Acid Reflux Disease May Lead to Erosion of Teeth

Posted by: Jason Hui, DDS, on June 19, 2013

Recently updated on March 3rd, 2014 at 02:18 pm

Acid Reflux Disease, also known as Gastroesophageal Reflux Disease (GERD), is a rather common condition whereby a leaky valve allows the acid from the stomach to seep up into the esophagus, which is the tube that connects the throat to the stomach. Acid reflux presents itself in a variety of ways, ranging from a lack of symptoms to heartburn, chronic bad breath, chronic sore throat, chronic cough, and regurgitation.  Regardless of the symptoms, acid reflux leading to stomach acid leaking into the oral cavity can be very damaging to teeth.

According to the U.S. Department of Health and Human Services, over seven million people suffer from severe acid reflux. Unfortunately, patients often are unaware of the damage caused by acid reflux to their teeth until it has reached an advanced stage of destruction (Figure 2).

Dental manifestations of acid reflux disease begins with mild pitting of the chewing surfaces of the teeth (Figure 1), and slowly progresses to involve severe pitting of the chewing surfaces as well as the areas near the gums (Figure 2).  The damage and wear on the teeth from acid reflux can cause toothache, sensitivity, and even TMJ pain. Repairing years of acid reflux tooth damage can be very costly ranging from a few hundred dollars to several thousand dollars, depending on whether fillings, onlays, crowns, root canal therapy, or extractions and dental implants are necessary.

Figure 1.  This image illustrates acid erosion of teeth from acid reflux disease. As one can see, the top of these teeth are no longer white, as the outer layer of enamel has been eroded away, and there is pitting near all the cusp tips (as indicated by the red arrows); there is also no longer any grooves or anatomy on these teeth. This is a consequence of the acid making the teeth softer and more susceptible to wear. If the acid reflux remains untreated, these teeth eventually get worn down even further and may lead to toothache or even tooth loss.

Figure 2.  This image illustrates severe tooth damage as a consequence of untreated, advanced acid reflux disease. The red arrows point to pitting of the teeth near the cusps; the green arrows point to gum and tooth damage.

Figure 3.  This image displays a full lower arch of teeth that have suffered considerable acid erosion from untreated acid reflux disease. Note how all the chewing surfaces of the teeth are pitted and flatted out, with all the cusp tips obliterated.

Symptomatic acid reflux disease is very easy to diagnose; however, acid reflux in a mild form can go undetected for years and result in similar extensive damage to the teeth!  In addition to tooth damage, acid in the oral cavity and esophagus can also induce cellular changes in the lining of the esophagus leading to esophageal cancer.

Did you know that dentists are often the first clinicians to detect early signs of acid reflux disease?  Because we develop close relationships over the years with our patients and usually see them every six months for preventive care, we are in a prime position to evaluate early clinical signs of tooth erosion and symptoms such as taste changes (sour taste), and suggest the need for referral and further examination with medical specialists.  Paragon Dentistry welcomes all interested parties to meet with us to evaluate whether acid reflux may be a problem and to acquire control before extensive tooth damages occur!