Anapplepie97

Dental relevance

Oral manifestations

Frontal view of severe tooth erosion caused by endogenous acid in a patient with GERD.

Maxillary occlusal view of severe tooth erosion caused by endogenous acid in a patient with GERD.

Acid reflux into the mouth can cause breakdown of the enamel, especially on the inside surface of the teeth. A dry mouth,, acid or burning sensation in the mouth, bad breath and redness of the palate may occur. Other not so common symptoms of GERD include difficulty in swallowing, water brash which is flooding of the mouth with saliva, chronic cough, hoarse voice, nausea and vomiting.

Besides, saliva is one of the main protection of our teeth, the mucosa of the oropharynx and of the oesophagus. Proton pump inhibitors (PPIs), a drug which is commonly given in patients who have GERD to suppress the amount of acid produced in the stomach can actually cause hyposalivation, a condition where there is decreased amount of saliva in the mouth, thus having less protective effect on the structures in our oral cavity.

Dental considerations

Dentists are often the first healthcare professional in detecting several systemic health issue by their oral manifestations, including GERD. Early recognition of such manifestations is crucial to stop the progression of dental erosions. Furthermore, dentists should also carry out a thorough examination and history taking to address the dental implications of the GERD symptoms. It should include medical history, dietary history, occupational and recreational history, dental history as well as intraoral examination, head and neck examination, and assess salivary functions.

Dietary history: Diet may lead to dental erosions such as frequent consumption of soft drinks and acidic citrus fruits shall be questioned specifically in order to rule out other causes of dental erosions.

Intraoral examination: It is of utmost importance to differentiate erosion from other lesions such as abrasion, attrition and abfraction beside evaluating its progression. Typical signs of enamel erosion on buccal and lingual sites are the appearance of a smooth, silky-glazed, sometimes dull, enamel surface with the absence of perikymata, together with intact enamel along the gingival margin.

Dental history: It will be evident in patients with restorations as tooth structure typically dissolves much faster than the restorative material, causing it to seem as if it “stands above” the surrounding tooth structure.

Salivary function: Check for any reduction in the loss of saliva secretion as it may contribute to the progression of enamel erosion.

Selection of dental restorative materials used in managing dental erosion is multifactorial, depending on analysis of remaining tooth structure, amount and location of tooth loss, and occlusion. The patients affected by severe erosive destruction need complex occlusal rehabilitation. The placement of extensive restorations like porcelain veneers only and full veneer crowns is utilized. Besides that, direct acid-etched composite can also be used as a restorative material for less severe erosions. Direct composite restorations are recommended for vertical dimension loss of less than 2 mm, while indirect ceramic veneer and overlays are recommended for more than 2 mm loss in vertical dimension.

References

References

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We also provide style advice about the structure and content of medicine-related encyclopedia articles. The welcome page is another good place to learn about editing the encyclopedia. If you have any questions, please feel free to drop me a note. Doc James (talk · contribs · email) 23:10, 31 January 2020 (UTC)

Each aspect should be discussed in the appropriate section. Symptoms of GERD on the teeth should be discussed in that section. Treatment of dental injuries from GERD should be discussed in that section rather than a specific section "Dental relevance".

Done some adjusting above. Let me know if you want to try integrating or should I? Doc James (talk · contribs · email) 23:12, 31 January 2020 (UTC)

Intergrated some[1] Doc James (talk · contribs · email) 23:26, 31 January 2020 (UTC)

Your class

How do I provide advice to your class generally? We should not have sections called "dental relevance" "dermatology relevance", oncology relevance, anesthesia relevance, etc etc etc. You need to integrate content into the article. As I had started doing. Doc James (talk · contribs · email) 01:18, 2 February 2020 (UTC)

Hi, so sorry for the late reply as we did not notice our notifications and the talk section. I have read through your comments and tried to amend and integrate the content accordingly. Thank you for your kind help and guidance. Anapplepie97 (talk) 11:15, 2 February 2020 (UTC)

Okay next issue is the content need to be specifically about GERD.

This content

Teeth

First step is to identify the source of dental erosions by ruling out any other possible etiological factors. Then preventive measures should be carried out by reducing intake of acidic food and drinks, increasing fluoride level and improving salivary flow rates. Restorative treatment could also be considered for patients with severe tooth loss.

Selection of dental restorative materials used in managing dental erosion is multifactorial, depending on analysis of remaining tooth structure, amount and location of tooth loss, and occlusion. The patients affected by severe erosive destruction need complex occlusal rehabilitation. The placement of extensive restorations like porcelain veneers only and full veneer crowns is utilized. Besides that, direct acid-etched composite can also be used as a restorative material for less severe erosions. Direct composite restorations are recommended for vertical dimension loss of less than 2 mm, while indirect ceramic veneer and overlays are recommended for more than 2 mm loss in vertical dimension. Post- treatment follow-up and counseling are also recommended to ensure a favourable prognosis of these restorative procedures.

Is supported by refs that do not EVEN mention GERD. This belongs at dental erosion not at GERD. Doc James (talk · contribs · email) 00:50, 3 February 2020 (UTC)