Have you ever felt heartburn or a painful burning sensation radiating from inside your chest area? If these symptoms persist and occur several times a week, it might be a sign of gastroesophageal reflux disease or GERD. GERD symptoms can be dangerous and lead to long-term dental problems.
GERD can lead to loss of enamel permanently and can increase your risk of tooth decay. Your enamel is a hard protective layer on the outside of your teeth. GERD symptoms can cause other long-term damage, such as irritation and inflammation of your esophagus.
Hence you should get a regular oral exam done at the dental clinic to avoid such severe dental problems. During the examination, your dentist might find early symptoms of potentially serious issues before it progresses.
You would be surprised to know that more than 90% of systemic diseases have some form of oral symptoms. These symptoms can be detected during an oral exam by your dentist.
What is Gastroesophageal Reflux Disease or GERD Symptoms?
Signs of gastroesophageal reflux disease, or GERD, are common and are seen in many. Although it is a digestive condition, GERD can actually cause damage to your teeth and gums. As powerful stomach acids flow upwards from your digestive tract into your mouth. It can also lead to other health problems.
You might indeed have experienced occasional acid reflux or heartburn after eating too much or after eating certain foods. If this painful, burning sensation caused by stomach acid occurs at least twice a week, it generally indicates symptoms of GERD.
This medical condition is common and is seen to affect one in every five adults. For many people, GERD symptoms make life miserable. But for others who have more subtle symptoms or no symptoms at all – chronic acid reflux might go undiagnosed.
Untreated GERD can damage the lining of the esophagus. This would also cause ulcers and pre-cancerous cells to develop, a condition known as Barrett’s Esophagus.
GERD can have potentially severe consequences on your oral health. If you have repeated acid reflux problems, it can eat away your teeth and damage the gums over a period. That is why dentists generally identify signs of this condition during a routine oral exam.
GERD Symptoms Leads to Dental Erosion
Gastroesophageal reflux disease or GERD occurs when the upper section of your digestive tract does not function properly. The GERD condition causes the content in your stomach contents to flow back into the esophagus regularly.
You might have noticed that your stomach content travels all the way up into your mouth. This disorder affects about 13 to 30% of the population. The most common symptom of GERD is a heart-burning feeling in the chest. However, tooth erosion becomes apparent in some people who experience GERD symptoms – especially during a routine dental check-up.
Dental erosion is also prominent in people who have a high intake of acidic food or repeatedly vomit due to various GI problems or eating disorders. Dental erosion is not tooth decay and dental caries (cavities) caused by the breaking down of sugar by bacteria into acidic components. It is a more chronic condition.
Dental erosion usually originates at the tooth enamel. The enamel is the durable, protective coating on your teeth. It is the most rigid substance found in your body. But it is vulnerable to an overly acidic environment. In this environment, your enamel slowly begins to soften and demineralize. This results in tooth wearing.
Once your teeth are worn out, it exposes the most sensitive parts of your tooth. The saliva generated by your mouth helps to put minerals back into the enamel after you consume acidic food.
But if your mouth constantly maintains a higher acidity level, as is the case with regular reflux, the saliva will not be able to regulate the pH in your mouth.
As your enamel erodes, the teeth become discolored. With time they might also become sensitive to hot, cold, and sweet foods and beverages.
Your Dentist Notice GERD Symptoms Before You
Yes, it is true. Your stomach acid will slowly eat away the enamel of your teeth. A pattern of enamel loss can be noticed at the back teeth – can indicate to your dentist that you have GERD. If you have GERD symptoms, your dentist will notice unusual signs of dental erosion.
Clinical evidence suggests that dietary and lifestyle modifications may not be sufficient to bring GERD symptoms under control. So your dentist might prescribe some medication to reduce the stomach acidity. Fortunately, some medications can help keep your dental erosion under control if used appropriately.
It might seem odd to you that acid reflux can do enough damage to your teeth to cause dental erosion. Even if you do not even feel the heartburn. However, research shows that there is a strong correlation between GERD and dental erosion.
A recent study was done to compare dental erosion in children between 3 to 12 years. They found that 98% of the children having GERD symptoms had dental erosion. Another study from Norway inferred that young adults who were affected with GERD – were seen to have more symptoms of dental erosion than those without the disease. Hence it was confirmed that GERD had been a key cause of dental decay for decades.
How Acid Affects Your Teeth Enamel
The muscles situated at the bottom of your esophagus are called the lower esophageal sphincter. The muscle acts as a one-way valve to keep your stomach contents from moving backward and reaching the digestive tract.
But when this muscle becomes damaged or weak, your stomach acids can flow upwards into the esophagus and even enter your mouth. You will have a burning sensation in your chest.
In fact, one of the prominent signs of GERD is tooth erosion. Your tooth’s protective outer coating breakdown is caused by acid wash. A normal, healthy oral pH measures around 7.0, the pH scale, which is the same as that of pure water.
If your mouth has an acidic pH of 5.5 or lower, your tooth enamel will slowly start to dissolve. If your stomach acid has a pH of 2.0 or less, is strong enough to break down your food items, and is also capable of causing serious dental damage.
Unfortunately, GERD symptoms can affect your oral health, which you might not be able to notice. Erosion from GERD is mostly visible on the inner surfaces of your upper teeth. These upper teeth might become sharp, chipped, thin, pitted, yellow and sensitive, which would require expensive dental work.
A lower salivary pH can harm and damage the soft tissues of your mouth. It is also linked to periodontal disease. A 2014 study also confirmed a strong relationship between chronic periodontitis and GERD condition. Periodontitis is an inflammation of your gums that could cause bone loss. The disease can also cause your teeth to become loose and eventually fall out.
Even if you notice subtle symptoms of GERD, you have chances of having dental erosion and gum disease. So your dentists can identify the condition and suggest the right treatment.
Tips to Protect Your Teeth from GERD Symptoms
You can do your bit in protecting your teeth from acid reflux, few suggestions:
1 To increase your saliva production, you can chew sugar-free xylitol gum. Saliva helps neutralize acid as it contains minerals that help build your tooth. All chewing gum stimulates saliva, but note that chewing gum with the sugar substitute is very helpful. Xylitol in the chewing gum interferes with the chemical reaction between the acid and your tooth structure, thus helping to reduce calcium loss.
2 Do not brush your teeth immediately after an acid reflux episode. The acid in your mouth actually softens the tooth enamel. Wait an hour to give your saliva a chance to wash out the acid. Instead, just after a reflux episode, try to rinse your mouth with water.
3 To neutralize the acid, mix half a teaspoon of baking soda into a cup of water and rinse. Or you might try chewing an antacid tablet or rinse with any antacid suspension. Use only sugar-free forms of antacids.
4 Ask your dentist to prescribe fluoride toothpaste, in-office treatments, or special mouth rinses – all these can help to strengthen your teeth. Toothpaste that contains amorphous calcium phosphate or ACP can also be beneficial in preventing acid erosion.
5 If you suffer from xerostomia or dry mouth, chew green tea gum or use a saliva substitute that can increase saliva flow and reduce the acid level in your mouth.
6 Lifestyle changes are very helpful in controlling the uncomfortable symptoms of GERD. Some of these could include avoiding caffeine, alcohol, and spicy, acidic foods and beverages. You can also try some other changes – like eating smaller meals and avoiding heavy meals just before bedtime. Remember, if you quit smoking and lose weight, you can reduce the GERD symptoms, thus benefiting your overall health.
Bottom Line
GERD seriously affects your overall health, impacting your oral health in a significant way. Treatment of GERD and prompt diagnosis can only prevent serious oral health problems. With regular check-ups, you can avoid other negative health effects.
Additionally, your doctor can recommend prescribed or over-the-counter medication to treat GERD. He can also discuss other lifestyle changes and tips that could be useful. Some of you might find avoiding spicy foods, caffeine, or alcohol very useful. So you can try to implement these changes in your lifestyle for better results.
Your dentist might recommend using fluoride toothpaste or switching to fluoride mouth rinses. These dental products can help to strengthen your tooth enamel. You can also ask your dentist about diet modifications or products that could help remineralize your teeth, preventing tooth erosion in the future.
Dr. Amal Al Qedrah Medical Center
Royal European Specialist Polyclinic