Romanian Journal of Oral Rehabilitation (Jul 2013)
EXTRAESOPHAGEAL MANIFESTATIONS OF GASTROESOPHAGEAL REFLUX DISEASE WITH IMPLICATIONS FOR ORAL CAVITY
Abstract
Background: Gastroesophageal reflux disease (GERD) is one of the most common chronic disorders of modern humans. The manifestations of GERD are classically described as heartburn and reflux, but GERD may also present atypically. Common extraesophageal manifestations include reflux cough syndrome, reflux asthma syndrome and reflux laryngitis syndrome which leads to reduced quality of life. Aims: Our purpose was to study the prevalence of extraesophageal symptoms and oral manifestations associated with gastroesophageal reflux disease, to estimate the connection between them, certain risk factors and severity of the disease. Methods: A prospective study was performed in 154 hospitalized patients diagnosed with GERD by barium examination and in some cases by upper gastrointestinal endoscopy and 40 controls with extradigestive diseases. They were screened for oral changes including dental evaluation. Results. The prevalence of extraesophageal symptoms increases significant from 31,81% to 79,22% if oral manifestations are taken into account. We identified statistically significant increased prevalence of oral manifestations in GERD patients: dental erosion 42,2%, oral burning sensation, halitosis, impaired taste, hypersalivation, tooth sensitivity. However the prevalence of caries and other periodontal lesions was similar in reflux patients and controls. Oral symptoms in GERD are likely to be associated with smokers, alcohol intake, consumption of soft drinks and other extraesophageal manifestations. Hiatal hernia and esophagitis were found with a greater frequency in patients with oral symptoms reflecting a severity of the reflux disease more marked or a longer period of evolution. Conclusion: Oral manifestations, other than caries and periodontal lesions are a common finding in patients with GERD and should be considered an atypical manifestation of this disease. Collaborative medical and dental management is therefore required to establish early diagnosis and to prevent a lifetime of debilitating dentition and the need for complex restorative therapy.
