Gastroesophageal disease (GERD) is caused when there is failure of the lower esophageal sphincter to prevent gastric contents from passing up through the esophagus and into the oral cavity. Typical symptoms of GERD include:

1. Heartburn
2. Hoarseness
3. Regurgitation of food
4. Coughing, wheezing, worsening asthma
5. Belching, nausea and vomiting

While the stomach lining is strong enough to resist the corrosive effects of gastric acids, the esophagus and teeth are not. Tooth enamel begins to erode at a pH of 5.5; gastric acid pH is between 1 and 3. Loss of enamel results in permanent weakening of the teeth. GERD causes the following oral manifestations:

1. Reflux-induced dental erosion of tooth enamel
2. Tooth chipping, sensitivity, yellow discoloration
3. Burning sensation in the mouth
4. Halitosis

Alleviating Measures

• Avoid foods that potentiate reflux: fried/fatty foods, chocolate, garlic, onions, caffeine, citrus fruits/juices, spicy foods, carbonated beverages
• Avoid large meals at one sitting or eating before bedtime
• Avoid brushing teeth immediately after a reflux episode (acid softens enamel and brushing will cause more enamel loss)
• Use a soft toothbrush and avoid aggressive brushing
• Use desensitizing agents and a low-abrasive toothpaste
• After reflux episodes, rinse mouth with water and let a sugar-free antacid dissolve in the mouth
• Use caries preventive measures (sealants, fluoride supplements, antimicrobial mouthwashes)