GERD and Your Teeth

Payson, Scottsdale and Phoenix, Arizona

GERD (an acronym for Gastro Esophageal Reflux Disease) affects three to five percent of people in the United States. GERD is an injury to the lining of the esophagus or symptoms caused by too much stomach acid flowing back into the esophagus. In most cases, it occurs because a muscle between the stomach and esophagus fails to contract when it should, allowing gastric acid to move back into the esophagus. Severe GERD occurs when that muscle is weak.

How Does GERD Affect the Teeth?

In silent GERD, symptoms do not occur and enamel erosion of the posterior dentition may be the first indications of GERD. Often the enamel of the lower molars can appear ditched or scooped out. The molars can look like areas where there has been some grinding, when in fact, it is erosion caused by the acid reflux into the mouth.

• GERD is a chronic condition
• Treatment for GERD can only be done during symptomatic periods

Symptoms of GERD

1. In Adults

The most common symptoms are difficulty with swallowing, heartburn, chest pain and regurgitation. Less common symptoms are nausea, excess saliva and painful swallowing.

In some cases, GERD injures the esophagus and some serious health conditions can result:

• Reflux esophagitis – necrosis (death) of the esophageal lining with ulcers developing where the esophagus joins to the stomach
• Esophageal strictures – progressive esophageal narrowing caused by inflammation in the esophagus
• Barrett’s esophagus – harmful changes in the cells of the esophageal lining near where it connects to the stomach
• Esophageal adenocarcinoma – a rare form of cancer
2. In Children

GERD can occur in babies and young children. Symptoms may or may not show up, but if they do, they include:

• Vomiting or spitting up
• Coughing
• Breathing difficulties
• Inconsolable crying
• Inability to eat
• Inadequate weight gain
• Bad breath
• Belching or burping

In the U.S., about four million babies are born each year and it is estimated that as much as 35 percent may have gastric reflux problems in their first few months. It may be just regarded as “spitting up”. Most children outgrow it within the first year of life.

A significant percentage will not outgrow it and it may even last into adolescence. These young people need good medical care for GERD.

GERD Causes and Risk Factors

• Certain drugs, like nitrates or calcium channel blockers
• Diabetes
• Scleroderma
• Obesity
• Pregnancy
• Tobacco use
• Use of alcohol, caffeine, carbonated beverages, chocolate, fatty foods, and overly large meals
• Tooth loss
• Bone loss
• Dental erosion and decay

Treatment

GERD can be managed effectively with lifestyle modifications and medical treatment.

Lifestyle Modifications

• Elevation of the head of the bed four to six inches
• Little or no alcohol, chocolate or caffeine
• Eating and drinking nothing two to three hours before bed
• Avoidance of greasy, fatty foods
• Weight loss
• Antacids to neutralize excess stomach acid

The dentist plays an important part in the diagnosis of Silent GERD. Dental Erosion of the posterior teeth is common with GERD. It is important to resolve the active medical condition while completing definitive dental treatment.

For related information, please see Halitosis, Periodontal Therapy and Advanced Hygiene and Periodontal Therapy .

To make arrangements for a personal consultation with Dr. Chris or Dr. Patrice, please contact our cosmetic dentistry office today. We serve the areas of Phoenix, Scottsdale and Payson, Arizona.