Gastric Reflux and your teeth

Gastric reflux can have a negative impact on oral health.  While soft tissues can try to heal after an acid burn, hard tissues such as the enamel of your teeth, are dissolved away irreparably through acid erosion.  Patients who have been diagnosed with GERD (gastroesophageal reflux disorder) at least should be aware of the possibility of enamel loss, though prescription and over-the-count medications can help control and even prevent  the damage.  But what about patients who have not been diagnosed with GERD? Does this mean they are not at risk of enamel erosion.  Unfortunatley, some patients have low enough levels of reflux which do not seem to warrant a diagnosis of GERD, and yet show the dental evidence of acid erosion.  The acid causing the erosion can be from internal causes such as builimia or reflux disorders, or external, such as the large consumption of acidic beverages such as soda.  Discounting external sources (not many people drink several cans of soda every day, or suck on lemons regularly) many patients show the dental signs of erosion which can be attributed to low level, and sometimes undiagnosed, reflux problems.

What is important is that unlike the soft tissues of the body which can replenish itself, once enamel is eroded away it is gone for good.  The danger then, is when the erosion becomes so severe; it jeopardizes the health of the tooth.  As the erosion progresses, it encroaches upon the pulp, or “nerve” of the tooth.  If the nerve gets irritated or dies, it will need a root canal, which in turn necessitates a crown (cap) for the tooth.  So what begins as a little notch of erosion can end up killing the tooth and becomes quite costly.  Most frequently, the erosions are seen by the gumline where the enamel is thinnest and most vulnerable to erosion.  These notched surfaces can reasonably treated when small by placing a filling, typically a tooth colored bonded composite restoration, or “bonding” for short. In addition, your doctor may recommend a medication to control and prevent the release of stomach acids.  The use of antacids is of little benefit in prevention, but may be of value when a person is aware of the presence of acid in the mouth.

It is important then, to see your dentist, in addition to your gastroenterologist to make sure all is being done to prevent damage to your teeth.