3511 GASTROESOPHAGEAL REFLUX AND DENTAL EROSIONS IN CHILDREN.

Abstract

Background: The incidence of dental erosions in children is increasing. This may be related to degeneration of the dental enamel due to excess contact with acid chemicals. This is found in many beverages and some foods but also may result from chronic contact with gastric acid such as in bulimia and gastroesophageal reflux disease (GERD). We performed this study to evaluate the effects of acid reflux on the development of dental erosion in children with progressive dentition. Methods: Prospective enrollment for detailed dental evaluation of children undergoing elective upper GI endoscopy for evaluation of possible GERD was done to evaluate their teeth for the presence, severity and pattern of erosion and to determine their stage of dentition. GERD was diagnosed by endoscopy and histology of two-level esophageal biopsies. Other factors including dietary habits, reported dental hygiene and socioeconomic status of the participating children were determined by a parent questionnaire. Results: 32 patients were recruited. 24 patients had reflux esophagitis on endoscopy and histology. 66.7% of patients with reflux had dental erosions while none of the non-refluxers had erosions. Most of the affected patients (61%) had at least some primary dentition. Unlike bulimic patients, the pattern of erosion showed more involvement of posterior teeth. There were no significant differences in the age distribution, reported dental hygiene, socioeconomic status or dietary habits between children with dental erosions and those without erosions. Conclusions: GERD appears to be associated with significant dental erosions in children. The potential of prevention of permanent dental erosions with early intervention is particularly relevant in the early years of primary dentition. Actively seeking and vigorously treating GERD may be indicated in any child with dental erosions. There may be a need in any child with GERD for periodic dental evaluation and possible intervention to prevent further progression of early erosions.