Tooth structure loss is a normal part of the aging process, with generalized predictable patterns. However, when a dentist is faced with an atypical pattern of extensive structural damage, identifying the etiology responsible for the catastrophic collapse of a patient's anterior incisal guidance can be a diagnostic challenge. Clinicians who are presented with plausible medical histories juxtaposed with socially and culturally accepted eating behaviors may clarify an otherwise nebulous clinical presentation. This article presents an unusual case report involving both synergistic and synchronous habitual and culturally adopted eating practices and pica, which resulted in severe tooth abrasion, abfraction, and erosion.