Children with Gastroesophageal Reflux Disease (GERD) are at risk for developing dental problems. During a reflux episode, stomach acid may enter the esophagus and mouth (also called backwashing) exposing the teeth to stomach acid. Over time, the stomach acid can wear out the outer layer of the tooth (called enamel), especially in the back of the mouth and the inside surfaces near the tongue.
Dental Problems associated with GERD include:
Tooth Enamel Erosion: When the protective layer of enamel is worn away, the teeth may be sensitive to foods and temperatures. Sensitivity can make tooth brushing uncomfortable.
Cavities: The dentist may notice a pattern of cavities on the back teeth (molars) and inside surfaces of the teeth in the back of the mouth.
Bad Breath: The backwashing of acid and stomach contents into the mouth (also called regurgitation) may lead to bad breath.
My daughter had a new cavity at each dental check up during the years when her reflux was at its worse. I tried every type of tooth brush and tooth paste and helped her brush daily. Her reflux was worse at night and I think she was just bathing her teeth in acid all night. Reflux was already making her asthma hard to manage. The added dental problems just added to my worries and frustration.
Toddlers and children with long term, chronic reflux symptoms may become highly sensitive to the taste and texture of foods and may resist touch near or in the mouth. This hyper sensitivity to touch and tastes can make daily brushing and oral care an ordeal. Going to the dentist may be traumatic to a child with oral sensitivity. It may be uncomfortable and aversive to have the dentist touch around and in the mouth.
I tried every brand of “kid friendly” toothpaste but they were all flatly rejected by my daughter. The reality is a kid with reflux doesn’t like most flavors that non refluxers find to be appealing. She would taste the bubblegum/fruity/minty flavor while brushing and again, mixed with acid when it backwashed a few minutes later. Who could blame her for avoiding tooth brushing?
Once the reflux is under control through medical treatment such as medication and diet, the teeth will be protected from further damage.
In my next blog, I will discuss recommended treatments and how to find a pediatric dentist for your child.