Gastroesophageal reflux - its effects on teeth?
Gastroesophageal Reflux - Its Affect on Your Child's Teeth
from Marty Rayman, DDS @ www.raymanpediatricdentistry.com
Guide for Parents Whose Children Have Dental Signs of GER
(Gastroesophageal Reflux)
The Effect of GER on the Teeth
When stomach acid rises into his/her mouth, your child's teeth can be severely affected. There can be areas of dental corrosion within your child’s teeth. This takes on the form of “reverse architecture” of the teeth. What were once cusp tips are now areas of moon cratering where parts of your child's teeth may appear scalloped out and be sensitive to cold foods and touch. These areas of erosion can become quite deep and in some instances will cause fillings to be washed out. This erosion of your child's teeth can cause exposure of the nerve or make untreated cavities worse. Other causes of dental erosion include drinking a lot of soda and frequent vomiting.
Some Symptoms Known to Result from GER:
- your child is irritable after meals
- your child has frequent belching after eating
- your child reports frequent “hot burps” or “baby vomit”
- your child has chronic hoarseness / laryngitis / pharyngitis / coughing
- you hear continuous coughing during sleep (usually GERD, not asthma)
- your child reports having burning in the area of the heart or a stomach ache
- your child reports bad taste (acidy, like vomit) taste in his/her mouth upon awakening in the
- morning, and his/her breath has an acid odor
- associated with asthma / premature birth / ADHD / cerebral palsy / obesity
What To Do Now:
Suggested changes to help reduce reflux:
- avoid overeating (supersizing)
- elevate the head of your child's bed
- don’t let your child lie down immediately after eating
- avoid fried, spicy foods as well as pickles and vinegar
- no mints or sour candies (Skittles, War Heads, or Altoids)
- use hard cheese as a snack or snack chaser, the calcium neutralizes acid
- have your child swish with water and rinse after a bad taste, acid food, or drink
- chew gum flavored mainly with Xylitol, a naturally occurring sugar substitute such as Trident for Kids®
- avoid juices (especially orange juice with pulp), carbonated sports drinks, and water with acid added like Vitamin waters ... read the label and look for acetic, phosphoric, or other acids
Normal saliva pH greater than pH 6.3 drops to about pH 3.5 after eating because bacteria create acid from our food. Saliva usually neutralizes that acid very quickly unless our food supply is constantly being replenished. Demineralization (dissolving) of enamel begins at about pH 5.5!
- do not let your child brush when experiencing symptoms of GER as brushing will remove recently dissolved enamel
- review resources for an in-depth understanding of GER:
- Articles on the internet (type GER or GERD into the search engine) or Libraries & Bookstores
- work with your child to assist him/her to be able to accurately describe:
how often reflux occurs
what it feels like when reflux occurs
how long has he/she been aware of refluxing
what time of day it occurs (bedtime, after meals, upon awakening)
whether certain foods seems to be related to refluxing (make a list)
Once you have gathered all the information you can, keep a diary of your child's symptoms. If symptoms, in addition to dental erosion are present, contact your child’s pediatrician for an evaluation of the need for diagnostic tests and/or medication.
Long term medical and dental risks:
If untreated, GER can predispose your child to esophageal (throat) problems in adulthood. There is a higher risk for tooth decay as saliva cannot neutralize the strong acid