A Clinicopathologic Study of Oral Changes in Gastroesophageal Reflux Disease, Gastritis, and Ulcerative Colitis

Abstract

Objectives The aim and objectives of this study are to identify oral changes in certain gastrointestinal (GI) diseases, namely gastroesophageal reflux disease (GERD), ulcerative colitis, gastritis, and to evaluate these oral symptoms as indicators for assessing GI disorders. Materials and methods In this study, the oral manifestations of various GI disorders were assessed in a varying age group of 250 patients in Government Stanley Medical College and Hospital, Chennai. Out of 250 patients, 142 were affected by GERD, 99 were affected by gastritis, and 9 patients were affected by ulcerative colitis. Of these patients, 177 were males and 73 were females. Results Evaluation of patients with gastritis revealed that 66.7% affected with gingivitis, 19.2% with dental erosion on the palatal and lingual aspects of maxillary and mandibular teeth predominantly in the anterior region, 10.1% with periodontitis, 2% with gingival erythema. Among the patients with GERD, 44% of the cases showed dental erosion, 25.5% periodontitis, 9.9% gingivitis, 5.7% gingival erythema, 2.8% palatal erythema, 2.1% gingival ulcers, glossitis 2%, 1.4% floor of the mouth erythema, and 0.7% erythema of the tongue. Patients with ulcerative colitis showed 44.4% of gingival erythema, 33.3% of dental erosions, and 22.2% of gingival ulcers and periodontitis. Conclusion In our study of 250 patients, oral manifestations were observed in 88% of the patients. Both soft tissue and hard tissue changes were evident. There was a high correlation between various GI disease and dental erosion, erythema at various sites of the oral cavity, oral ulcers, gingivitis, periodontitis, and glossitis. Careful evaluation of oral cavity may unveil many GI disorders and help the patient by providing early diagnosis, which further facilitates the prognosis. How to cite this article Vinesh E, Masthan KMK, Kumar MS, Jeyapriya SM, Babu A, Thinakaran M. A Clinicopathologic Study of Oral Changes in Gastroesophageal Reflux Disease, Gastritis, and Ulcerative Colitis. J Contemp Dent Pract 2016;17(11):943-947.

Laryngopharyngeal reflux, gastroesophageal reflux and dental disorders: A systematic review

“…Initial screening identified 386 papers. Among these papers, 22 articles met our inclusion criteria and were kept for analysis (Fig 1, Table 2) [11][12][13][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41]. Two additional basic research studies were included.…”

“…More recently, Vinesh et al reported a periodontitis rate of 25.5% in GERD patients [39]. In the same study, the authors reported that <10% of GERD patients had oral mucosa or gingival inflammation findings (erythema, ulcer) [39]. These results did not corroborate those of Yoshikawa et al and Watanabe et al who reported more frequently mucosa inflammatory findings (papillary, marginal, attached index) in GERD patients compared with controls [11,34].…”

“…Munoz et al did not find significant differences between patients with positive esophageal pH testing and healthy individuals in the periodontal status, including plaque index, hemorrhagic index, and gingival recessions [30]. More recently, Vinesh et al reported a periodontitis rate of 25.5% in GERD patients [39]. In the same study, the authors reported that <10% of GERD patients had oral mucosa or gingival inflammation findings (erythema, ulcer) [39].…”

“…A total of 18 papers investigated the relationship between reflux and dental erosion in patients with a suspected or confirmed diagnosis of reflux [13,[23][24][25][26][27][28][29][30][31][32][33][34]36,[38][39][40][41]. The prevalence of dental erosion in reflux patients ranged from 16% to 44%, [27,28,31,34,36,[39][40][41] whereas dental erosion occurred in <20% of healthy individuals [31,36,40]. Overall, controlled studies showed that GERD patients have a significantly higher rate or severity score of dental erosion compared with healthy individuals (Table 2) [13,[29][30][31]36,40].…”

“…The involvement of reflux in the development of both gingival and periodontal disorders has been studied in 5 studies [11,30,37,39,41]. Munoz et al did not find significant differences between patients with positive esophageal pH testing and healthy individuals in the periodontal status, including plaque index, hemorrhagic index, and gingival recessions [30].…”