Title Patients With Gastroesophageal Reflux Disease Have Lower Salivary Flow and a Higher Incidence of Dental Erosion
Clinical Question In patients with Gastroesophageal reflux disease (GERD), does adequate salivary flow contribute to the prevention of dental erosion?
Clinical Bottom Line Patients with Gastroesophageal reflux disease (GERD) have a low salivary flow and a higher incidence of dental erosion. This association is supported by a cross sectional case-control study where the salivary volume was evaluated in patients with GERD as compared to the control patients without GERD.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
22200941Yashikawa/201270 total patients 40 GERD patients 30 non-GERD patients (15 older and 15 younger)Case Control
Key resultsNine of the 40 patients that had GERD (including the 3 completely edentulous patients), showed signs of dental erosion. Eight out of 9 of these patients exhibited mild erosion while the other patient showed severe erosion. There was a significant difference in salivary volume among the 3 groups (p < 0.05). “The Saxon test results were significantly lower in the GERD group (range 0.1–10.8; mean ± SD 3.0 ± 2.3 g/2 min; score 0.8 ± 0.8) than those groups (older control group: 3.9 ± 2.0 g/2 min, 1.4 ± 0.5; younger control group, 4.0 ± 1.5 g/2 min, 1.4 ± 0.5, respectively (p < 0.05); (Fig. 5a, b).”
23011245Correa/201260 total patients 30 with GERD and 30 controlsCase Control
Key resultsThe patients with GERD (group 1) had a higher incidence of erosions when compared to the control group (p<0.001). There was not much difference between the 2 groups when it came to salivary flow (P = 0.49; P = 0.80 and P = 0.85, respectively) but results showed a difference when it came to the salivary buffering capacity (P=0.018) with group 1 having lower values than the control group.
Evidence Search ("Gastroesophageal Reflux"[Mesh] AND "Saliva"[Mesh]) AND "Tooth Erosion"[Mesh]
Comments on
The Evidence
Validity: Both case-control studies evaluated the patients at a single point in time. This is why it was useful for both studies to use patients that were previously identified as having Gastroesophageal reflux disease before the start of the study. This allowed both studies to identify the effects of low salivary flow in patients who experienced GERD for a longer duration as compared to those patients with a shorter GERD conditions. There were no competing interests in these studies. Perspective: Since one of the studies focused on salivary flow and the other on salivary buffering capacity, it is difficult to conclude which was the causative agent.
Applicability These studies were observed with patients with the GERD diagnosis who were examined in dental settings. Since GERD is prevalent for the aging population, it is beneficial to further investigate the correlation between the salivary flow and GERD in order to prevent enamel erosion.
Specialty (General Dentistry)
Keywords Dental erosion, salivary flow, Gastroesophageal reflux disease
ID# 3039
Date of submission 03/29/2016
E-mail smallsd@livemail.uthscsa.edu
Author Deana Smalls
Co-author(s) e-mail
Faculty mentor Moshtagh Farokhi, DDS, MPH
Faculty mentor e-mail farokhi@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available