When you settle into our dental chair, you may not feel as though you are visiting Sherlock Holmes and Dr. Watson. But much of our work involves playing dental detective. Sometimes we may find the first clues that identify a systemic disease or disorder. When we see enamel worn away on molars or on the back of other teeth, and we can rule out tooth-grinding as a cause, the most likely suspect is gastroesophageal reflux disease (GERD).
How can a person have a condition as typically uncomfortable as GERD and not know it? After all, GERD is also known as acid reflux disease. People with GERD suffer from a malfunction of the esophageal sphincter, a kind of valve situated between the esophagus and stomach that normally prevents stomach acid from backing up into the esophagus. If the valve doesn’t close, the acid comes up. All that regurgitated acid usually spells heartburn.
But not everyone with GERD experiences heartburn. Other symptoms—which aren’t exclusive to GERD, and thus can throw clinicians off the GERD trail—can include dry mouth, chest pain, sore throat or the sensation of a lump in the throat. Although heartburn may eventually develop, we may be the first to see visible evidence of GERD: enamel loss.
Hydrochloric acid—the primary ingredient of what “comes up” during a reflux episode—is strong enough to destroy tooth enamel. Since enamel doesn’t regenerate, once it’s gone, it’s gone for good (and decay can more easily flourish). But if we catch GERD early enough and treat it aggressively, we can keep enamel destruction to a minimum.
What’s more, early treatment may help to avoid the other possible consequences of untreated long-term GERD. These range from inflammation and swallowing difficulties all the way to esophageal cancer.
Please be sure to keep your regularly scheduled oral health appointments. They not only give you clean teeth but provide a chance for us to view your mouth as a window into your overall health.