Gastroesophageal reflux disease (GERD) is a frequently occurring digestive disorder resulting in acid reflux into the oral cavity. Apart from its esophageal symptoms, it also manifests in the mouth, with erosive tooth wear (ETW) being the most encountered oral affliction. ETW is a cumulative and irreversible condition; if it remains unrecognized, it progressively worsens over time, significantly impacting the quality of life and imposing a substantial economic burden, especially when associated with untreated GERD. Early identification and timely intervention are essential to preventing disease progression and minimizing long-term consequences. An interdisciplinary approach that integrates medical and dental care offers the most effective management strategy. Preventive measures, including lifestyle and dietary modifications, patient education on appropriate oral hygiene, and the application of fluoride, play an important role in mitigating ETW risk. This paper explores the pathophysiological link between ETW and untreated GERD, focusing on its etiology, clinical presentation, and diagnostic considerations. It also examines the economic burden of untreated ETW and discusses the potential of emerging technologies, like artificial intelligence, digital and teledentistry in improving early detection and tailored treatment. Additionally, the review outlines effective management strategies aimed at improving clinical outcomes and ensuring comprehensive patient care.