Reflux disease is a common condition with heartburn being the most recognisable symptom as the acid flows up from your upper stomach or lower chest towards your neck. However, less known is that stomach acid can reach your mouth, causing a lot of damage to teeth.
Below, Dr Andrea Shepperson, lead clinician at Lumino City Dental at Quay Park, writes about the relationship between reflux and dental health. She has a special interest in tooth wear, with her practice focused on its management.
From a dentist’s perspective, reflux causes a distinctive pattern of tooth wear.
How does acid affect the teeth?
You’re likely no stranger to dentists’ advice to lessen the intake of sugary drinks for your oral health – that’s partly because these drinks are often acidic. When teeth encounter something acidic, the enamel becomes softer for a while, increasing the risk of being eroded or dissolved away. Your saliva is protective and slowly cancels out this acidity until your mouth gets back to its natural balance. If acid attacks happen too often, or when the mouth is dry, your mouth doesn’t get time to repair itself, and over time you start to lose the surface of your teeth.
What does reflux damage your teeth?
But acidic food and drinks aren’t the only source of acid in your mouth. Reflux brings up gastric acid and we may see hollows, pitting or craters in the back teeth of patients who look after their mouths well.
Other signs of reflux-induced erosion are sensitive grooves near the gumline,
thinning transparent front teeth, and wear of the palatal surfaces of the teeth, adjacent to the roof of the mouth.
How dentists tell if you have reflux?
It’s interesting to think that although reflux is defined as a digestive system problem, dentists are often the first healthcare professionals to notice the problem, especially for those patients with ‘silent reflux’, a term used to differentiate the less obvious reflux symptoms from the classic reflux symptoms such as heartburn.
Hidden, less obvious symptoms of reflux include:
A hoarse, croaky voice or need to clear the throat.
An acid taste in the mouth in the mornings.
Bubbly, frothy saliva at the back of the tongue.
Chronic cough, without asthma or a chest infection.
Asthma that isn’t improving.
A sore throat.A chronic lump in the throat.
Studies have also suggested silent reflux often affects us when we’re lying down or asleep. It’s surprising how far acid will reach, sitting at the back of the mouth creating a pooling of acid solution around the back teeth, or spreading around the mouth by tongue movements during sleep. Sometimes sleep problems can be associated with reflux; snoring and waking gasping for air may also relate to reflux. We have cases where we refer patients to sleep apnea specialists when we suspect there is a connection.
That’s why I’m excited to be one of the first clinics in New Zealand to offer a saliva test called Peptest to help detect undiagnosed reflux in patients with no other obvious cause of damage to teeth.
Peptest is the world’s first non-invasive saliva test for reflux.
Ask your doctors if they provide Peptest in their clinics. If not, you can still book a test online at peptest.co.nz where all you need to do is to produce saliva samples as instructed and send them back for us to analyze.
Credit: Dr Andrea Shepperson, Lumino City Dental at Quay Park; VERVE.