Tooth Erosion & Pediatric Gastric Reflux

Tooth erosion, also sometimes called tooth surface loss (TSL), occurs when the surface of the tooth is being destroyed, exposing the underlying softer material. The hard enamel surface of your teeth is important to protect against decay and other dental diseases. You can have tooth erosion because of things like clenching and grinding, improper brushing or chemical corrosion. In children, tooth erosion is frequently caused by chemical corrosion resulting from gastric reflux.

Gastric Reflux

• Gastric reflux is a condition in which acids, bile and enzymes from the stomach back up into the esophagus, throat and mouth. These acids can cause symptoms such as stomach aches, burning in the chest or throat, and a funny taste in the mouth. While the prevalence of acid reflux decreases with age, kids who have reflux are prone to related problems and conditions, including tooth erosion.

Tooth Erosion

• The most common place for tooth erosion is on the back of the front teeth, because this are is farthest from the salivary glands. Saliva helps reduce the impact of gastric reflux in the mouth.

Progression

• You may first notice tooth erosion because of reduced luster on the teeth. This may be followed by increased sensitivity of the teeth to hot and cold, and finally by loss of enamel to the point where the dentin is exposed.

Diagnosis

• The root cause of a child's tooth erosion may be difficult to identify, because the child may have several other factors besides gastric reflux that contribute to or cause tooth erosion. For example, the rate of saliva flow can affect tooth erosion, as can movement of the cheeks and tongue, tooth shape and diet. Diagnosis is also complicated by the fact that a child often cannot describe her symptoms. A parent’s observation of symptoms such as burping and excessive drool can help lead to an appropriate diagnosis.

Treatment

• Tooth erosion should be treated by a dentist to prevent further erosion and other dental problems. Typical treatment includes applying dental sealants to the teeth, which is becoming a more common practice in pediatric dentistry in general. Pediatric gastric reflux should be treated by a physician rather than with over-the-counter adult remedies. The exact treatment depends on the symptoms. Typical treatment may include medication, nutritional therapy and behavioral modification.

Prevention

• The best prevention for tooth erosion caused by gastric reflux is to control the gastric reflux. Parents can have a significant positive impact by limiting their children’s consumption of acidic foods such as sodas, citrus fruits and juices.