Dental erosion in gastro-esophageal reflux disease. A systematic review.

The growing interest reflected in the studies on dental erosion is justified by the severe health problems it entails, i.e. esthetic, phonetic, masticatory disturbances and pulp complications. Most studies investigate the prevalence of dental erosion in adults and children, the severity of lesions and etiopathogenetic factors.

Background and aim: Dental erosions (DE) are one of the extraesophageal complications of gastroesophageal reflux disease (GERD). An increasing amount of papers shed light on this topic. We carried out a systematic review on the association between GERD and DE.

Methods: We studied the association between DE and GERD in adults and children. The search for published studies was performed in PubMed using search terms "dental erosion" and "gastro-esophageal reflux disease". References published since 2007 were included and a systematic review was carried out. Articles not assessing DE in GERD patients were excluded, and also case presentations and articles in languages of limited circulation. The prevalence of DE in patients with GERD, extrinsic and intrinsic etiological factors of DE and the severity of dental erosion lesions were analyzed.

Results: A total of 273 articles were found, 10 studies being retained for analysis. Correlations between DE and GERD, namely the prevalence and severity of dental erosion in GERD patients, were investigated. DE prevalence was between 10.6% - 42%, median 25.5%. Mean values of DE prevalence were 48.81% in GERD patients, compared to 20.48% in non-GERD controls. Comparative values of DE frequency in adults with GERD was 38.96%, compared to 98.1% in children with GERD.

Conclusions: DE is a condition associated with GERD. DE prevalence is higher in GERD patients. Intrinsic pathogenetic factors with direct action on the hard dental tissues are GERD, while extrinsic factors are represented by diet. Among the patients diagnosed with GERD, youth under the age of 18 had a higher frequency compared to adults.