The increasing prevalence of gastroesophageal reflux disease (GERD) in children and adults, and of “silent refluxers” in particular, increases the responsibility of dentists to be alert to this potentially severe condition when observing unexplained instances of tooth erosion. Although gastroesophageal reflux is a normal physiologic occurrence, excessive gastric and duodenal regurgitation combined with a decrease in normal protective mechanisms, including an adequate production of saliva, may result in many esophageal and extraesophageal adverse conditions.
The elevation is accomplished either by putting blocks under the bed’s feet at the head of the bed or, more conveniently, by sleeping with the upper body on a foam rubber wedge. These maneuvers raise the esophagus above the stomach and partially restore the effects of gravity. It is important that the upper body and not just the head be elevated. Elevating only the head does not raise the esophagus and fails to restore the effects of gravity. Symptoms of nausea, vomiting, and regurgitation may be due either to abnormal gastric emptying or GERD.
Therefore, some patients with GERD will have normal amounts of acid reflux and some patients without GERD will have abnormal amounts of acid reflux. It requires something other than the pH test to confirm the presence of GERD, for example, typical symptoms, response to treatment, or the presence of complications of GERD. GERD also may be confidently diagnosed when episodes of heartburn correlate with acid reflux as shown by acid testing.
Talk to your doctor about lifestyle changes and medications that can minimize your acid reflux and the resulting bad breath. If you suffer from acid reflux, see your dentist regularly so they can make sure your teeth stay healthy, recommend ways to prevent tooth enamel erosion and suggest ways to get relief if you are also suffering from dry mouth. If heartburn, acid reflux or other stomach problems are part of your daily life, work with your physician on a care plan to treat the underlying causes of your stomach troubles. Another concern is the dry mouth caused by many acid reflux medicines.
Therefore, prescription strength H2 antagonists or PPIs are appropriate. If damage to the esophagus (esophagitis or ulceration) is found, the goal of treatment is healing the damage. In this case, PPIs are preferred over H2 antagonists because they are more effective for healing. There are several ways to approach the evaluation and management of GERD.
Heartburn, or acid indigestion, is the most common symptom of GERD. Heartburn is described as a burning chest pain.
Also, ask your doctor whether any medication could be triggering your heartburn or other symptoms of acid reflux disease. Fibrous foods also keep you feeling full longer and may help you maintain your weight. GERD has been linked to being overweight, so talk to your doctor about losing weight to relieve acid reflux and heartburn.
If you’ve been diagnosed with gastroesophageal acid reflux disease, or GERD, your dental health might be at risk. Heartburn is the most common symptom of acid reflux. Your stomach is protected from the corrosive effects of stomach acid. If your lower esophageal sphincter doesn’t prevent your stomach acid from leaking out of your stomach and into your esophagus, you will experience a painful burning sensation in your chest.
Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents leak backward from the stomach into the esophagus (food pipe). Food travels from your mouth to the stomach through your esophagus. GERD can irritate the food pipe and cause heartburn and other symptoms.
In both of these situations, the pH test can be very useful. If testing reveals substantial reflux of acid while medication is continued, then the treatment is ineffective and will need to be changed. If testing reveals good acid suppression with minimal reflux of acid, the diagnosis of GERD is likely to be wrong and other causes for the symptoms need to be sought.
Sometimes this valve doesn’t work properly because the muscle weakens. When this happens, gastric acids can travel up the esophagus and cause a burning sensation — this is heartburn. When these acids travel up into the mouth and then down into the lungs, they can cause gastroesophageal reflux disease (GERD). We as dentists, owe it to our patients to notice the problem and provide the information and support they require to improve their GERD.
Nevertheless, it is still debated whether a finding of reduced gastric emptying should prompt changes in the surgical treatment of GERD. Gastric emptying studies are studies that determine how well food empties from the stomach. As discussed above, about 20 % of patients with GERD have slow emptying of the stomach that may be contributing to the reflux of acid.
The esophagus of most patients with symptoms of reflux looks normal. Therefore, in most patients, endoscopy will not help in the diagnosis of GERD. However, sometimes the lining of the esophagus appears inflamed (esophagitis). Moreover, if erosions (superficial breaks in the esophageal lining) or ulcers (deeper breaks in the lining) are seen, a diagnosis of GERD can be made confidently.