Elsevier

Journal of Dentistry

Volume 32, Issue 6, August 2004, Pages 489-494
Journal of Dentistry

Dental erosion, gastro-oesophageal reflux disease and saliva: how are they related?

https://doi.org/10.1016/j.jdent.2004.03.004Get rights and content

Abstract

Aims. The purpose of this study was to assess the prevalence of tooth wear, symptoms of reflux and salivary parameters in a group of patients referred for investigation of gastro-oesophageal reflux disease (GORD) compared with a group of control subjects.

Materials and methods. Tooth wear, stimulated salivary flow rate and buffering capacity and symptoms of GORD were assessed in patients attending an Oesophageal Laboratory. Patients had manometry and 24-h pH tests, which are the gold standard for the diagnosis of GORD. Tooth wear was assessed using a modification of the Smith and Knight tooth wear index. The results were compared to those obtained from a group of controls with no symptoms of GORD.

Results. Patients with symptoms of GORD and those subsequently diagnosed with GORD had higher total and palatal tooth wear (p<0.05). The buffering capacity of the stimulated saliva from the control subjects was greater than patients with symptoms of GORD (p<0.001). Patients with hoarseness had a lower salivary flow rate compared with those with no hoarseness.

Conclusions. Tooth wear involving dentine was more prevalent in patients complaining of symptoms of GORD and those diagnosed as having GORD following 24-h pH monitoring than controls. Patients had poorer salivary buffering capacity than control subjects. Patients complaining of hoarseness had lower salivary flow rate than controls.

Section snippets

Aim

This study was designed to assess the prevalence and hence the extent of the problem of tooth wear in a group of patients presenting with symptoms of gastro-oesophageal reflux disease (GORD) to an Oesophageal Laboratory in the UK. Following 24-h pH measurement, tooth wear was assessed in patients that had pathological reflux according to the internationally recognised normals1., 2. and compared with a group of matched controls with no symptoms of GORD. Stimulated salivary flow rate and

Method and materials

Patients were recruited from those attending the Oesophageal Laboratory of St Thomas' Hospital who had been referred for investigation of GORD by manometry and 24-h oesophageal pH tests from a variety of medical sources. All patients selected had both procedures carried out. The presence or absence of oesophageal (heartburn, dysphagia, regurgitation, retrosternal chest pain) and/or extra-oesophageal (non-cardiac chest pain, hoarseness, laryngitis, globus and dental erosion) symptoms were

Results

One hundred and four patients with a mean age of 44 (standard deviation (SD)=14.4, 60 males and 44 females) and 31 controls with a mean age 42 (SD=16.2, 13 males and 18 females) were recruited. Saliva was assessed in all control subjects and 41 of the patients with the mean age of 46 (SD=13.2, 20 males and 21 females). The most common oesophageal symptoms were heartburn (72%), regurgitation (44%), dysphagia (36%) and the extra-oesophageal symptoms were asthma (16%), hoarsness (13%) and globus

Discussion

The level and assessment of tooth wear is interpreted differently around the world. Subtle differences in the diagnosis and the assessment mean that the prevalence data may not be entirely comparable across different countries.14 This difference would have clinical significance, especially if some countries diagnose cervical wear as erosion and others diagnose the same lesion as abrasion or abfraction. Therefore, comparing data from reflux patients with or without tooth wear may present

References (19)

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