Gastrointestinal conditions related to tooth wear

Gastro-oesophageal reflux disease (GORD) is a relatively common condition that occurs in adults and less commonly in children. It develops when the reflux of stomach contents into the oesophagus causes troublesome symptoms and/or complications. Signs and symptoms include heartburn, retrosternal discomfort, epigastric pain and hoarseness, dental erosion, chronic cough, burning mouth syndrome, halitosis and laryngitis. A proportion of patients will, however, have silent reflux. Strongly associated risk factors include family history, age, hiatus hernia, obesity and neurological conditions, such as cerebral palsy. There are different treatment options which may be considered for GORD, consisting of conservative, medical and surgical therapy. Dentists should be aware of the symptoms of GORD and dental signs of intrinsic erosion indicative of possible GORD so that they can question patients about this and, if appropriate, initiate a referral to a general medical practitioner. Key points Details the common signs and symptoms of gastro-oesophageal reflux disease (GORD) that dentists should be aware of. The principle causes of GORD are sphincter incompetence, increased gastric pressure and increased gastric volume. There are a number of medical, diet and lifestyle risk factors which contribute to these causes. Management options of GORD consist of conservative, medical and surgical therapy. Dentists should refer patients to their general medical practitioner if undiagnosed GORD is suspected.