Acid Reflux, Your Teeth and Your Dentist

Posted on: October 2, 2015

DentistAs a dentist, we are always observing our patients for unexplained tooth erosion, which can lead to myriad conditions. With an increase in the number of patients who come in with mild to chronic gastroesophageal reflux disease (GERD), it is important to understand the role that acid reflux, as it is commonly known, plays on the erosion of teeth and how untreated GERD can be extremely detrimental to your teeth, as well as to your overall health and quality of life. It is important to examine two critical elements. First, what GERD is, and second, the critical role that saliva plays in keeping your tooth enamel healthy from the perspective of how GERD affects your teeth.

GERD, or gastroesophageal reflux disease, is a physiological condition where acids that are supposed to remain in the stomach for the purposes of digestion flow into the esophagus in a process known as reflux. Typically, this condition is postprandial, meaning that they occur after meals, causing esophageal pH levels to drop below 4.0 for at least 30 seconds. A dentist or a doctor will tell you that the esophageal peristalsis and saliva are typically able to clear the acid reflux within one to two minutes in healthy people. In patients who have GERD, the condition can last significantly longer, which risks damage to the tooth enamel by the food bolus. In many cases, the patients with GERD will have an esophageal pH level of 4.0 for up to 60 minutes, with approximately 10 minutes where the esophageal pH levels are around 1.0. For the person experiencing GERD, they will experience extreme heartburn and acid regurgitation both nocturnally and while they are awake. While the body has several defensive mechanisms to prevent the stomach acid from making its way into the esophagus, patients with GERD have been found to have weakened lower esophageal sphincter (LES) muscles, which are responsible for allowing food into the digestive tract while simultaneously preventing acid from flowing into the esophagus.  The vast majority of patients who have GERD find that it is caused by transient relaxation of the LES, which is caused by factors including alcohol, nicotine, caffeine, many medications, obesity, pregnancy, eating excessively heavy meals, and intestinal obstructions, to name a few.

Describing the importance of saliva from a dentist perspective would take an entire paper, but suffice to say, saliva plays a critical role in the reconstruction of teeth by providing the raw material teeth need to repair themselves through a process known as remineralization. In addition, a dentist knows that saliva has anti-bacterial and anti-fungal qualities that help create a balanced relationship between the enamel and the oral biofilm. An adverse relationship can lead to oral diseases. While saliva is an excellent protector of the teeth under normal circumstances, it has little protective ability in severe erosive conditions, which is what occurs when a patient has acid reflux or GERD. The present of such corrosive elements causes the rapid demineralization of the teeth, which saliva cannot stop. In recent studies, it has been found by dentists that there is a median prevalence of 24 percent for tooth erosion in patients with GERD and a 32.5 percent prevalence for GERD in adult patients who have tooth erosion. This literally makes your dentist one of the first health care providers who can identify and diagnose you with acid reflux or GERD.


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