Bariatric Surgery Impact on Gastroesophageal Reflux and Dental Wear: A Systematic Review

Abstract

Introduction: Several oral problems may be perceived in individuals who were submitted to bariatric surgery, due to metabolic and behavioral changes relative to diet and oral hygiene. Tooth wear appears to suffer impact after bariatric surgery, because there may be an increase in gastroesophageal reflux. Objective:To systematically review the literature regarding the impact of bariatric surgery on gastroesophageal reflux and tooth wear. Method: The following databases were accessed by two independent, calibrated examiners: PubMed, Medline, Lilacs, Scielo and Cochrane using the following descriptors: “bariatric surgery” AND “dental erosion” OR “bariatric surgery” AND “dental erosion” AND “gastroesophageal reflux disease”. After excluding duplicate studies, 12 studies were initially evaluated by the title and abstract. The excluded studies were those without relevance to the present research, literature review studies and case reports. Thus, four articles were included in this study. All the articles evaluated indicated high association between gastroesophageal reflux and tooth wear in patients submitted to bariatric surgery. Association of these outcomes was more evident six months after the surgical procedure. Conclusion: Patients submitted to bariatric surgery showed higher prevalence of gastroesophageal reflux and tooth wear.

Oral Manifestations in Obesity and Bariatric Surgery: Narrative Review

“…[2,9]. Gastroesophageal reflux can occur in both obese and bariatric patients; thus, they may experience teeth erosion, which is caused by oral cavity acidity [10][11][12].…”

“…Quantitative and qualitative imbalance in the oral flora is introduced as dysbiosis, which can increase the pathogens causing caries or periodontitis in the oral cavity [6]. Bariatric surgery is the main method to control morbid obesity through decreasing food reser-O voir and gastric emptying, which can induce some oral complications, like teeth caries, periodontitis, teeth wear, xerostomia, or sialorrhea [4,5,[7][8][9][10][11].…”

Risk Factors for Dental Erosion After Bariatric Surgery: A Patient Survey

“…Longer term, there is evidence of oral complications after bariatric surgery. 17 One such complication, dental erosion, may not be attributable solely to an increase in prevalence of reflux. Preferences in what and how patients eat and drink/ingest may also have changed in the years following bariatric surgery.…”

Dental Erosion in Obese Patients before and after Bariatric Surgery: A Cross-Sectional Study

“…Among patients with poorly managed obesity, metabolic/bariatric surgery has been proven to be the most effective and durable therapy for obesity [ 1 ]. Obesity and bariatric surgery have been shown to be associated with a higher risk for dental wear [ 2 , 3 ], which is multifactorial: frequent consumption of soft drinks is associated with obesity and dental problems [ 4 , 5 , 6 ]; unhealthy food choices might have led to micronutrient deficiency before surgery, e.g., iron, vitamin D and calcium [ 7 , 8 , 9 , 10 ]; aversion to special foods and taste changes were often reported after surgery [ 11 , 12 , 13 , 14 ]; and the reduced intestinal absorptive surface area affected hormonal mediators, which can lead to micronutrient deficiency postoperatively, including lower vitamin D and calcium in serum [ 15 , 16 , 17 ].…”