Tu1776 The Risk of Dental Erosion in GERD Patients As Measured by the Basic Erosive Wear Examination

Abstract

Background and aims: While symptoms and complications from gastroesophageal reflux disease (GERD) such as heartburn, esophageal stricture, bleeding, and Barrett's esophagus are commonly known, dental complications of GERD may go unrecognized. The prevalence of dental erosion in subjects with GERD is poorly described. The aim of this study was to determine the risk of dental erosion in a population diagnosed with GERD. The association between dental erosion and salivary flow, salivary buffering capacity and dietary acidic challenges was also assessed. Methods: Subjects were recruited from The University of North Carolina's Center for Esophageal Disease and Swallowing with a physician diagnosis of GERD, and typical symptoms of heartburn and regurgitation. Subjects received a basic dental exam using the Basic Erosive Wear Exam (BEWE, table); the general population has about a 10% prevalence of erosive wear. Subjects provided a stimulated salivary sample which was used to determine their stimulated salivary flow rate and salivary buffering capacity. A diet diary was given to the subjects to complete for 4 days which was used to calculate daily average acidic challenges. Xerostomia was defined as a flow rate less than 0.1mL/minute. Salivary flow was considered low risk if flow rate was between 0.7-0.1 mL/ minute. Salivary buffering was considered high risk if pH was below 4.0. while the risk was considered moderate if pH was between 4.0-4.9. Simple percentages are reported. Results: To date, 22 GERD subjects (13 female, 9 male) have been enrolled. Of these, 41% have moderate erosive wear (BEWE cumulative score 9-13), 50% have low erosive wear (BEWE score 3-8), and 9% show no erosive wear (BEWE score 0-2) Stimulated salivary flow rate was normal for 77% of the subjects, low for 18.5% and 4.5% of the subjects had xerostomia. Salivary buffering capacity was normal for 46% of the subjects while, 36% were at high risk and 18% of the subjects were at moderate risk. Dietary acidic challenges were low for 50% of the subjects, moderate for 35.7% and high for 14.3%. Conclusion: A high proportion of subjects with GERD show erosive wear of their teeth. Inadequate salivary flow or buffering capacity may in part explain this defect. BEWE Criteria for Grading Erosive Wear