齿。长期咀嚼维生素C、酸梅、苹果的人群发生下颌磨牙酸蚀的概率大增。 

Drugs and dietary supplements: some drugs themselves are acidic, and when they are orally chewed or chewed, they may erode teeth if they do not rinse in time. People who chew vitamin C, sour plum and apple for a long time increase the probability of acid etching of mandibular molars. It

⑤ 口腔卫生：平常刷牙对牙齿组织的表面结构是没有损伤的，但是暴露在酸性产物下的松软牙齿组织比较容易被刷牙去除，而这些松软的牙齿组织在较短时内难以自身再矿化。吃山楂、喝红葡萄酒不漱口也会引起牙齿表面产生脱钙现象，因此，在进食酸性食物后，应及时漱口，有条件的情况下可以使用氟化锡保护剂涂布在牙齿的表面。

Oral hygiene: the surface structure of the tooth tissue is not damaged, but the soft teeth exposed to acid products are easily removed by brushing, and these soft teeth are difficult to remineralized in a shorter time. Eating hawthorn and drinking red wine does not gargle also cause decalcification on the surface of the teeth. Therefore, after eating acidic food, we should rinse the mouth in time and apply tin fluoride protective agent to the surface of the tooth under conditions of condition.

⑥ 职业环境：些职业因素也会导致牙齿表面硬组织快速丧失，如红酒的品酒师，长期在含氯游泳池训练的蛙泳运动员，电池厂的工人暴露在酸性气体环境下都会导致牙齿酸蚀症的产生。

Occupational environment: some occupational factors also lead to rapid loss of hard tissue on the surface of the teeth, such as wine taster, breaststroke trained in the chlorine swimming pool for a long time, and the exposure of workers in the battery factory to the acid corrosion in the acid gas environment.