Understanding erosion and how it interacts with orthodontics is a key aspect of practicing as an orthodontist. Erosion can stem from diet, medicine, GI issues, and even pregnancy. It is crucial to learn the difference between erosion and attrition and understand what causes erosion to properly treat these patients. Without addressing the underlying cause of erosion, you can find yourself facing liability further down the road if you proceed with treatment.

After you have determined the source, you can proceed to treat this patient via recommendations or orthodontics. But which is better for erosion patients – braces or aligners? Let’s discuss it!


With erosion cases, you are dealing with teeth that have unsupported enamel. Whatever the reason, be it a medical condition, drug use, medication side effects, or even bulimia. Erosion causes damage to the teeth that can be furthered with orthodontic intervention. Because of this, braces are absolutely not an option that you want to choose for erosion cases.

You risk fracturing the teeth during treatment when doing braces on an erosion case. And unfortunately, the risk is very high. Especially when taking braces off, you are at risk of seriously harming the teeth. So, the best option for erosion cases is to move forward with aligners. However, you cannot just move forward with aligners as is.

You must consider whether or not the erosion is severe enough to warrant restorative work to give the teeth enough strength to handle orthodontics. These cases will need to be referred back to the general dentist before they can be seen for aligners. Once they are ready for orthodontics, you will need to use many different attachments to use aligners. These teeth will need to move extremely slowly in order to avoid damage to the teeth, such as fractures.