Dental Erosion, Gastroesophageal Reflux
Conditions
Brief summary
Dental erosions, the chemical dissolution of enamel without bacterial involvement, are considered to be an established complication of gastroesophageal reflux disease (GERD) by the Montreal global consensus statement. Given the high prevalence of dental erosions and the absence of any pH-impedance data or medical management guidelines for GERD-associated dental erosions, reflux characteristics will be characterized using questionnaires, endoscopy and esophageal pH-impedance testing, in successive patients dental erosions referred by dentists for evaluation of GERD. For assessment of the role of additional factors besides H+ activity in the refluxate, a sample of gastric juice will be aspirated during endoscopy and frozen for analysis of pepsin and other proteases. Prognostic factors for progression of dental erosions will be determined by repeating the evaluation after chronic dosing with esomeprazole 20mg twice-daily, which is prescribed to all patients.
Interventions
None listed
Sponsors
Brain-Gut Research Group
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Successive male and female patients * Over 18 years of age presenting to the University of Bern Department of Dentistry and affiliated dentists * Dental erosions
Exclusion criteria
* Non-reflux causes of erosion * Reduced salivary flow and buffering capacity * History of bruxism, eating disorders, recurrent vomiting, severe obesity (BMI\>35kg/m2) or past bariatric surgery * Dietary or abrasive causes for dental erosion
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The % of time with pH<4 and 5.5 during 24-hour pH-impedance | 1 year |
Secondary
| Measure | Time frame |
|---|---|
| The number of acidic and weakly acidic reflux episodes during 24-hour pH-impedance | 1 year |
Other
| Measure | Time frame | Description |
|---|---|---|
| Association between dental erosion grades, gastric juice pepsin conc. and reflux episodes and % time with pH<4 and <5.5 during 24-hour pH-impedance | 1 year | the % of reflux episodes reaching 15cm above the lower esophageal sphincter, concentration of pepsin and the tooth wear (BEWE) score: multivariate analysis with forward and backward elimination model to assess the best predicting variables. |
Countries
Switzerland
Contacts
Primary ContactClive Wilder-Smith, MD
Outcome results
None listed