Is histologic esophagitis associated with dental erosion: a cross-sectional observational study?

Abstract

BackgroundGastroesophageal reflux disease (GERD) affects 15–25% of children and adolescents in the United States. The diagnosis of GERD in children is complex as reported symptoms or symptom profiles have been found to be unreliable. Frequently, the diagnosis must be confirmed by objective tests such as pH monitoring or histological evidence of esophagitis on an esophageal biopsy. Dental erosion has been shown to be associated with GERD as an atypical complication and has the potential to be a marker of GERD. The purposes of this study were to compare the frequency and patterns of dental erosion in children and adolescents with and without histologic esophagitis.MethodsTwenty-five subjects were recruited from patients scheduled for an upper gastrointestinal endoscopy. Information regarding potential GERD symptoms, food habits, and dental hygiene habits were obtained. Intra-oral photographs were taken, and a dental exam for erosion was performed. The results of a standard biopsy taken from the lower third of the esophagus during an endoscopy were used to divide subjects into either the control group or the GERD group (i.e. those with histologic esophagitis).ResultsTwenty-two subjects yielded 586 evaluable teeth. No significant difference was found between frequency or erosion patterns of those with and without histologic esophagitis. Dental erosions were more frequent in primary teeth.ConclusionsDental erosions do not appear to be associated with histologic esophagitis indicative of GERD.Electronic supplementary materialThe online version of this article (doi:10.1186/s12903-017-0408-z) contains supplementary material, which is available to authorized users.

Risk factors associated with oral manifestations and oral health impact of gastro-oesophageal reflux disease: a multicentre, cross-sectional study in Pakistan

“…GORD has multiple systemic effects, particularly in the GI tract (table 2). There is considerable medical literature on GORD and its impact on the oral hard tissue (ie, DE), as well as its periodontal effects8; however, data on the relationship between GORD-mediated acidic oral mucosal lesions and oral health are either scarce or controversial 7–12 14–16 22–25. Our finding of a prevalence of DE in patients with GORD of 35.3%, fits well within the regionally (South Asian population) reported prevalence of DE (ranges between 5.0% and 58.4%)24 26–28; while global prevalence ranges from 2% to 77%, this wide range differs with age, gender, ethnicity and population-based underlying risk factors 5.…”

“…Our study findings demonstrate a positive association of chronic GORD with OSF, which is an oral precancerous lesion 42. OSF has never been reported in association with GORD, partly because these oral pathologies were not studied in-depth among GORD population 3–15 20–22 24–28 43 44. However, because of its significant impact on quality of life, it should be considered and addressed in future researches.…”

“…The OGD findings in patients with GORD include oesophageal erosions, erythema and strictures, a lax oesophageal sphincter, oesophagitis, Barrett’s oesophagus, oesophageal adenocarcinoma and hiatal hernia 17. Accurate diagnosis of oesophagitis was crucial in this study because it is a risk factor for DE 10. Compelling evidence from plasma biomarkers (increased Erythrocyte sedimentation rate (ESR)), clinical symptoms (painful swallowing and dysphagia), signs of erythema, inflammation and ulceration on OGD were markers considered for a definitive diagnosis of oesophagitis 18…”

“…Studies have highlighted the detrimental effects of gastroduodenal contents on oral soft-tissue pathology as well as their propensity to cause DE 3 7. These include effects on the oesophageal epithelium, soft palate and oral mucosa, and manifest as burning mouth syndrome, aphthoid lesions, hoarseness of voice, erythema of the soft palate and uvula, glossitis, epithelial atrophy and xerostomia 6–11. Epithelial atrophy and xerostomia further aggravate GORD-induced injury to the epithelium in the oral cavity and oesophagus 12 13…”

Factors associated with dental erosions in gastroesophageal reflux disease: a cross-sectional study in patients with heartburn

“…In a recent study the DE did not correlate with the presence of histologically proven esophagitis, i.e. patients with nonerosive reflux disease are also able to develop DE [30].…”