Erosion tooth wear is a multifactorial condition, in which the interplay of chemical, biological and behavioural factors explain its prevalence and severity. Chemical erosive tooth wear can be caused by extrinsic factors (acidic diet) or by intrinsic factors (acidic content of the stomach). Mechanical tooth wear can also be extrinsic or intrinsic. Extrinsic factors include the chewing of abrasive food components and the use of highly abrasive dental care products, which causes abrasion. Intrinsic factors include tooth grinding, which causes attrition. The erosive potential of acidic drinks or foods depends on chemical factors, such as pH, titratable acidity and mineral content. Biological factors such as saliva flow and tooth position are also related to the pathogenesis of erosive tooth wear. Furthermore, behavioural factors such as eating and drinking habits and excessive oral hygiene were also found to cause erosive tooth wear. Diagnosis of erosive tooth wear should take into consideration its multifactorial origin.