Dental Issues Related to GRED Gastrointestinal Reflux Disease
Acid Reflux
By Dr. Binon
GERD not
only causes serious medical issues but just as important, its uncontrolled
presence results in serious and costly dental issues.
In a
healthy patient there is a valve where the esophagus (the long tube that
connects the mouth to the stomach) enters the stomach. The valve opens when the
bolus of food that you swallowed moves downward so it can enter the stomach.
Food in the stomach is broken down during the digestive process by stomach
acid, enzymes and duodenal bile. When
the valve doesn’t work correctly it allows stomach contents (acidy liquid food)
to be pushed up back into the very sensitive esophagus. The liquid burns the
lining of the esophagus and when it reaches the mouth it burns the oral tissues
and disintegrates your teeth. More on that subject later.
GERD can
result in a laryngitis, a tickling chronic cough, earaches and when untreated
for an extended time, pre-cancer.
GERD is
associated with obesity, eating large meals before going to sleep, eating acidy
and highly spiced food. The use of some medicines such as prednisolone, and the
presence of a Hiatal hernia and sleep apnea have been linked with acid reflux.
If the
previous information does not stimulate your interest then think out your teeth
and gums. The acid causes chronic gum inflammation that leads to more severe
gum disease and bone loss. When the teeth are bathing in acid on a regular
basis for a prolonged period of time, the enamel is washed away; the dentine
and the roots get sensitive. Once the protective enamel is gone and the teeth
are sensitive many patients avoid brushing and flossing allowing plaque to
build up. That coupled with dry mouth due to a myriad of prescription
medications, results in a damaging cycle that allows dental decay to run
rampant, especially around the gum line.
GERD
affects ten to twenty percent of the population, with adults over 60 yrs of age
being most commonly afflicted. With our aging population, more and more of the
seniors are experiencing this devastating disease. The condition is also reported to occur in young children.
So what
do you do about it? First off get a good medical check up and tell you MD that
you have an acid burn in your throat and mouth. He or she will prescribe a medication to control the acid
production. There are many different medications and some work better than
others. My own personal experience has been with Nexium. Its great medicine and heals up the acid
burnt tissues petty fast. Ask your physician about it. Sleep on an incline (head raised) or on your
left side to decreases acid reflux. Another significant factor is to eat a
small light meal in the evening, as early as possible before bedtime.
If you
eat a large spicy dinner with hard to digest items such as fatty meats, you are
guaranteed to have an episode.
You can
have a surgical treatment as a last resort.
If you do
have an episode, rinse your mouth with glass of water that has ½ teaspoon full
of baking soda (Arm and Hammer) as this neutralizes the acid and stops the
burn. You can also drink some of it or a glass of milk and antacid tablets.
Prevention is really the key.
Loose
weight, eat an early and light dinner, take the appropriate medication,
practice good oral hygiene and use fluoride topical gels to protect your teeth.
If you
ignore the effects of acid reflux on your mouth, you are inviting lots of
expensive dental treatment that can be avoided. So please take the consequences
seriously and avoid the GERD destructive cycle.
Stomach contents move
up the esophagus and into the mouth causing burning (acid burn) of the
esophagus lining and the mouth and erosion of the teeth.
The photo illustrates the gum inflammation and
recurrent type gum line caries frequently associated with GERD
References:
1) MayoClinic.org
2) ADA – American Dental Association (Search for Gastrointestinal Reflux Disease)