Evaluation of dental erosion in patients with gastroesophageal reflux disease

The cause of dental erosion may be difficult to establish because of its many presentations. Determination of the cause is an important aspect of diagnosis before extensive prosthodontic rehabilitation.

This cross-sectional study evaluated the association between loss of tooth structure as a result of dental erosion and gastroesophageal reflux disease.

Twenty consecutive adult dentate subjects referred to the Division of Gastroenterology for investigation of gastroesophageal tract disease were also evaluated for signs of dental erosion. All subjects underwent a dental evaluation that included a patient history to determine potential etiologic factors responsible for dental erosion. Subjects were examined clinically to quantify loss of tooth structure using a Tooth Wear Index (TWI). Endoscopic examination and 24-hour pH manometry were carried out to determine which subjects met the criteria for gastroesophageal reflux disease (GERD). Scores for maxillary versus mandibular dentition and anterior versus posterior dentition were also compared. Data were analyzed with the Kruskal-Wallis test (P =.004).

Ten subjects were diagnosed with GERD and 10 subjects had manometry scores below the level indicating GERD. Overall, subjects diagnosed with GERD had significantly higher TWI scores compared with control subjects (mean difference = 0.6554; P =.004). GERD subjects had higher TWI scores in all quadrants, except in the mandibular anterior region where there was no difference.

The results indicated that a relationship exists between loss of tooth structure, as measured by the TWI index, and the occurrence of GERD in this group of subjects.