Investigation of the effect of gastroesophageal reflux disease on dental erosion and oral tissue alterations

Year 2022, , 108 - 115, 15.01.2022

Fatma Aytaç Bal , Engin Ersöz

https://doi.org/10.16899/jcm.943150

Abstract

Aim: This study aimed to investigate the relationship between gastroesophageal reflux disease (GERD) and dental erosion and the alterations in oral tissues. Materials and Methods: In this study, the GERD group consisted of 50 individuals with gastroesophageal reflux symptoms, and the control group consisted of 50 healthy individuals. The prevalence of teeth wears and caries was evaluated using the Smith and Knight tooth wear index (TWI) and the decayed, missing, and filled teeth index (DMFT), respectively. Oral complaints were also evaluated. Stimulated saliva samples were collected, and the salivary buffering capacity, pH and flow rate values were measured. Results: In the GERD group, wear was observed in the palatal surface of the maxillary teeth, whereas no wear was observed in the control group (p<0.05). Although the incisal surfaces of the maxillary anterior teeth and the occlusal surfaces of the maxillary/mandibular posterior teeth were observed as eroded in both groups, the values in the patient group were significantly higher compared with those of controls (p<0.05). In the GERD group, complaints of inflammatory mouth sensitivity, tongue sensitivity, nonspecific itching and burning, halitosis, dry mouth, tooth sensitivity, erythema in the soft/hard palatinal mucosa/uvula were significantly more frequent than the control group (p<0.05, for each). The groups were similar with respect to DMFT (p=0.480). The salivary flow rate, pH and buffering capacity values were found to be significantly lower in the GERD group (p<0.05, for each). Conclusion: The results showed that patients with GERD had wear in palatal surfaces of maxillary teeth. Moreover, these patients also complained more commonly from oral tissue alterations and had lower salivary flow rate, pH, and buffering capacity. Hence dentists should consider GERD as a potential risk factor for oral health.

Keywords

Dental erosion, gastroesophageal reflux disease, saliva

Gastroözofageal reflü hastalığının dental erozyona ve ağız dokularındaki değişikliklere etkisinin araştırılması

Abstract

Amaç: Bu çalışmanın amacı, gastroözofageal reflü hastalığı (GÖRH) ile dental erozyon ve ağız dokularındaki değişiklikler arasındaki ilişkinin araştırılmasıdır. Gereç ve Yöntem: Çalışmada GÖRH grubu gastroözofageal reflü semptomları olan 50 kişiden, kontrol grubu ise 50 sağlıklı bireyden oluşturuldu. Diş aşınması ve çürük prevalansı sırasıyla Smith ve Knight diş aşınma indeksi (TWI) ve çürük, eksik ve dolgulu dişler indeksi (DMFT) kullanılarak değerlendirildi. Ayrıca ağız içerisindeki şikayetler de değerlendirildi. Uyarılmış tükürük örnekleri toplandı ve tükürük tamponlama kapasitesi, pH ve akış hızı değerleri ölçüldü. Bulgular: GÖRH grubunda üst dişlerin palatinal yüzeyinde aşınma görülürken, kontrol grubunda aşınma gözlenmedi (p<0,05). Her iki grupta da üst ön dişlerin insizal yüzeyleri ve üst/alt arka dişlerin oklüzal yüzeylerinin aşınmış olduğu görülmesine rağmen, hasta grubundaki değerler kontrollere göre anlamlı olarak yüksek bulundu (p<0,05). GÖRH grubunda yangılı ağız duyarlılığı, dil hassasiyeti, nonspesifik kaşıntı ve yanma, ağız kokusu, ağız kuruluğu, dişlerde hassasiyet, yumuşak/sert palatinal mukoza/uvulada eritema şikayetlerine kontrol grubundan anlamlı olarak daha sık rastlandı (her biri için p<0,05). Gruplar DMFT'ye göre benzer bulundu (p=0,480). GÖRH grubunda tükrük akış hızı, pH ve tamponlama kapasitesi değerleri anlamlı olarak düşük bulundu (her biri için p<0,05). Sonuç: Çalışmanın sonuçları GÖRH grubundaki katılımcıların üst dişlerinin palatinal yüzeylerinde aşınma olduğunu gösterdi. Ayrıca bu hastaların daha yaygın olarak ağız içi doku değişikliklerinden şikayet ettiklerine ve daha düşük tükürük akış hızı, pH ve tamponlama kapasitesine sahip oldukları da tespit edildi. Bu nedenle diş hekimleri GÖRH'nı ağız sağlığı için potansiyel bir risk faktörü olarak düşünmelidir.

Keywords

Dental erozyon, gastroözofageal reflü hastalığı, tükürük

References

• 1. Gregory-Head B, Curtis DA. Erosion caused by gastroesophageal reflux: diagnostic considerations. J Prosthodont 1997;6(4):278-85.
• 2. Meurman JH, ten Cate JM. Pathogenesis and modifying factors of dental erosion. Eur J Oral Sci 1996;104(2):199-206.
• 3. Zero DT. Etiology of dental erosion: extrinsic factors. Eur J Oral Sci 1996;104(2):162-77.
• 4. Scheutzel P. Etiology of dental erosion-intrinsic factors. Eur J Oral Sci 1996;104(2):178-90.
• 5. Van Roekel NB. Gastroesophageal reflux disease, tooth erosion, and prosthodontic rehabilitation: a clinical report. J Prosthodont 2003;12(4):255-9.
• 6. Mousa H, Hassan M. Gastroesophageal reflux disease. Pediatr Clin North Am 2017;64(3):487-505.
• 7. Bartlett DW, Evans DF, Anggiansah A, Smith BG. The role of the esophagus in dental erosion. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;89(3):312-5.
• 8. Bartlett DW, Coward PY. Comparison of the erosive potential of gastric juice and a carbonated drink in vitro. J Oral Rehabil 2001;28(11):1045-7.
• 9. Wang GR, Zhang H, Wang ZG, Jiang GS, Guo CH. Relationship between dental erosion and respiratory symptoms in patients with gastro-oesophageal reflux disease. J Dent 2010;38(11):892-8.
• 10. Lundell LR, Dent J, Bennett JR, Blum AL, Armstrong D, Galmiche JP, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut 1999;45(2):172-80.
• 11. Smith BG, Knight JK. An index for measuring the wear of teeth. Br Dent J 1984;156(12):435-8.
• 12. Gudmundsson K, Kristleifsson G, Theodors A, Holbrook WP. Tooth erosion, gastroesophageal reflux, and salivary buffer capacity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995;79(2):185-9.
• 13. Moazzez R, Bartlett D, Anggiansah A. Dental erosion, gastro-oesophageal reflux disease and saliva: how are they related? J Dent 2004;32(6):489-94.
• 14. Holbrook WP, Furuholm J, Gudmundsson K, Theodórs A, Meurman JH. Gastric reflux is a significant causative factor of tooth erosion. J Dent Res 2009;88(5):422-6.
• 15. Bartlett DW, Evans DF, Smith BG. The relationship between gastroesophageal reflux disease and dental erosion. J Oral Rehabil 1996;23(5):289-97.
• 16. Richter JE. Extraesophageal presantations of gastroesophageal reflux disease. Semin Gastrointest Dis 1997;8(2):75-89.
• 17. Millward A, Shaw L, Smith A. Dental erosion in four year old children from differing socio-economic backgrounds. ASDC J Dent Child 1994;61(4):263-6.
• 18. Milosevic A, Young PJ, Lennon MA. The prevalence of tooth wear in 14-year-old school children in Liverpool. Community Dent Health 1994;11(2):83-6.
• 19. Meurman JH, Toskala J, Nuutinen P, Klemetti E. Oral and dental manifestations in gastroesophageal reflux disease. Oral Surg Oral Med Oral Pathol 1994;78(5):583-9.
• 20. Schroeder PL, Filler SJ, Ramirez B, Lazarchik DA, Vaezi MF, Richter JE. Dental erosion and acid reflux disease. Ann Intern Med 1995;122(11):809-15.
• 21. Muñoz JV, Herreros B, Sanchiz V, Amoros C, Hernandez V, Pascual I, et al. Dental and periodontal lesions in patients with gastro-oesophageal reflux disease. Dig Liver Dis 2003;35(7):461-7.
• 22. Benages A, Muñoz JV, Sanchiz V, Mora F, Mínguez M. Dental erosion as extraoesophageal manifestation of gastro-oesophageal reflux. Gut 2006;55(7):1050-1.
• 23. Bartlett DW, Evans DF, Anggiansah A, Smith BG. A study of the association between gastro-oesophageal reflux and palatal dental erosion. Br Dent J 1996;181(4):125-31.
• 24. Tugut F, Ozdemir Dogan D, Polat T, Yılmaz K, Ozdemir AK. Prevalence of dental erosion in patients with gastroesophageal reflux disease. CDJ 2009;12(1):29-32.
• 25. Grobler SR, Senekal PJ, Laubscher JA. In vitro demineralization of enamel by orange juice, apple juice, pepsi cola and diet pepsi cola. Clin Prev Dent 1990;12(5):5-9.
• 26. Larsen MJ, Nyvad B. Enamel erosion by some soft drinks and orange juices relative to their pH, buffering effect and contents of calcium phosphate. Caries Res 1999;33(1):81-7.
• 27. Milosevic A, Bardsley PF, Taylor S. Epidemiological studies of tooth wear and dental erosion in 14-year old children in North West England. Part 2: The association of diet and habits. Br Dent J 2004;197(8):479-83.
• 28. Jensdottir T, Holbrook P, Nauntofte B, Buchwald C, Bardow A. Immediate erosive potential of cola drinks and orange juices. J Dent Res 2006;85(3):226-30.
• 29. Järvinen VK, Rytömaa II, Heinonen OP. Risk factors in dental erosion. J Dent Res 1991;70(6):942-7.
• 30. Lazarchik DA, Filler SJ. Effects of gastroesophageal reflux on the oral cavity. Am J Med 1997;103(5):107-3.
• 31. Farrokhi F, Vaezi MF. Extra esophageal manifestations of gastroesophageal reflux. Oral Dis 2007;13(4):349-59.
• 32. Järvinen V, Meurman JH, Hyvärinen H, Rytömaa I, Murtomaa H. Dental erosion and upper gastrointestinal disorders. Oral Surg Oral Med Oral Pathol 1988;65(3):298-303.
• 33. DeVault KR. Should upper gastrointestinal endoscopy be part of the evaluation for supraesophageal symptoms of GERD? Am J Gastroenterol 2004;99(8):1427-9.
• 34. Di Fede O, Di Liberto C, Occhipinti G, Vigneri S, Lo Russo L, Fedele S, et al. Oral manifestations in patients with gastro oesophageal reflux disease: a single-center case–control study. J Oral Pathol Med 2008;37(6):336-40.