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BMC Gastroenterology

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Open Access 01-12-2017 | Research article

Longitudinal study of gastroesophageal reflux and erosive tooth wear

Authors: Clive H. Wilder-Smith, Andrea Materna, Lukas Martig, Adrian Lussi

Published in: BMC Gastroenterology | Issue 1/2017

Abstract

Background

Approximately 60% of patients presenting to dentists with erosive tooth wear have significant gastroesophageal reflux (GERD), despite minor reflux symptoms. No longitudinal studies of reflux-associated erosive tooth wear and of reflux characteristics have been reported to date.

The aim of this study was to characterize the longitudinal course of GERD and of associated erosive tooth wear, as well as factors predictive of its progression, in a large group of patients.

Methods

Seventy-two patients presenting to dentists with clinically significant erosive tooth wear and increased esophageal acid exposure by 24-h multichannel intraluminal pH-impedance measurement (MII-pH) were re-assessed clinically and by MII-pH after 1 year treatment with esomeprazole 20 mg twice-daily. Predictive factors for erosive tooth wear were assessed by logistic regression.

Results

At follow-up, no further progression in erosive tooth wear was observed in 53 (74%) of patients. The percentage of time with a pH < 4, the number of acid reflux episodes and the percentage of proximal esophageal reflux off-PPI did not change significantly after one year, but the number of weakly acidic reflux episodes decreased significantly in the large subgroup without progression. None of the baseline demographic, clinical, endoscopic or esophageal acid exposure characteristics were significantly associated with progression of erosive tooth wear at follow-up.

Conclusions

In this longitudinal study in patients with erosive tooth wear and oligosymptomatic GERD receiving esomeprazole for one year, erosive tooth wear did not progress further in the majority of patients. Background acidic esophageal reflux exposure appeared stable over time, whereas weakly acidic exposure decreased significantly in patients without erosion progression. MII-pH measurements on-PPI and with healthy controls will be useful in the further elucidation of the causal role of reflux in erosive tooth wear.

Trial registration

ClinicalTrials.gov, retrospectively registered: NCT02087345.

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Title: Longitudinal study of gastroesophageal reflux and erosive tooth wear
Authors: Clive H. Wilder-Smith
Andrea Materna
Lukas Martig
Adrian Lussi
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Gastroenterology / Issue 1/2017
Electronic ISSN: 1471-230X
DOI: https://doi.org/10.1186/s12876-017-0670-1

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