Skip to main content

Prevention and Control of Dental Erosion: Gastroesophageal Reflux Disease Management

  • Chapter
Dental Erosion and Its Clinical 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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Bartlett DW, Evans DF, Smith BGN, et al. The relationship gastro-oesophageal reflux disease and dental erosions. J Oral Rehabil. 1996;23:289–97.

    Article  PubMed  Google Scholar 

  2. Mair LH. Wear in the mouth: the tribological dimension. In: Addy M, Edgar WM, Embery G, Orchardson R, editors. Tooth wear and sensitivity. London: Martin Dunitz; 2000. p. 181–8.

    Google Scholar 

  3. Picos A, Chisnoiu A, Dumitrascu DL, et al. Dental erosion in patients with gastroesophageal reflux disease. Adv Clin Exp Med. 2013;22:303–7.

    PubMed  Google Scholar 

  4. Vakil N, van Zanten SV, Kahrilas P, et al. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006;101:1900–43.

    Article  PubMed  Google Scholar 

  5. Pace F, Pallotta S, Tonini M, et al. Systematic review: gastro-oesophageal reflux disease and dental lesions. Aliment Pharmacol Ther. 2008;27:1179–86.

    Article  PubMed  Google Scholar 

  6. Wong BC-Y, Wong WM, Smales R, et al. Gastroesophageal reflux disease and tooth erosion. In: Yip KHK, Smales RJ, Kaidonis JA, editors. Tooth erosion: prevention and treatment. New Delhi: Jaypee Brothers Medical; 2006. p. 47–53.

    Google Scholar 

  7. Pisegna J, Holtmann G, Howden CW, et al. Review article: oesophageal complications and consequences of persistent gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2004;20:47–56.

    Article  PubMed  Google Scholar 

  8. Sandler RS, Everhart JE, Donowitz M, et al. The Burden of selected digestive diseases in the United States. Gastroenterology. 2002;122:1500–11.

    Article  PubMed  Google Scholar 

  9. Saltzman JR. Gastroesophageal reflux disease. In: Greenberger N, Blumberg R, Burakoff R, editors. Current diagnosis & treatment: gastroenterology, hepatology, and endoscopy. 2nd ed. New York: McGraw-Hill; 2012. p. 147–55.

    Google Scholar 

  10. Holbrook WP, Furuholm J, Gudmundsson K, et al. Gastric reflux is a significant causative factor of tooth erosion. J Dent Res. 2009;88:422–6.

    Article  PubMed  Google Scholar 

  11. Ersin NK, Onçağ O, Tümgör G, et al. Oral and dental manifestations of gastroesophageal reflux disease in children: a preliminary study. Pediatr Dent. 2006;28:279–84.

    PubMed  Google Scholar 

  12. Linnett V, Seow WK, Connor F, et al. Oral health of children with gastro-esophageal reflux disease: a controlled study. Aust Dent J. 2002;47:156–62.

    Article  PubMed  Google Scholar 

  13. Dahshan A, Patel H, Delaney J, et al. Gastroesophageal reflux disease and dental erosion in children. J Pediatr. 2002;140:474–8.

    Article  PubMed  Google Scholar 

  14. Farahmand F, Sabbaghian M, Ghodousi S, et al. Gastroesophageal reflux disease and tooth erosion: a cross-sectional observation study. Gut Liver. 2013;7:278–81.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Jones MP, Sloan SS, Rabine JC, et al. Hiatal hernia size is the dominant determinant of esophagitis presence and severity in gastroesophageal reflux disease. Am J Gastroenterol. 2001;96:1711–7.

    Article  PubMed  Google Scholar 

  16. Dodds WJ, Dent J, Hogan WJ. Mechanisms of gastroesophageal reflux in patients with reflux esophagitis. N Engl J Med. 1982;307:1547–52.

    Article  PubMed  Google Scholar 

  17. Horowitz M, Su YG, Rayner CK, et al. Gastroparesis: prevalence, clinical significance and treatment. Can J Gastroenterol. 2001;15:805–13.

    PubMed  Google Scholar 

  18. El-Serag HB, Ergun GA, Pandolfino J, et al. Obesity increases oesophageal acid exposure. Gut. 2007;56:749–55.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Jacobson BC, Somers SC, Fuchs CS, et al. Body-mass index and symptoms of gastroesophageal reflux in women. N Engl J Med. 2006;354:2340–8.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Moayyedi P, Axon AT. Review article: Gastroesophageal reflux disease: the extent of the problem. Aliment Pharmacol Ther. 2005;22:11–9.

    Article  PubMed  Google Scholar 

  21. Helm JF. Role of saliva in esophageal function and disease. Dysphagia. 1989;4:76–84.

    Article  PubMed  Google Scholar 

  22. Bouchoucha M, Callais F, Renard P, et al. Relationship between acid neutralization capacity of saliva and gastro-esophageal reflux. Arch Physiol Biochem. 1997;105:19–26.

    Article  PubMed  Google Scholar 

  23. Groen JN, Smout AJ. Supra-oesophageal manifestations of gastro-oesophageal reflux disease. Eur J Gastroenterol Hepatol. 2003;15:1339–50.

    Article  PubMed  Google Scholar 

  24. Filipi K, Halackova Z, Filipi V, et al. Oral health status, salivary factors and microbial analysis in patients with active gastro-oesophageal reflux disease. Int Dent J. 2011;61:231–7.

    Article  PubMed  Google Scholar 

  25. Gudmundsson K, Kristleifsson G, Theodors A, et al. Tooth erosion, gastroesophageal reflux, and salivary buffer capacity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79:185–9.

    Article  PubMed  Google Scholar 

  26. Lazarchik DA, Filler SJ. Dental erosion: predominant oral lesion in gastroesophageal reflux disease. Am J Gastroenterol. 2000;95:33–8.

    Article  Google Scholar 

  27. Busscher HJ, Goedhart W, Ruben J, et al. Wettability of dental enamel by soft drinks as compared to saliva and enamel demineralization. In: Addy M, Embery G, Edgar WM, Orchardson R, editors. Tooth wear and sensitivity. London: Martin Dunitz; 2000. p. 197–200.

    Google Scholar 

  28. Imfeld T. Prevention of progression of dental erosion by professional and individual prophylactic measures. Eur J Oral Sci. 1996;104:215–20.

    Article  PubMed  Google Scholar 

  29. Jones L, Lekkas D, Hunt D, et al. Studies on dental erosion: an in vivo-in vitro model of endogenous dental erosion—its application to testing protection by fluoride gel application. Aust Dent J. 2002;47:304–8.

    Article  PubMed  Google Scholar 

  30. Rees J, Loyn T, Chadwick B. Pronamel and tooth mousse: an initial assessment of erosion prevention in vitro. J Dent. 2007;35:355–7.

    Article  PubMed  Google Scholar 

  31. Ranjitkar S, Narayana T, Kaidonis JA, et al. The effect of casein phosphopeptide-amorphous calcium phosphate on erosive dentine wear. Aust Dent J. 2009;54:101–7.

    Article  PubMed  Google Scholar 

  32. Ramalingam L, Messer LB, Reynolds EC. Adding casein phosphopeptide-amorphous calcium phosphate to sports drinks to eliminate in vitro erosion. Pediatr Dent. 2005;27:61–7.

    PubMed  Google Scholar 

  33. Ganss C, Klimek J, Brune V, et al. Effects of two fluoridation measures on erosion progression in human enamel and dentine in situ. Caries Res. 2004;38:561–6.

    Article  PubMed  Google Scholar 

  34. Willumsen T, Øgaard B, Hansen BF, et al. Effects from pretreatment of stannous fluoride versus sodium fluoride on enamel exposed to 0.1M or 0.01M hydrochloric acid. Acta Odontol Scand. 2004;62:278–81.

    Article  PubMed  Google Scholar 

  35. Ranjitkar S. Biology of tooth wear: preventive strategies. Ph.D. thesis. Adelaide: The University of Adelaide; 2009.

    Google Scholar 

  36. Ranjitkar S, Kaidonis JA, Smales RJ. Gastroesophageal reflux disease and tooth erosion. Int J Dent. 2012. Article ID 479850, 10 pages.

    Google Scholar 

  37. Rabine JC, Nostrant TT. Oral manifestations of gastrointestinal diseases. In: Yamada T, Alpers DH, Kalloo AN, et al., editors. Atlas of gastroenterology. 4th ed. Oxford: Blackwell Publishing; 2009. p. 839–45.

    Chapter  Google Scholar 

  38. Tasker A, Dettmar PW, Panetti M, et al. Is gastric reflux a cause of otitis media with effusion in children? Laryngoscope. 2002;112:1930–4.

    Article  PubMed  Google Scholar 

  39. Lussi A, Jaeggi T, Scharer S, et al. The influence of different factors on in vitro enamel erosion. Caries Res. 1993;27:387–93.

    Article  PubMed  Google Scholar 

  40. Smith BGN, Knight JK, et al. An index for measuring the wear of teeth. Br Dent J. 1984;156:435–8.

    Article  PubMed  Google Scholar 

  41. Fass R, Ofman JJ, Gralnek IM, et al. Clinical and economic assessment of the omeprazole test in patients with symptoms suggestive of gastroesophageal reflux disease. Arch Intern Med. 1999;159:2161–8.

    Article  PubMed  Google Scholar 

  42. Jones R, Coyne K, Wiklund I. The gastro-oesophageal reflux disease impact scale: a patient management tool for primary care. Aliment Pharmacol Ther. 2007;25:1451–9.

    Article  PubMed  Google Scholar 

  43. Manterola C, Muñoz S, Grande L, et al. Initial validation of a questionnaire for detecting gastroesophageal reflux disease in epidemiological settings. J Clin Epidemiol. 2002;55:1041–5.

    Article  PubMed  Google Scholar 

  44. Rubin G, Uebel P, Brimo-Hayek A, et al. Validation of a brief symptom questionnaire (ReQuest in Practice) for patients with gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2008;27:846–51.

    Article  PubMed  Google Scholar 

  45. Ofman JJ, Shaw M, Sadik K, et al. Identifying patients with gastro-esophageal reflux disease: validation of a practical screening tool. Dig Dis Sci. 2002;47:1863–9.

    Article  PubMed  Google Scholar 

  46. Shaw MJ, Talley NJ, Beebe TJ, et al. Initial validation of a diagnostic questionnaire for gastroesophageal reflux disease. Am J Gastroenterol. 2001;96:52–7.

    Article  PubMed  Google Scholar 

  47. Vakil N, Dent J, Jones R, et al. The accuracy and predictors of a clinical diagnosis of GERD by family practitioners and gastroenterologists. Gastroenterology. 2008;134:A598.

    Google Scholar 

  48. Bai Y, Du Y, Zou D, et al. Gastroesophageal reflux disease questionnaire (GerdQ) in real-work practice. J Gastroenterol Hepatol. 2013;28:626–31.

    Article  PubMed  Google Scholar 

  49. Jonasson C, Moum B, Bang C, et al. Randomised clinical trial: a comparison between a GerdQ-based algorithm and an endoscopy-based approach for the diagnosis and initial treatment of GERD. Aliment Pharmacol Ther. 2012;35:1290–300.

    Article  PubMed  Google Scholar 

  50. Jonasson C, Wernersson B, Hoff DA, et al. Validation of the GerdQ questionnaire for the diagnosis of gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2013;37:564–72.

    Article  PubMed  Google Scholar 

  51. DeVault KR, Castell DO. American College of Gastroenterology. Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. Am J Gastroenterol. 2005;100:190–200.

    Article  PubMed  Google Scholar 

  52. Hirano I, Richter JE. Practice Parameters Committee of the American College of Gastroenterology. ACG practice guidelines: esophageal reflux testing. Am J Gastroenterol. 2007;102:668–85.

    Article  PubMed  Google Scholar 

  53. Lichtenstein DR, Cash BD, et al. Standards of Practice Committee: role of endoscopy in the management of GERD. Gastrointest Endosc. 2007;66:219–24.

    Article  PubMed  Google Scholar 

  54. Pritchett JM, Aslam M, Slaughter JC, et al. Efficacy of esophageal impedance/pH monitoring in patients with refractory gastroesophageal reflux disease, on and off therapy. Clin Gastroenterol Hepatol. 2009;7:743–8.

    Article  PubMed  Google Scholar 

  55. Vaezi MF, Richter JE. Duodenogastroesophageal reflux and methods to monitor nonacidic reflux. Am J Med. 2001;111:160S–8.

    Article  PubMed  Google Scholar 

  56. Kahrilas PJ, Shaheen NJ, Vaezi MF. American Gastroenterological Association Institute, Clinical Practice and Quality Measurement Committee. American Gastroenterological Association Institute technical review on the management of gastroesophageal reflux disease. Gastroenterology. 2008;135:1392–413.

    Article  PubMed  Google Scholar 

  57. Kaltenbach T, Crockett S, Gerson LB. Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach. Arch Intern Med. 2006;166:965–71.

    Article  PubMed  Google Scholar 

  58. Gao X, Lo ECM, Kot SCC, Chan KCM. Motivational interviewing in improving oral health: a systematic review of randomized controlled trials. J Periodontol. 2014;85(3):426–3.

    Article  PubMed  Google Scholar 

  59. Resnicow K, McMaster F. Motivational Interviewing moving from why to how with autonomy support. Int J Behav Nutr Phys Act. 2012;9:19.

    Article  PubMed Central  PubMed  Google Scholar 

  60. Lundahl B, Burke BL. The effectiveness and applicability of motivational interviewing: a practice-friendly review of four meta-analyses. J Clin Psychol. 2009;65:1232–45. In session.

    Article  PubMed  Google Scholar 

  61. Klok RM, Postma MJ, van Hou BA, et al. Meta-analysis: comparing the efficacy of proton pump inhibitors in short-term use. Aliment Pharmacol Ther. 2003;17:1237–45.

    Article  PubMed  Google Scholar 

  62. Yang YX, Metz DC. Safety of proton pump inhibitor exposure. Gastroenterology. 2010;139:1115–27.

    Article  PubMed  Google Scholar 

  63. Inadomi JM, Jamal R, Murata GH, et al. Step-down management of gastroesophageal reflux disease. Gastroenterology. 2001;121:1095–100.

    Article  PubMed  Google Scholar 

  64. Inadomi JM, McIntyre L, Bernard L, et al. Step-down from multiple-to single-dose proton pump inhibitors (PPIs): a prospective study of patients with heartburn or acid regurgitation completely relieved with PPIs. Am J Gastroenterol. 2003;98:1940–4.

    Article  PubMed  Google Scholar 

  65. Wilder-Smith CH, Wilder-Smith P, Kawakami-Wong H, et al. Quantification of dental erosions in patients with GERD using optical coherence tomography before and after double-blind, randomized treatment with esomeprazole or placebo. Am J Gastroenterol. 2009;104:2788–95.

    Article  PubMed Central  PubMed  Google Scholar 

  66. Catarci M, Gentileschi P, Papi C, et al. Evidence-based appraisal of anti-reflux fundoplication. Am J Surg. 2004;239:325–37.

    Google Scholar 

  67. Finlayson SR, Laycock WS, Birkmeyer JD. National trends in utilization and outcomes of anti-reflux surgery. Surg Endosc. 2003;17:864–7.

    Article  PubMed  Google Scholar 

  68. Buzalaf MA, Cardoso CA, Magalhães AC, Amaechi BT. Prevention and control of dental erosion: patient self-care. In: Amaechi BT, editor. Dental erosion and its clinical management. Berlin: Springer; 2015. p. 133–50.

    Google Scholar 

  69. Amaechi BT, Higham SM. Dental erosion: possible approaches to prevention and control. J Dent. 2005;33:243–52.

    Article  PubMed  Google Scholar 

  70. Kaidonis JA. Prevention and control of dental erosion: professional clinic care. In: Amaechi BT, editor. Dental erosion and its clinical management. Berlin: Springer; 2015. p. 151–68.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Akit Patel MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Patel, A., Amaechi, B.T., Brady, C. (2015). Prevention and Control of Dental Erosion: Gastroesophageal Reflux Disease Management. In: Amaechi, B. (eds) Dental Erosion and Its Clinical Management. Springer, Cham. https://doi.org/10.1007/978-3-319-13993-7_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-13993-7_12

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-13992-0

  • Online ISBN: 978-3-319-13993-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics