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

Abstract

Background and aim. Dental erosion (DE) represents a frequent condition in adults and the elderly. The gastroesophageal reflux disease (GERD) is considered an important endogenous factor causing dental erosions. The objective of this study was to assess the prevalence of DE in GERD patients and to establish the correlation between pathogenic intrinsic and extrinsic factors of DE and their relation to GERD. 
 Methods. A cross-sectional study was conducted on 263 patients (median age 43). Patients with heartburn were recruited in two countries with different prevalence of GERD. Patients were recruited from France (n=158, 60%) and Romania (n=105, 40%) including 163 females and 100 males. The Basic Erosive Wear Examination (BEWE) index for diagnosis and evaluation of dental erosion was used. Based on the value of BEWE score, each patient was included in a risk group for DE development (low risk: BEWE=3-8, medium risk: BEWE=9-13, high risk: BEWE ≥14). Patients filled a questionnaire regarding GERD symptoms, medications, life style. Salivary parameters (pH and buffering capacity) were also assessed and analyzed. 
 Results. DE was significantly more frequent and more severe in GERD subjects than in the non-GERD controls. Low salivary pH but not salivary buffering capacity was associated with BEWE scores. Buffering capacity however was significantly more altered in patients with BEWE score over 9 (medium DE) than in patients with mild DE (BEWE <9). Although extrinsic factors (consumption of citrus fruits, soda drinks) were associated with DE in GERD, there was no statistical correlation with the BEWE score. From the total of 263 patients, 229 (87.1%) presented BEWE score <9, and 34 (12.9%) presented BEWE ≥9. The DE was significantly associated with the presence of GERD (p<0.001). BEWE score >9 was more frequently present in GERD patients (30 patients: 21.3%) than in non GERD patients (4 patients: 3.3%). DE were more frequent in French subjects compared to Romanian subjects. Romanians had lower BEWE scores than the French. 
 Conclusions. DE is more frequent and more severe with GERD vs. non-GERD. DE in GERD is associated with extrinsic dietary factors like citrus fruits and soda drinks.

Atomic force microscopy analysis of the surface alterations of enamel, dentin, composite and ceramic materials exposed to low oral pH in GERD

“…Composite materials present a porous structure that determines an increased adherence of the bacterial plaque, even if their surface is well polished. Ceramic materials being glazed do not present porosity, which minimizes the adherence of bacterial plaque ( 46 , 47 ) ( Figs. 7 and 8 ).…”

Aspectos característicos da perimólise: uma revisão de literatura entre os anos de 2010 a 2021

“…Assim, a erosão dentária do tipo perimólise, é caracterizada pela desmineralização ácida progressiva de estrutura dental sem o envolvimento de ação bacteriana, ocorrendo este desgaste por meio de agentes químicos endógenos (Belila et al, 2021;Cruz da Silva et al, 2019;Daniel et al, 2015;Picos et al, 2020).…”

“…Em relação a etiologia da erosão dentária, a sua forma extrínseca se dá pelas particularidades do estilo de vida do paciente, como a dieta, ambientes de trabalho (exposição a gases industriais), consumo de alguns medicamentos que alteram a acidez bucal, alcoolismo crônico, misturas de álcool com energéticos, e ainda, estas formas de erosão podem estimular o agravamento dos efeitos já instalados pela forma intrínseca (Canto et al, 2020;Cruz da Silva et al, 2019;Daniel et al, 2015;Kulkarni et al, 2020;Picos et al, 2020).…”

Teatro De Fantoches Como Ferramenta Educativa Para Promoção E Recuperação Da Saúde De Crianças

“…(VIEIRA PEDROSA , DE MENEZES, 2020). Evidências mostram que hábitos alimentares ligados `a ingestão de refrigerantes, lanches / doces ácidos e sucos de frutas ácidos aumentaram as chances de ocorrência de erosão (SALAS et al,2015) e que o DDE torna-se ainda mais frequente e grave se, associado `a fatores alimentares, o paciente apresenta doença do refluxo gastroesofágico (PICOS et al, 2020). Também, distúrbios alimentares associados ao vômito têm um claro impacto na prevalência de erosão.…”