Prevention and Control of Dental Erosion: Gastroesophageal Reflux Disease Management

Abstract

Approximately 10–20 % of the general population suffers from gastroesophageal reflux disease or GERD. GERD can manifest as esophageal and extraesophageal symptoms. GERD may damage the dental tissues, causing disorders such as dental erosion. According to studies, 24 % of patients with GERD have dental erosion, and 32 % of adults and 17 % of children with dental erosion have GERD. However, not all affected persons will have classic symptoms of GERD. Dentists may be the first persons to diagnose GERD in these “silent refluxers,” particularly when observing unexplained tooth erosion. The cause of GERD is multifactorial, but the basic cause is incompetent antireflux barriers at the gastroesophageal junction. However, other causes have also been attributed to GERD which include decreased saliva production, diet, eating habits, medications, and obesity. Typical manifestations of GERD are heartburn, regurgitation, and dysphagia. Other symptoms have also been associated with GERD, and if any “alarm symptoms” are present, then further evaluation is required. The location of the erosive tooth wear in the dentition is specific to each etiologic factor. Refluxed acid first damages the palatal surface of the upper incisors then the other surfaces of the maxillary teeth. In chronic GERD, the labial or buccal surfaces are affected then the occlusal surfaces of maxillary and mandibular teeth. The diagnosis of GERD can be made clinically, physiologically, anatomically, or functionally depending on the testing modality. The mainstay management strategy for GERD includes lifestyle modifications, dentist’s teeth protection care, and medical therapy such as antacids, histamine-2 receptor blockers, and proton pump inhibitors.