Evaluation of dental erosion in patients with gastroesophageal reflux disease

Statement of problem. The cause of dental erosion may be difficult to estab lish because of its many presentations. Determination of the cause is an im portant aspect of diagnosis before extensive prosthodontic rehabilitation. Purpose. This cross-sectional study evaluated the association between loss of tooth structure as a result of dental erosion and gastroesophageal reflu x disease. Material and methods. Twenty consecutive adult dentate subjects referred to the Division of Gastroenterology for investigation of gastroesophageal tra ct disease were also evaluated for signs of dental erosion. All subjects un der went a dental evaluation that included a patient history to determine p otential etiologic factors responsible for dental erosion. Subjects were ex amined clinically to quantify loss of tooth structure using a Tooth Wear In dex (TWI). Endoscopic examination and 24-hour pH manometry were carried out to determine which subjects met the criteria for gastroesophageal reflux d isease (GERD). Scores for maxillary versus mandibular dentition and anterio r versus posterior dentition were also compared. Data were analyzed with th e Kruskal-Wallis test (P=.004). Results. Ten subjects were diagnosed with GERD and 10 subjects had manometr y scores below the level indicating GERD. Overall, subjects diagnosed with GERD had significantly higher TWI scores compared with control subjects (me an difference = 0.6554; P=.004). GERD subjects had higher TWI scores in all quadrants, except in the mandibular anterior region where there was no dif ference. Conclusion. The results indicated that a relationship exists between loss o f tooth structure, as measured by the TWI index, and the occurrence of GERD in this group of subjects.