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In people suffering from heartburn, dental evaluations (dental erosions, periodontal diseases) are useful for differential diagnosis of functional heartburn and GERD.
A study depicted that the differentiation of gastroesophageal reflux disease (GERD) from functional heartburn (FHB) can be facilitated by conducting dental evaluations. The presence of dental erosions (DE) and periodontal diseases (PD) usually pointed to GERD, while the absence of dental disorders was often linked with FHB. Krisztina Helle et al. conducted a study to assess the occurrence of DE and PD in individuals experiencing heartburn.
The study also explored the connections between these dental conditions and both GERD and FHB. The study involved 116 subjects with heartburn (51 males, 65 females) aged 17 to 80 years. They underwent esophageal and orodental examinations. Medications affecting digestion were stopped one month before esophageal testing. Gastroscopy was performed with local anesthesia, and esophageal issues were noted.
Using the Los Angeles criteria, esophagitis severity was measured. Based on this criterion, a scoring system (0 for no erosion, 1 for LA-A, 2 for LA-B, 3 for LA-C, and 4 for LA-D) was utilized to quantitatively examine the extent of esophagitis. Major motility disorders were ruled out through high-resolution esophageal manometry as per the Chicago classification 3.0. pH-impedance monitoring required the careful positioning of a pH sensor, with guidance from manometry, approximately 5 centimeters above the lower esophageal sphincter.
In 89% (103/116) of participants, dental diseases were detected. Individuals with both PD and DE displayed notably elevated esophagitis scores (1.8 versus 0.9), higher occurrences of pathologic reflux (90.0% versus 27.8%), and a distinct mean impedance curve when contrasted with those who did not have any dental diseases. Conversely, when examining patients with GERD, a considerably greater incidence of DE and PD, particularly when both were present (28.9% versus 2.0%), more severe PD (1.5 versus 1.0), and a longer history of heartburn (15 years versus 9 years) were observed in comparison to those with FHB.
For differential diagnosis of GERD and FHB, conducting a dental assessment for individuals experiencing heartburn appears to be beneficial. DE and PD were often indicative of GERD, while the absence of dental problems commonly associated with FHB was a significant diagnostic indicator.
World Journal of Gastroenterology
Dental evaluation is helpful in the differentiation of functional heartburn and gastroesophageal reflux disease
Krisztina Helle et al.
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