ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Tooth Surface Loss in People with Gastroesophgeal Reflux Disease is Much Greater Than Those Without This Disorder
Clinical Question In adult patients diagnosed with GERD, what is the incidence that gastric acid regurgitation will cause new tooth structure loss as compared to control participants?
Clinical Bottom Line In a patient diagnosed with GERD, there is a greater incidence of the amount of tooth structure loss compared to a control group of participants. The results of this study confirmed that erosive tooth surface wear has been shown to affect both the posterior and anterior dentition, and specifically the occlusal surfaces of these teeth when combined with attrition.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 22383209Daranee/2012Adult patients, 14 with GERD and 6 control participants. Participants had no allergies to dental materials; had specific non-restorable teeth; and were absent of periodontal disease. Cohort Study
Key resultsIn this study the amount of volume loss per tooth in a participant with GERD (0.18±0.12 mm3) was much greater than that of a control patient (0.06±0.03 mm3, t-test P<0.013). The pattern of decreased of enamel structure was predominately found in non-contact and contact area in both the anterior and posterior dentition. This study also concluded that the amount of erosive tooth wear on the occlusal surfaces was twice as evident when it was combined with attrition.
Evidence Search ("tooth"[MeSH Terms] OR "tooth"[All Fields]) AND surface[All Fields] AND loss[All Fields] AND ("gastroesophageal reflux"[MeSH Terms] OR ("gastroesophageal"[All Fields] AND "reflux"[All Fields]) OR "gastroesophageal reflux"[All Fields] OR ("gastroesophageal"[All Fields] AND "reflux"[All Fields] AND "disease"[All Fields]) OR "gastroesophageal reflux disease"[All Fields])
Comments on
The Evidence
Validity: The study stated that from the 14 participants with GERD, 13 returned for the 6 month follow up visit, and one participant was excluded because of periodontal complications. According to the evidence, 6 of the 12 participants with GERD had 38 teeth with enamel loss from erosion. From these 38 teeth, 16 where from non-contact erosion and 22 had erosion/attrition from areas of contacting occlusion.
Applicability Oral health professionals should advise and educate their patients about the importance of seeing their family physician to help them treat and/or diagnose GERD. Thus, controlling the gastric acid regurgitation caused by GERD will help reduce the erosion in the oral cavity. The amount of tooth surface loss may be reduced for those patients who are taking medication to control their acid reflux.
Specialty/Discipline (General Dentistry) (Periodontics)
Keywords Gastroesophageal reflux disease, acid reflux, tooth wear, erosion.
ID# 2679
Date of submission: 04/03/2014spacer
E-mail garzacc@livemail.uthscsa.edu
Author Catherine Garza
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Georgiana S. Gross, MPH
Faculty mentor/Co-author e-mail Grossg@uthscsa.edu
Basic Science Rationale
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