How does the acid reflux affect your teeth?
According to the article, Extra-esophageal manifestations of gastroesophageal reflux, published in the June 2007 issue of Oral Diseases, 35-40% of adults in the western world are affected by gastroesophageal reflux disease (GERD), and 10% of ear, nose, and throat doctor visits are GERD-related complaints. Symptoms such as sore throat, hoarseness, or coughing may be signs of GERD, but GERD does not only affect the throat. Patients affected by GERD are also at risk for dental erosions.
In the study, a large disparity was noticed between the general population and people with GERD. It was found that while 5-16% of the general population has dental erosions, 40% of the population diagnosed with GERD has dental erosions.
The December 2011 issue of the Journal of Gastroenterology and Hepatology released an article called Oral manifestations of gastroesophageal reflux disease. In this study, it was found that while 96% of doctors agree there is an association between GERD and dental erosion, only 42% of doctors strongly agree. The study points out that the distinction probably comes from the fact that physicians may not have extensive oral health training. The dental erosions may be caused by factors such as decrease in saliva production (sometimes secondary to the medications that the patients take) or increase in acid wear amongst other factors.
Dental erosions are multi-factorial, and unless a dentist is consulted early, they may result in severe deterioration of enamel, as seen in these images. In the aforementioned study published in Oral Diseases, previously unfound dental erosions were found in 40% of patients with reflux symptoms and esophageal acid exposure.
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Additional Information:
Extra-esophageal manifestations of gastroesophageal reflux
Published in Oral Diseases | http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2011.06945.x/full
Abstract
Gastroesophageal reflux disease (GERD) is a common medical condition affecting approximately 35 40% of the adult population in the western world. The role of GERD in causing extra-esophageal symptoms including laryngitis, asthma, cough, chest pain, and dental erosions is increasingly recognized with renewed interest among gastroenterologists and other specialists. Direct injury by mucosal contact, and vagally mediated reflex from distal esophageal acid exposure are the two possible mechanisms by which reflux-related extra-esophageal tissue injuries may occur. Several investigational techniques may be used to diagnose gastroesophageal reflux; however, because of the poor sensitivity of endoscopy and pH monitoring, and the poor specificity of laryngoscopy, empiric therapy with proton-pump inhibitors (PPI) is now considered the initial diagnostic step in patients suspected of having GERD-related symptoms. In those who improve with such therapy, it is likely that GERD may be the cause of the extra-esophageal presentation. In those who are unresponsive to such therapy, other diagnostic testing such as impedance/pH monitoring may be reasonable in order to exclude continued acid or weakly acid reflux. However, PPI-unresponsive patients usually have causes other than GERD for the extra-esophageal symptoms and signs.
Citation
Farrokhi, F. and Vaezi, M. (2007), Extra-esophageal manifestations of gastroesophageal reflux. Oral Diseases, 13: 349 359. doi: 10.1111/j.1601-0825.2007.01380.x
Oral manifestations of gastroesophageal reflux disease
Published in Journal of Gastroenterology and Hepatology
| http://onlinelibrary.wiley.com/doi/10.1111/j.1601-0825.2007.01380.x/full
Abstract
Numerous case-control and other studies involving confirmation of gastroesophageal reflux disease (GERD) by esophageal pH-metry and the assessment of dental erosions have shown significant associations between the two conditions in both adults and children. By contrast, when asked to vote on whether GERD may cause dental erosions, only 42% of physicians strongly agreed that such an association existed in adults, and just 12.5% strongly agreed for children, respectively in two global consensus reports. Part of this divergence between the perceptions of physicians and the findings of research publications may reflect a general lack of oral health education during medical training, and cursory oral examinations being made under less-than-ideal conditions. Adequate salivary secretions are essential for the protection of the teeth and the oropharyngeal and esophageal mucosa. The quantity and quality of the saliva require monitoring as many drugs, including several of the proton pump inhibitors (PPIs), can cause hyposalivation. In addition, PPIs do not always result in adequate acid suppression. Therefore, collaboration between physicians and dentists is strongly advocated to prevent or ameliorate possible adverse oral effects from both endogenous and exogenous acids, and to promote adequate saliva production in patients with GERD.
Citation
Ranjitkar, S., Smales, R. J. and Kaidonis, J. A. (2012), Oral manifestations of gastroesophageal reflux disease. Journal of Gastroenterology and Hepatology, 27: 21 27. doi: 10.1111/j.1440-1746.2011.06945.x
Images
Source: smiledentalgroup.com
Source: annals.org
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