Abstract
Extra esophageal manifestation of Gastro-esophageal reflux disease (GERD) include erosive wear dental lesions. Early erosive wear lesions in this group of patients can be easily missed as they are accompanied by few clinical signs and hardly any symptoms. This case series aims to report the prevalence and severity of erosive wear lesions amongst a sample of GERD patients in Malaysia. Eleven subjects with well characterized GERD, diagnosed based on modified Reflux Disease Questionnaire (RDQ) or via endoscopy, were included in this case series. A standardized intra oral clinical examination was performed to assess presence and severity of erosive wear lesions on tooth surfaces using Basic Erosive Wear Examination (BEWE) index. Majority of BEWE score 1 lesions were distributed in maxillary anterior teeth, followed by maxillary posterior and mandibular teeth. BEWE score 2 lesions were most prevalent in maxillary anterior teeth and there were no BEWE score 3 lesions observed. Based on the clinical findings, more erosive wear lesions were found on the buccal surfaces of maxillary and mandibular teeth in GERD patients. This case series further confirms the link between GERD and erosive wear lesions. The authors would like to highlight the need for both medical and dental practitioners to be aware of early clinical presentations of GERD and erosive wear lesions. Early diagnoses allow for intervention and conservative management of these conditions.
Highlights
Gastro-esophageal reflux disease (GERD) is defined as involuntary muscle relaxing of the lower esophageal sphincter, allowing refluxed gastric acid and its contents to move upward through esophagus into the oral cavity (Mitre and Katzka, 2004)
This study reported that participants with GERD were more likely to have erosive wear lesions
Apart from GERD, this study reported on the prevalence of reflux esophagitis (RE) (13.4%) and non-erosive reflux disease (NERD) (65.5%) (Rosaida and Goh, 2004)
Summary
Gastro-esophageal reflux disease (GERD) is defined as involuntary muscle relaxing of the lower esophageal sphincter, allowing refluxed gastric acid and its contents to move upward through esophagus into the oral cavity (Mitre and Katzka, 2004). Rosaida and Goh examined 1000 patients prospectively and reported that 38.8% of these patients were diagnosed as having GERD based on either predominant symptom of heartburn and acid regurgitation and/or findings of RE. Apart from the study by Li and colleagues in China, there is no reported data on the prevalence and severity of erosive wear lesions amongst GERD patients in the Asian region in general and Malaysia in particular. This case series documents the association of GERD and erosive wear lesions, the prevalence and severity, in a sample of GERD patients in Malaysia. Tooth wear observed on the incisal surfaces of anterior teeth are usually a combination of attrition and erosion with attrition being the predominant contributor
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