Gastroesophageal reflux disease (GERD) is a condition where stomach acid frequently flows back into the esophagus. This acid reflux can lead to heartburn and significantly impact oral health. Understanding this link is important for dental well-being.
How Acid Reflux Harms Teeth
Stomach acid is highly corrosive, with a pH of 2.0 or less, far more acidic than the mouth’s neutral pH of 7.0. When this strong acid repeatedly travels into the mouth, it directly interacts with tooth enamel, the hard, protective outer layer of teeth. Enamel begins to demineralize and soften at a pH of 5.5 or lower, making it vulnerable to erosion. This process is distinct from typical tooth decay, which is caused by bacteria producing acids from sugars.
Constant exposure to stomach acid washes away the enamel’s mineral content. While saliva normally helps neutralize acids and remineralize enamel, frequent acid reflux can overwhelm its buffering capacity. This effect is particularly pronounced during sleep when saliva production naturally decreases, allowing acid to linger on tooth surfaces. Over time, this repeated softening and wearing away of enamel can lead to significant and irreversible tooth damage.
Identifying Dental Damage from GERD
Dental damage from GERD often presents with specific signs that differ from conventional cavities. One common symptom is increased tooth sensitivity, particularly to hot, cold, or sweet foods and beverages, as the enamel thins and exposes the underlying dentin. Teeth may also become discolored with a yellowish or dull hue as the darker dentin becomes more visible. Some individuals might notice their teeth appearing more translucent, especially at the edges, or developing a rough, uneven texture.
Teeth affected by GERD can show small indentations or pitting on their surfaces, and existing dental fillings might appear elevated as the surrounding enamel erodes. This type of erosion typically occurs on the lingual (tongue-facing) surfaces of the upper front teeth and the chewing surfaces of the back teeth, distinguishing it from erosion caused by dietary acids. Dentists are often the first healthcare professionals to identify these unique patterns of erosion, sometimes leading to an initial diagnosis of GERD in individuals unaware of their condition.
Protecting Teeth from Acid Exposure
Individuals with GERD can adopt several strategies to protect their teeth from acid exposure:
After a reflux episode, rinse the mouth thoroughly with plain water or a solution of water and half a teaspoon of baking soda to neutralize lingering acids.
Wait at least 30 minutes to an hour before brushing teeth after reflux or consuming acidic foods, as softened enamel can wear further with immediate brushing.
Use fluoride toothpaste, as fluoride strengthens enamel and provides added protection against acid erosion. Dentists may also recommend prescription-strength fluoride products or professional fluoride treatments.
Chew sugar-free gum, especially those containing xylitol, to stimulate saliva production, which naturally helps neutralize acids and remineralize tooth enamel.
Manage GERD through prescribed medications and lifestyle adjustments, such as avoiding trigger foods like spicy dishes, citrus fruits, caffeine, and alcohol, to reduce the frequency of acid exposure.
Attend regular dental check-ups for early detection and management of any dental damage.