Comparison of the Laryngopharyngeal/Esophageal Symptoms Between High and Low Endoscopic Laryngeal Findings in Japanese Patients With Laryngopharyngeal Reflux Symptoms

Abstract

Dental erosions are loss of tooth enamel caused by prolonged and/or repeated acid exposure, occurring in 2 to 5% of the general population. Acid in the mouth may occur from ingestions of soft drinks or fruit juices. Acid in the mouth may also occur from gastroesophageal reflux disease (GERD), although this relationship is not well established in children. The aims of this study were to assess correlations between dental erosions and GERD in pediatric subjects, and correlate the stage and number of teeth involved with dental erosions to the presence of GERD. We did a retrospective chart review from July 2009 to June 2010, which included 14 subjects (12 male), 5 to 12 yr old (mean 9 yr), referred by pediatric dentists for GERD evaluation because of dental erosions. A GERD diagnosis was confirmed by positive results of esophagoscopy, esophageal biopsies, impedance and/or pHmetry. We assessed symptoms associated with GERD, including recurrent or chronic heartburn, chest pain, coughing, nausea, abdominal pain, spitting up, vomiting, anorexia, and sour taste in the mouth. Of the 14 subjects 3 had GERD (21%), diagnosed based on abnormal pHmetry in 2 (1 with abnormal impedance) and on abnormal histology in 1. Two of 14 subjects met symptombased (Rome) criteria for rumination syndrome. Nine of 13 subjects had symptoms. Of the symptomatic subjects, 1 had GERD. Of 4 asymptomatic subjects, 2 had GERD. Symptoms were not associated with the presence or absence of GERD. We had staging data for 12 subjects: 1 with stage 1, 3 with stage 2, 7 with stage 3, and 1 with stage 4 dental erosions. There was no correlation between the stage of dental erosions or number of affected teeth and GERD. Conclusion: GERD may not be the major cause for dental erosions in children. Because rumination syndrome is thought to be uncommon, it appeared that the risk of dental erosions may be increased by co-morbid rumination syndrome.