Background: Erosive tooth wear (ETW) and dental caries have common etiological factors, such as unhealthy eating habits, and reduced salivary flow rate. Aim: To analyze the asso-ciation between caries experience (CE) and ETW in adolescents 13–14 years. Study design: Ninety-seven cases with distinctive ETW were identified and then sex-matched with a group of 97 controls and a group of 97 cases with initial ETW. The variables included were CE, presence of debris/dental calculus, salivary parameters, food and beverage consumption, chewable vitamin C tablet consumption, gastroesophageal reflux, frequent vomiting, and tooth brushing. Multinomial logistic regression models were adjusted. Results: An association was found between cases with a distinctive ETW defect and CE (OR = 1.09 (95% CI: 1.01–1.17); p = 0.020), sweet carbonated drinks consumption (OR = 1.16 (95% CI: 1.03–1.31); p = 0.012), and frequent vomiting (OR = 3.19 (95% CI: 1.02–10.01); p = 0.047). Conclusions: The preventive management of both ETW and dental caries should aim to reduce exposure to foods and beverages with high acid and sugar content. Given the association between ETW and acid attack by gastric juice, this would be an indicator of the need for referral to a specialist for treatment.