Stopping the ‘burn’ in your mouth

Gastroesophageal reflux disease (GERD) is a chronic condition commonly known as heartburn. Caused by stomach acid regurgitation into the esophagus and mouth, GERD
is widely known for its effects on the digestive system. It can cause ulcers and erosion of
the esophageal lining, and it may increase the risk of esophageal cancer.

As a dentist, I also see the impact of GERD on the mouth and teeth. Symptoms range
from bad breath and a sour taste in the mouth to teeth sensitivity, dental erosion and
inflammation of the oral tissue.

About 25% of adult GERD patients experience dental erosion, which results from a
dissolution of the tooth enamel when exposed to gastric acid. (Tooth enamel dissolves
when the pH in the mouth drops below 5.2; gastric acid has a pH value of about 2.0.)

Dentists are often the first to diagnose GERD. Telltale signs include loss of tooth enamel,
especially on the inner surfaces of the upper front teeth and the biting surfaces of the back
teeth. Often we see cup-shaped craters on the biting surfaces of the back teeth.

Enamel loss can lead to teeth hypersensitivity and discoloration. It may also result in the
“hyper-eruption” of opposing teeth.

The first line of defense against GERD’s effects should be treating the underlying
disease. If you suspect GERD, seek medical treatment. Your physician may advise
you on managing controllable GERD risk factors, which include alcohol consumption,
obesity, sleep apnea and the use of certain drugs, such as certain pain relievers. Prilosec,
Tagamet, Nexium or another medication may be prescribed, as well.

Your dentist can provide additional counseling and treatment options. To reduce mouth
acidity and potentially reverse enamel erosion, you may be advised to rinse your teeth
with water, chew xylitol-sweetened gum, use fluoride pastes and rinses and avoid
consuming highly acidic foods and drinks.

To restore lost tooth enamel, your dentist may recommend a number of interventions:
orthodontic treatment (to relieve tooth crowding caused by hyper-eruption), reshaping
of the opposing teeth, crowns, onlays or veneer restorations, and/or using composites
or porcelain to build up the biting surfaces of the back teeth. Occasionally, root canal
therapy is required to treat damage to the tooth pulp or to prepare a tooth for aggressive
restorative treatment.

Because damage from GERD happens gradually, the sooner the underlying problem is
diagnosed and corrected, the less aggressive your treatment can be. Please call our office
at 651-490-9011 if you have any concerns about your oral health related to GERD.

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