Children with acid reflux more likely to have poor dental health

By Kate Vidinsky

Melvin Heyman, MD

Children who have symptoms of chronic acid reflux are significantly more likely to have dental erosions than those without reflux symptoms, according to a new study led by researchers at the University of California, San Francisco.

The study, which is the first to examine the relationship between acid reflux and dental health in pediatric patients, was presented today, May 4, 2009, at the Pediatric Academic Societies annual meeting in Baltimore, Md.

The research is also among the first to find a conclusive link between chronic acid reflux and dental erosions in any age group, as previous studies have produced inconsistent results, according to Melvin Heyman, MD, chief of pediatric gastroenterology, hepatology and nutrition at UCSF Children’s Hospital and the study’s senior author.

“These findings demonstrate that we really need to start looking for dental erosions in pediatric patients with chronic acid reflux and integrate proper dental care into their treatment regimens,” Heyman said.

Researchers from UCSF Children’s Hospital and the UCSF School of Dentistry compared the dental health of young patients 9 to 17 years old who had symptoms consistent with gastroesophageal reflux disease, or GERD, with a group of healthy controls who had no symptoms and were in the same age group. They found that children with GERD were almost six times more likely to have substantially eroded teeth than children without reflux.

According to Peter Rechmann, DDS, PhD, a professor of dentistry at UCSF and director of the Clinical Sciences Research Group in the Department of Preventive and Restorative Dental Sciences, dental erosions wear away the tooth’s outer covering, the enamel, and leave the weaker underlying tissue, called dentin, exposed. This can lead to a permanent weakening of the teeth, a predisposition to tooth decay, and often a need for major dental work to repair and disguise eroded teeth.

GERD is a chronic form of acid reflux that occurs when the muscular valve at the lower end of the esophagus opens spontaneously, causing stomach acid to seep back up through the esophagus, according to the National Institutes of Health. Children with GERD often experience heartburn, nausea, vomiting, asthma and other respiratory problems.

According to Heyman, GERD can be alleviated by taking certain medications and by adopting better eating habits, like not overeating or losing extra weight. However, if it is not treated properly, GERD can lead to a host of complications, including ulcers and even pre-cancerous changes in the lining of the esophagus.

A total of 80 children participated in the study – 60 had symptoms of GERD and 20 served as controls. Each subject was evaluated for GERD and had a thorough dental examination. In order to eliminate bias, the health care providers who performed the dental exams did not know whether a particular patient had been diagnosed with GERD.

“Having shown that there is a positive correlation between GERD and dental erosions, we must now try to determine exactly what causes children with reflux to develop these erosions,” said Ann Clark, BS, a research assistant in Heyman’s laboratory and co-author who presented the findings at the conference.

Additional co-authors of the study are Beate Rechmann of the Department of Preventive and Restorative Dental Sciences at the UCSF School of Dentistry, and Janet Wojcicki, PhD, MPH, of the Division of Pediatric Gastroenterology, Hepatology and Nutrition at UCSF Children’s Hospital.

The research was supported through a combination of funds from NIH and Takeda Pharmaceuticals North America, Inc.

One of the nation’s top children’s hospitals, UCSF Children’s Hospital creates an environment where children and their families find compassionate care at the healing edge of scientific discovery, with more than 150 experts in 50 medical specialties serving patients throughout Northern California and beyond. The hospital admits about 5,000 children each year, including 2,000 babies born in the hospital.

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