Acid Reflux and Dental Health

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Did you know that your digestive health can affect your teeth? If you have a frequent stomach upset it can cause a gradual wearing away of the protective enamel on your teeth. This process is known as tooth erosion. This can affect the appearance of your teeth. Moreover, it can open the door for harmful bacteria to enter your mouth that might cause cavities.

This stomach upset is commonly referred to as acid reflux. Acid reflux, also known as GERD, affects more than 50% of adults and 37% of young people. It occurs when the contents of your stomach end up in the esophagus and oral cavity. The scenario is the result of an inadequate closure of your esophageal sphincters. 

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The pain of heartburn is a common symptom that occurs in only 10% of people. While others might experience symptoms like post-nasal drip, hoarseness, sore throat, throat clearing, chronic cough, difficulty in swallowing, choking, asthma-like wheezing and chest pain.

What is Acid Reflux?

Acid reflux could be an uncomfortable situation for you. But do you know that it can silently damage your teeth in the process? How does acid reflux occur? It occurs when acid produced by your stomach moves up into the esophagus. This slowly causes chest pain known as heartburn. 

That same acid when it reaches your mouth can wear away the enamel of your teeth. The tooth enamel is the strongest substance in your body. It is a hard outer layer that protects your teeth from extreme temperatures, chemicals and acids.

However, this strong shell can erode over time. Leaving your teeth vulnerable to tooth cavities and tooth decay. Your first clue will  be that cold or hot food, drinks, and sweets that start bothering your teeth. 

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That is because food particles are getting in via holes in your enamel . Thus aggravating your nerves within your tooth root.

Stomach acid slowly eats away at the enamel on your teeth. You might notice a pattern of enamel loss on the back teeth. This can be an indication to your dentist that you have GERD.

How Do Stomach Problems Affect Your Teeth?

Your stomach continuously produces natural acids that help your body digest food. At times these acids travel up your throat and into the mouth. This behaviour is noticed especially after you have a large meal. Ordinarily, your saliva rebalances the acid levels in your mouth and everything is just fine. 

Gastroesophageal reflux is also known as GERD or acid reflux. For people who suffer from gastroesophageal reflux the gastric acids reach the mouth during the day. This process is very damaging when you are sleeping. Since you swallow less often while you sleep and your mouth produces less saliva.

Another concern is the dry mouth often caused by several acid reflux medicines you take. Saliva in your mouth helps neutralize the acids caused by acid reflux. Besides, it also helps to wash away food particles present on your teeth. Thus reducing the bacteria that attack your tooth enamel. This is why lower saliva production by your salivary glands might increase your risk for tooth cavities.

How Acid Reflux Affects Your Teeth?

There is a ring of muscle situated at the bottom of your esophagus. This is called the lower esophageal sphincter which acts as a one-way valve. Helping to keep your stomach contents from moving back up your digestive tract into your throat. 

But when this muscle becomes weak or damaged, the stomach acids can travel up into the esophagus. And it can even enter your mouth. As your stomach contents start to flow backwards, a burning sensation is felt in your throat or chest. As a result, heartburn and acid indigestion might result. A prominent sign of GERD is tooth erosion. A breakdown of your tooth’s protective outer coating or the enamel is caused by acid washing. 

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On the pH scale, which measures acidity, a normal healthy oral pH is about 7.0 (same as that of pure water). A more acidic solution with a pH of 5.5 or lower starts to dissolve your tooth enamel. Stomach acid has a pH of 2.0 or less and is strong enough to break down the food. And it is also capable of causing serious dental damage.

Unfortunately, you may not notice how acid reflux will affect your oral health. Until severe damage has already been done – which can only be examined by your dentist. 

Erosion from acid reflux is most frequently seen on the inside surfaces of upper teeth. These teeth can become sharp, thin, chipped, pitted, yellow and sensitive. Which might require extensive and also expensive dental work in the future. 

A lower salivary pH in your mouth can also damage the soft tissues and is linked to periodontal or gum disease. A 2014 study confirmed a strong correlation between acid reflux and chronic periodontitis. 

Periodontal disease is the inflammation of your gums and other supporting structures of your teeth. It could even cause bone loss. Periodontitis can also cause teeth to become loose from the gums and eventually fall out.

Even if you experience very subtle symptoms of acid reflux, you can have dental erosion and gum disease. So your dentist can only help identify the condition and suggest the right treatment plan.

Acid Reflux Erodes Your Teeth

Do you know that acid reflux can wear away your enamel on the inside surfaces of your teeth? It can wear away the chewing surfaces as well. Your dentist might notice this during a dental check-up.

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Unfortunately, your tooth erosion is permanent. If the enamel of your teeth has started to wear away, you might feel the following symptoms:

  • Feel pain or sensitivity when taking hot, cold or sweet drinks.
  • Notice an uncommon yellowish discoloration of the teeth.
  • Notice that your fillings have changed.
  • You might face greater risks for tooth cavities over time.
  • Develop a tooth abscess in extreme cases.
  • Even experience tooth loss, also in extreme cases.

Once tooth erosion occurs, you may need dental crowns, tooth fillings, a root canal treatment or even extraction. Dental veneers may be an option to restore the look of your smile.

Oral Symptoms of Acid Reflux

Oral symptoms of acid reflux may include any of the following:

  • Excess salivation
  • Dysphagia
  • Sour taste
  • Pain on swallowing
  • Tooth sensitivity
  • Generalized mouth pain and irritation
  • Demineralization of enamel (initially chalky look)
  • Excessive erosion of enamel – may be located on the palatal surfaces of the maxillary teeth initially
  • Chronic decay

What Can You Do? Visit Your Dentist

The loss of your tooth enamel is permanent and can increase your risk of tooth decay in the long run. Remember your tooth enamel is a protective layer on the outside of your teeth. Acid reflux can cause other long-term damage, such as inflammation and irritation of your esophagus. This will make you more susceptible to esophageal cancer when you age.

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Hence getting a regular oral check-up from your dentist is essential. As your dentist may find early symptoms of a potentially serious problem of acid reflux before it progresses. Interestingly more than 90% of systemic diseases have some type of oral manifestations. Which may be detected during an oral examination by your dentist.

How to Protect Your Teeth if You have Acid Reflux?

There are several things that can eat away your teeth enamel. Eating too many sweets, sour food, dry mouth condition, binge drinking, drugs with high acids in them, brushing your teeth too hard, and teeth grinding also called bruxism. 

Perhaps the most damaging of all the above-mentioned conditions is acid reflux disease. A few of these tips can help prevent acid reflux from damaging your teeth:

1 Chew only sugar-free gum to reduce the amount of acid.

In order to stimulate saliva production, try to chew sugar-free xylitol gum. The saliva will help to neutralize acid and minerals that help build up of plaque. Almost all chewing gums will stimulate saliva. But chewing gum with the sugar substitute xylitol is especially beneficial. It helps to interfere with the chemical reaction between the acid and your tooth structure. This reduces the calcium loss. Chewing gum also has the added benefit of assisting in the production of more saliva. Eventually helping to strengthen your teeth with minerals.

2 Do not brush your teeth just after acid reflux.

You should refrain from brushing your teeth immediately after an acid reflux episode. Acid tends to soften your tooth enamel. So wait an hour so that the saliva can wash out the acid and help to build the minerals in the teeth. Once the acidity levels normalize, your tooth enamel will re-harden.

3 After a reflux episode, rinse your mouth with water.

Do not brush your teeth immediately after an acid reflux episode. Instead, rinse your mouth with normal water. You can also use a mouth rinse to help neutralize acidity in your mouth. 

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4 Neutralize the acid.

You need to neutralize the acidic effect. Mix half a teaspoon of baking soda in a cup of water and use it to rinse your mouth. Else you can chew an antacid tablet or rinse with antacid suspension. Sugar-free forms of antacids are best.

5 Ask your dentist about fluoride treatments.

Discuss with your dentist about fluoride treatments in order to strengthen your teeth. These could include fluoride toothpaste, special mouth rinses or in-office treatments. Toothpaste that contains ACP or amorphous calcium phosphate can also be beneficial in preventing erosion.

6 Food items that might trigger acid reflux.

Researchers have compiled a long list of food items that might trigger heartburn. You need to identify any food that could trigger an acid reflux attack which could be alcohol, acidic or spicy foods, citrus fruits, beverages and caffeine. Some people find it helpful to eat smaller meals and to make sure they finish eating three hours before bedtime.

Keep Your Acid Reflux Under Control

See your dentist every six months for a thorough cleaning and check-up. Brushing and flossing as directed can be helpful. And consult your dentist if there are any issues that may concern you.

You should also visit a gastroenterology specialist. Your doctor might be the right person to advise you on ways to control your acid reflux. Thus helping the acid to reach your teeth in the first place. Your doctor might ask you to lose weight, eat smaller meals, avoid acidic foods, refrain from lying down right after dinner, quit smoking, and reduce alcohol intake.

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