If you have reflux, you might have tooth wear
Did you know that acid reflux and stomach acid can damage your teeth? Gastroesophageal reflux disease (GERD) allows stomach acid to reach your mouth, weakening tooth enamel over time and causing irreversible tooth loss.
Even if you don't feel typical heartburn, acid can still erode your teeth, causing long-term damage. Silent reflux or LPR is a term to describe acid getting up to the level of the throat. This often happens at night, when lying flat. Gravity doesn't keep the acid in the stomach. It can cause swelling, inflammation and a feeling of an irritated or blocked throat. Symptoms are not the obvious heartburn pain. They include:
Chronic cough
Hoarseness or voice changes
Sore throat or frequent throat clearing
Sensation of a lump in the throat (globus sensation)
Difficulty swallowing
Post-nasal drip
Excessive throat mucus
Bad breath
Ear discomfort or frequent ear infections
Feeling of choking or tightness in the throat
Bitter or sour taste in the mouth
Tooth erosion or sensitivity due to acid exposure around back teeth
We will look carefully at you teeth for signs of GERD or LPR (Laryngopharyngeal Reflux -also called Silent Reflux), and review your medical questionnaire. If we have concerns we will recommend referral to a gastroenterologist for further testing and confirmation.
We will also put in place simple preventative measures and recommend lifestyle changes to help symptoms.
Regular dental check-ups and managing your reflux are key to protecting your smile from this hidden threat. If you're experiencing any of these signs, talk to us about protecting your teeth from acid erosion.
What if I have reflux?
Seeking medical advice is important if you have reflux. While Over The Counter medication will provide short term relief, long term reflux can lead to serious health issues and dental damage. A medical assessment is important to rule out any complications of reflux. If you a taking antacid tablets after every meal to relieve symptoms, or have had a chronic cough for more than a few weeks, we recommend seeking advice.
Some simple lifestyle changes can relieve symptoms and these include:
Eating your evening meal earlier.
Avoiding over eating at meals.
Elevating your bed or sleeping with your head and shoulders on more than one pillow.
Losing weight.
Avoiding trigger foods.
Minimising or stopping alcohol, which opens up the oesophageal sphincter letting acid escape.
If dental damage has occurred, you may need damaged teeth rebuilt. We may recommend reparative gels or pastes, and wearing protective guards over teeth at night.
A link with Sleep Disordered Breathing
There is an association between patients with sleep disordered breathing, or obstructive sleep apnoea, LPR and reflux. When the throat becomes inflamed and swollen, some patients have trouble breathing, making reflux worse.
When soft tissues of the palate and throat get lax, or the tongue enlarges and obstructs the airway, the desire to keep breathing can create a pressure gradient change in the oesophagus that causes acid to be sucked up towards the mouth. Part of our investigation will be to screen for sleep and breathing disorders.
How can I protect my teeth?
You might notice increased sensitivity, thinning teeth, potholes or hollows on molars, sensitive gum areas, or a yellowish tint as the enamel wears away. We will design a personalised protective plan for teeth at risk of damage from reflux. Regular checkups are important to monitor the effects of stomach acid, especially in cases with ongoing symptoms. We might recommend:
Calcium based products to replace and remineralise the surface damage.
Fluoride containing toothpaste and mouthrinses.
Application of protective fluoride varnishes in the dental office.
Low abrasion toothpastes, to avoid scouring softened teeth.
It is best not to brush teeth after exposure to acid, including from vomiting or regurgitation.
If the condition is severe levels, restoration of teeth may be recommended.
