EFFECTS OF GASTROESOPHAGEAL REFLUX ON THE ORAL CAVITY

The effects of chronic exposure of the oral cavity to gastric acid can be many and varied. Soft tissue symptoms (nonspecific burning and sen sitivity) have been mentioned in the literature, but pathognomonic sof t tissue lesions have not been documented. Dental erosion can be consi dered to be the predominant oral manifestation of gastroesophageal ref lux disease. Erosion begins with subtle changes in the surface enamel and can progress to severe loss of tooth substance. Because the causes of such tooth lesions may be multifactorial, combining the effects of erosion, attrition, and abrasion and because of the subtle changes pr esent in the beginning stages of such lesions, diagnosis may be diffic ult. Although the basic mechanism of erosion in gastroesophageal reflu x patients is the dissolution of enamel and dentin due to acid exposur e, a multitude of other factors can modify the effects of gastric acid . Salivary parameters, in particular, may play an important role in af fecting oral pH after reflux episodes. Once dental erosion is diagnose d, thorough evaluation is necessary to document the extent of damage a nd to detect a cause, which may have both intrinsic and extrinsic comp onents. Treatment goals include eliminating the causes of acid exposur e, preventing the effects of acid exposure when it is not controllable , treating symptoms of soft tissue irritation and dental erosion, and restoring the dentition to an esthetically and functionally acceptable level. (C) 1997 by Excerpta Medica, Inc.