Dental erosion, gastro-oesophageal reflux disease and saliva: how are they related?

Aims. The purpose of this study was to assess the prevalence of tooth wear, symptoms of reflux and salivary parameters in a group of patients referred for investigation of gastro-oesophageal reflux disease (GORD) compared with a group of control subjects. Materials and methods. Tooth wear, stimulated salivary flow rate and buffering capacity and symptoms of GORD were assessed in patients attending an Oesophageal Laboratory. Patients had manometry and 24-h pH tests, which are the gold standard for the diagnosis of GORD. Tooth wear was assessed using a modification of the Smith and Knight tooth wear index. The results were compared to those obtained from a group of controls with no symptoms of GORD. Results. Patients with symptoms of GORD and those subsequently diagnosed with GORD had higher total and palatal tooth wear (p < 0.05). The buffering capacity of the stimulated saliva from the control subjects was greater than patients with symptoms of GORD (p < 0.001). Patients with hoarseness had a lower salivary flow rate compared with those with no hoarseness. Conclusions. Tooth wear involving dentine was more prevalent in patients complaining of symptoms of GORD and those diagnosed as having GORD following 24-h pH monitoring than controls. Patients had poorer salivary buffering capacity than control subjects. Patients complaining of hoarseness had lower salivary flow rate than controls. (C) 2004 Elsevier Ltd. All rights reserved.