Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease (GERD) is the passage of gastric contents into the esophagus, a condition which affects an estimated 10% of the US population on a daily basis. The most definitive tool for diagnosing GERD is a 24-hour pH monitoring of the esophagus, while the most widely accepted criteria for diagnosis of GERD is the occurrence of heartburn two or more times per week. GERD can be the result of a faulty lower esophageal sphincter muscle, increased abdominal pressure which results in improper acid removal by esophageal muscles, or an overproduction of stomach acid. .

More deleterious symptoms of GERD include erosion of teeth and esophageal cancer. Dental erosion is defined as irreversible loss of dental hard tissue by a chemical process not involving bacterial action. The outer enamel surface of teeth dissolves as a result of the introduction of gastric acid into the mouth. This erosion can further be promoted by the consumption of dietary acids such as fruits/juices and soda. The loss of enamel results in the exposure of the softer, more caries prone dentin layer. Patients with advanced erosion will also experience increased sensitivity to temperature and biting, requiring extensive restorative therapy. Additional symptoms of erosion are changes in bite, formation of spaces between teeth, drifting and tipping of teeth, and loss of vertical dimension. Patients with acid erosion are encouraged to begin daily fluoride rinses and to use prescription fluoride toothpaste with A.C.P. (Amaphous Calcium Phosphates) to re-mineralize enamel surfaces and impede further erosion.

There are two types of esophageal cancer - squamous and adenocarcinoma. Squamous form is more common in African Americans and smokers/drinkers, while adenocarcinoma is more common in Caucasians and those diagnosed with GERD.