Acid Reflux From Chronic Heartburn May Damage Teeth

THURSDAY, March 8 (HealthDay News) — If you have chronic
heartburn, it’s not only your esophagus that you should be worried about.
New research reveals how the condition known as gastroesophageal reflux
disease, or GERD, can severely damage your teeth thanks to an influx of
acid into the mouth.

The study, which followed patients over six months, found that almost
half of those with the condition suffered much worse tooth wear and
erosion than healthy people. The disease can ultimately lead to thin,
sharp and pitted teeth.

“We hope we can raise awareness that gastroesophageal reflux disease, a
condition quite common in any population, is able to cause tooth damage.
Dental professionals are mostly aware of tooth erosion, but the public may
not be,” said study lead author Dr. Daranee Tantbirojn, an associate
professor in the department of restorative dentistry at the University of
Tennessee Health Science Center.

GERD, which is also known as acid reflux disease, causes chronic
heartburn. The stomach contents, including acid, leak into the esophagus
and often work their way back up into the mouth, causing burning pain.

Dentists know that chronic heartburn can damage teeth, Tantbirojn said.
The acid from the stomach is strong enough “to dissolve the tooth surface
directly, or soften the tooth surface, which is later worn down layer by
layer. The damage from acid reflux looks like tooth wear — the tooth is
flattened, thin, sharp or has a crater or cupping.”

In the new study, researchers used an optical scanner to measure
chronic heartburn’s effect on teeth of 12 patients with GERD and compared
them to six healthy patients without the disease over six months. The
study appears to be the first to follow people for that long, Tantbirojn
said.

It’s normal to have tooth erosion due to chewing, and about half of
those with the condition had about the same or slightly more erosion than
healthy people, she said. “However, almost half of the GERD participants
had tooth wear and erosion several times higher than the healthy
participants.”

Several patients with chronic heartburn said they were taking
medications, but they still suffered from tooth erosion. “Some patients
told us that they still have acid reflux episodes despite the medication,
or they might have skipped the medication every now and then,” Tantbirojn
said.

Dr. David Leader, an associate clinical professor at Tufts University
School of Dental Medicine, who’s familiar with the study findings, said
the research is innovative and uses technology that more dentists will
have on hand in the near future so they too can track the progress of
tooth erosion.

“Even though a patient wouldn’t notice all of a sudden that ‘my teeth
are different,’ a dentist might be able to notice that using this
technique in a six-month visit,” Leader said.

Once the outer coating of the teeth (known as enamel) is gone, it’s
gone for good, he noted. “The only thing that you can do is wait for it to
become bad enough that we have to put a crown, veneer or filling on the
tooth,” Leader added.

Tantbirojn discussed what helps prevent tooth damage in patients with
heartburn. “Generally speaking, saliva is good as the body’s defense
mechanism. Saliva has a so-called buffering capacity, meaning it can
neutralize acid,” she said. “Saliva also contains small amounts of calcium
and phosphate ions that can reduce the damage of the tooth.”

But there’s a limit to what saliva can do, Tantbirojn said. “That’s why
we saw the erosion.”

Here are some tips from Tantbirojn: Don’t brush immediately after an
acid reflux episode, but a fluoride rinse is a good idea. Dentists may
prescribe a special toothpaste for acid reflux patients, and they also may
recommend that patients take baking soda or antacids after acid reflux
episodes to protect their teeth.

Leader said Xylitol chewing gum, which reduces acid in the mouth, is
another good idea.

The study appears in the March issue of the Journal of the American
Dental Association
.

More information

For more about gastroesophageal reflux disease, visit the U.S. National
Library of Medicine.

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