This patient had a very severe gastro-esophageal reflux disease (GERD), a condition where the stomach acid is coming up to the esophagus. Such acidity also erodes the surface of the dentition chemically, resulting in excessive loss of tooth structure. The problem was compounded by the fact that the patient also grinds and clenches his teeth. More than half of the tooth structure had been worn away. The patient received ten porcelain fused to metal crowns and eight full metal crowns to restore the lost tooth structure. In this case, form, function and aesthetics have been restored.