Dental erosion as extraoesophageal manifestation of gastro‐oesophageal reflux

Dental erosion can be considered as an extraoesophageal manifestation of gastro‐oesophageal reflux disease (GORD). Many reports have implicated gastric acid reflux as a contributory factor in the development of extraoesophageal disorders (“atypical” symptoms related to GORD),¹ but the presence of lesions in the oral cavity in patients with acid reflux has been less studied. The association between acid reflux and dental erosion was first described by Howden in 1971 and was confirmed in other studies later, both in the adult population and in children.

We studied two groups of subjects: 181 patients with GORD and 72 healthy volunteers.² Clinical assessment, including sex, age, body mass index, and consumption of tobacco and alcohol, was performed in all subjects, as well as a dental examination performed by a dental physician, blind to the diagnosis of the subjects. Parameters evaluated were the presence and number of dental erosions, location, and severity, according to the Eccles and Jenkins index, modified by Hattab. Clinical parameters were similar in both groups (p>0.05).

Compared with the control group, the percentage of dental erosions was significantly higher in the GORD group (12.5% v 47.5%; p<0.001, χ² test), as was the number and severity of dental erosions (p<0.001, Student's t test). Location of dental erosions was significantly different between the groups. Given the high prevalence of dental erosions in patients with acid reflux, the collaboration between gastroenterologists and dentists is necessary in order to identify dental involvement in patients diagnosed with GORD. In contrast, subjects with unexplained dental erosions should be referred to gastroenterologists to investigate the presence of probable GORD.