Prevalence of erosive wear lesions in Gastro-Esophageal Reflux Disease patients – A case series

Authors

  • Prema Sukumaran University of Malaya
  • Siti Nurshakina Abdul Kamar Faculty of Dentistry, University of Malaya
  • Nur Azwa Nadia M Zalani Faculty of Dentistry, University of Malaya
  • Divya Nambiar Ministry of Health, Malaysia
  • Rathna Devi Vaithilingam Department of Restorative Dentistry, University of Malaya
  • Khean Lee Goh Faculty of Medicine, University of Malaya

DOI:

https://doi.org/10.22452/adum.vol28no1

Keywords:

GERD, tooth wear, BEWE, prevalence

Abstract

Extra esophageal manifestation of Gastro-esophageal reflux disease (GERD) include erosive wear dental lesions. Early erosive wear lesions in this group of patients can be easily missed as they are accompanied by few clinical signs and hardly any symptoms. This case series aims to report the prevalence and severity of erosive wear lesions amongst a sample of GERD patients in Malaysia. Eleven subjects with well characterized GERD, diagnosed based on modified Reflux Disease Questionnaire (RDQ) or via endoscopy, were included in this case series. A standardized intra oral clinical examination was performed to assess presence and severity of erosive wear lesions on tooth surfaces using Basic Erosive Wear Examination (BEWE) index. Majority of BEWE score 1 lesions were distributed in maxillary anterior teeth, followed by maxillary posterior and mandibular teeth. BEWE score 2 lesions were most prevalent in maxillary anterior teeth and there were no BEWE score 3 lesions observed. Based on the clinical findings, more erosive wear lesions were found on the buccal surfaces of maxillary and mandibular teeth in GERD patients. This case series further confirms the link between GERD and erosive wear lesions. The authors would like to highlight the need for both medical and dental practitioners to be aware of early clinical presentations of GERD and erosive wear lesions. Early diagnoses allow for intervention and conservative management of these conditions.

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Author Biography

Siti Nurshakina Abdul Kamar, Faculty of Dentistry, University of Malaya

Undergraduate student

Faculty of Dentistry, University of Malaya

References

1. Ab Halim N, Esa R, Chew HP. General and erosive tooth wear of 16-year-old adolescents in Kuantan, Malaysia: prevalence and association with dental caries. BMC Oral Health. 2018;18(1):11-18. DOI: 10.1186/s12903-017-0451-9.
2. Addy M, Shellis RP. Interaction between attrition, abrasion and erosion in tooth wear. Monogr Oral Sci. 2006;20:17-31. DOI: 10.1159/000093348.
3. Bargen JA, Austin LT. Decalcification of teeth as a result of obstipation with long continued vomiting: Report of a case. J Am Dent Assoc. 1937;24: 1271.
4. Bartlett D, Ganss C, Lussi A. Basic Erosive Wear Examination (BEWE): a new scoring system for scientific and clinical needs. Clin Oral Investig. 2008;12 (Suppl 1) S65-68.
5. Chandra A, Moazzez R, Bartlett D, Anggiansah A, Owen WJ. A review of the atypical manifestations of gastroesophageal reflux disease. Int J Clin Pract. 2004;58(1):41-48.
6. Chang CS, Poon SK, Lien HC, Chen GH. The incidence of reflux esophagitis among the Chinese. Am J Gastroenterol. 1997;92:668-671.
7. Dent J, El-Serag HB, Wallander MA et al. Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2005; 54:710-717.
8. Goh KL, Choi MG, Hsu WPI, Chun HJ, Mahachai V, Kachintorn U, Leelakusolvong S, Kim N, Rani AA, Wong BCY, Wu J, Chiu CT, Chu R, Shetty V, Bocobo JC, Chan MM, Lin JT. Unmet treatment needs of gastroesophageal reflux disease in Asia: Gastroesophageal reflux disease in Asia Pacific Survey. J Gastroen Hepatol. 2014;29(12):1969-1975.
9. El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2014;63(6):871-880.
10. Ho KY, Kang JY, Seow A. Prevalence of gastrointestinal symptoms in a multiracial Asian population, with particular reference to reflux-type symptoms. Am. J. Gastroenterol. 1998;93(10):1816-1822.
11. Ho KY. From GERD to Barrett's esophagus: Is the pattern in Asia mirroring that in the West? J Gastroen Hepatol. 2011;26(5):816-824.
12. Holbrook WP, Furuholm J, Gudmundsson K, Theodors A, Muerman JH. Gastric reflux is a significant causative factor of tooth erosion. J. Dent. Res. 2009;88(5):44244-6.
13. Johansson A, Johansson A-K, Omar R, Carlsson GE. Rehabilitation of worn dentition. J Oral Rehabil. 2009; 35(7):548-566.
14. Johansson AK, Lingstrom P, Birkhed, D. Comparison of factors potentially related to the occurence of dental erosion in high- and low-erosion groups. Eur J Oral Sci. 2002;110:204-211. DOI:10.1034/j.1600-0447.2002.11211.x.
15. Kang JY, Tay HH, Yap I, Guan R, Lim KP, Math MV. Low frequency of endoscopic esophagitis in Asian patients. J Clin Gastroenterol. 1993;16(1):70-73
16. Li W, Liu J, Chen S, Wang Y, Zhang Z. Prevalence of dental erosion among people with gastroesophageal reflux disease in China. J Prosthet Dent, 2017;117(1):48-54.
17. Lussi A, Jaeggi T. Erosion--diagnosis and risk factors. Clin Oral Investig. 2008;12(Suppl 1):S5-13.
18. Mitre MC, Katzka DA. Pathophysiology of GORD: Lower Esophageal Sphincter Defects. Practical Gastroenterology. 2004;44-58.
19. Moazzez R, Smith BGN, Bartlett DW. Oral pH and drinking habit during ingestion of a carbonated drink in a group of adolescents with dental erosion. J Dent. 2000;28(6):395-397.
20. Nik WNNW, Banerjee A, Moazzez R. Gastro-Oesophageal Reflux Disease Symptoms and Tooth Wear in Patients with Sjogren's Syndrome. Caries Res. 2011;45(3):323-326.
21. Rosaida MS, Goh KL. Gastro-oesophageal reflux disease, reflux oesophagitis and non-erosive reflux disease in a multiracial Asian population: a prospective, endoscopy based study. Eur J Gastroen Hepat. 2004;16(5):495-501.
22. Sonnenberg A. Effects of Environment and Lifestyle on Gastroesophageal Reflux Disease. Digest Dis. 2011;29(2):229-234. DOI: 10.1159/000323927.
23. Sujatha S, Jalihal U, Devi Y, Rakesh N, Chauhan P, Sharma S. Oral pH in gastroesophageal reflux disease. Indian J Gastroenter. 2016;35(3): 186-189.
24. Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R, and the Global Consensus Group. The Montreal Definition and Classification of Gastroesophageal Reflux Disease: A Global Evidence-Based Consensus. Am J Gastroenterol. 2006;101:1900–1920. DOI:10.1111/j.1572-0241.2006.00630.x.
25. Wild YK, Heyman MB, Vittinghoff E, Dalal DH, Wojcicki JM, Clark AL, Rechmann B, Rechmann P. Gastroesophageal Reflux Is Not Associated With Dental Erosion in Children. Gastroenterology. 2011;141(5):1605-1611.

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Published

2021-02-11

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Section

Case Report