Dental Problems in Children with GERD

Copyright Pediatric Adolescent Gastroesophageal Reflux Assocation ( This document is medically reviewed and used with permission.


Question: Do children with acid reflux have more dental problems than other children?

Answer: Yes, there is some evidence that children with pediatric acid reflux are more likely to experience several types of dental problems including: cavities, bad breath and enamel erosion. Children with acid reflux who experience frequent vomiting (daily, weekly) are especially at risk for tooth decay.

Question: Why do children with acid reflux have more dental problems than other children?

Answer: Acid Reflux can cause the teeth to be exposed to acid due to the abnormal backwashing of stomach contents into the esophagus and mouth. Stomach acid is very caustic and can quickly strip away the outer layer of enamel, especially on the inner surfaces of the teeth next to the tongue.
Some children with acid reflux may experience the following problems:

  • Poor nutrition in infancy may lead to soft teeth.
  • Frequent meals and snacks may lessen reflux symptoms but cause an increase in tooth decay.
  • The child with acid reflux may favor a diet rich in carbohydrates. Unfortunately, starchy foods tend to stick on the teeth and cause decay.
  • Multiple medications may be needed to treat reflux and associated complications. However, sugar is frequently added to medications and is known to cause tooth decay.
  • Some medications decrease saliva, which helps to “wash” the teeth of food and irritants.
  • Some children with acid reflux dislike toothbrushing due to oral sensitivity, a hyperactive gag reflex or negative oral experiences. In addition, enamel erosion can cause sensitivity and make toothbrushing unpleasant.
  • Many children report that toothpaste tastes bad and they are less likely to brush their teeth effectively as a result.
  • A pacifier may help with the fussiness associated with acid reflux but it can lead to problems with tooth alignment later on.
  • Fluoride, a key component of dental health may be lacking.
  • Dental care may be overlooked in a child with overwhelming medical needs. There may be little time and money left to attend to dental health.
  • Going to the dentist may be traumatic for a child with oral sensitivity, a strong gag reflex, swallowing difficulties, nausea and vomiting.
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