Acid reflux (also known as gastroesophageal reflux) is a common condition that occurs when acids from the stomach flow upward into the esophagus (the tube that connects the mouth to the stomach) and occasionally into the mouth.
Sometimes acid reflux progresses to GERD – gastro esophageal reflux disease – a more severe form of reflux. The stomach acid flowing up into the esophagus irritates and inflames the lining of the esophagus.
Left untreated, acid reflux and GERD can have an impact on overall health as well as oral health. Individuals who have the disease are at risk for serious damage to the esophagus, including developing esophageal cancer. They are also at an increased risk for tooth erosion and oral health problems.
THE IMPACT ON ORAL HEALTH
The stomach’s gastric acids are refluxed up through the esophagus and into the oral cavity. Constant exposure to these acids can erode the tooth’s outer surface (enamel). Often clients are not aware of the damage that refluxinduced erosion has caused to their teeth until it has reached an advanced stage of destruction.
Silent GERD, presenting without the symptoms of acid burn or heartburn, could still erode tooth enamel.
Tooth enamel begins to dissolve at a pH (acid level) of 5.5 and because stomach acid has an extremely low pH of 2.0, significant chemical erosion could result.
If significant enamel is lost, then the underlying tissue (called dentin) may be exposed. This can lead to permanent weakening of the teeth that are prone
to chipping, increased wear and decay. Teeth may become overly sensitive and unsightly, possibly leading to extensive restorations, fillings, crowns and bridge work.
SIGNS AND SYMPTOMS
- Heartburn – a burning sensation in the chest
- Regurgitation of food or sour liquid
- Difficulty swallowing
- Coughing, wheezing and chest pain, especially while lying down
- Hoarseness and sore throat
- Belching, nausea, vomiting
- Stomach ache and pain on awakening
- Sinus infections
- Asthma may worsen
- Burning mouth
- • Tooth enamel erosion – increased wear and decay
- Tooth chipping, sensitivity, discolouration (yellow appearance)
- Bad breath
Maintaining good oral hygiene
- Visit a dental hygienist for regular professional cleaning and evaluation/treatment for tooth erosion.
- Brush twice a day using a toothpaste for dentin sensi tivity. Use a low abrasive fluoridated toothpaste and a soft toothbrush. Toothpastes containing baking soda are low in abrasion and will aid in neutralizing acids.
- Do not brush after being exposed to acid, whether from acid reflux or food and beverages. Because acid softens the tooth’s surface, brushing will cause more enamel loss. Wait 30 minutes until the natural flow of saliva washes away and neutralizes the acids.
- After reflux episodes, rinse with water or use a sugarfree antacid and let it dissolve in the mouth.
- Avoid mint flavoured products, since they relax the valve that can release the backward flow of stomach acid.