It is estimated that between 15 and 30% of people in the United States have Gastroesophageal Reflux Disease, or GERD for short. Many of these people have symptoms such as heartburn, belching, stomachache, and acid in their mouth. But some patients with GERD don’t even know they have it, because they either don’t have any symptoms or have non-traditional symptoms like coughing, hoarseness, and frequent clearing of the throat – a phenomenon known as “silent GERD”.
Surprisingly, your dentist may be the first one to recognize signs of acid reflux, especially if you don’t have traditional symptoms or don’t see a medical doctor regularly. In patients with GERD, acid from the stomach comes up into the throat and mouth. Dental professionals can detect damage to your teeth due to acid attack. This damage is called erosion. In people with GERD, tooth damage and wear will usually be seen on the backs of the top teeth or on the chewing surface of lower back teeth. The outer layer of tooth, called enamel, will begin to be damaged and dissolved by the acid present in the mouth of patients with GERD. This process will cause the softer second layer of tooth, called dentin, to become exposed. As a result these teeth will be more prone to sensitivity, wear, cavities, and damage to the nerve inside the tooth.
If your dental professionals notice signs and symptoms of acid reflux and GERD at your exam, they will likely recommend that you see your medical doctor for further evaluation and treatment. Following this advice is important because chronic GERD can lead to erosive esophagitis, stricture formation, and a change in the esophagus, or throat, known as Barrett’s esophagus. Barrett’s esophagus is considered a precancerous condition and progresses to cancer in about 1 out of 200 diagnosed patients.
If you do have GERD, there are some things you can do to help reduce the damage it causes to your teeth. It is recommended that you NOT brush your teeth immediately after an acid challenge. This could increase the damage the acid does to your teeth. Instead, rinse with water, sodium bicarbonate (baking soda), and a mouthwash that contains fluoride after reflux episodes. You may also use a SUGAR-FREE antacid and talk to your medical doctor about other medications or interventions. Finally, chewing a Xylitol or other sugar-free gum will help to stimulate salivary flow to help counteract the acid in your mouth.