Oral impact of gastro-oesophageal reflux disease: a case report.
BACKGROUND
This case report describes the dental management of a 30-year-old male with cerebral palsy and dyspraxia. Recall examination identified multiple erosive carious lesions despite previous oral hygiene and dietary related instruction. A comprehensive approach to patient management was required to identify the aetiological factors associated with the continued loss of tooth structure.


METHODS
The identification of the aetiological factors required a detailed medical history and clinical examination, as well as liaison with the patient's general medical practitioner. Preventive measures were adopted prior to restorative intervention in order to stabilize and remineralize the dentition.


RESULTS
Medical intervention for gastro-oesophageal reflux disease (GORD) and a targeted prevention programme resulted in remineralization of all carious exposed dentine with stabilization of the dentition.


CONCLUSIONS
Patients with cerebral palsy are known to have a higher incidence of GORD as well as problems with swallowing, vomiting and recurrent chest infections. Long-term gastric acid attacks can contribute to dental erosion, and dental professionals may be the first to diagnose silent GORD. The successful treatment of erosion caused by GORD requires a multidisciplinary and minimal intervention approach.
Liberali
Sac
S
Adelaide Dental Hospital, South Australian Dental Service,The University of Adelaide, South Australia, Australia. sharon.liberali@health.sa.gov.au
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use; D000328:Adult; D000863:Antacids / Q000627:therapeutic use; D001072:Apraxias / Q000150:complications; D002547:Cerebral Palsy / Q000150:complications; D005247:Feeding Behavior; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D009910:Oral Hygiene; D000077402:Pantoprazole; D010347:Patient Care Planning; D054328:Proton Pump Inhibitors; D017001:Tooth Demineralization / Q000209:etiology* / Q000628:therapy; D014077:Tooth Erosion / Q000209:etiology* / Q000628:therapy; D014089:Tooth Remineralization / Q000379:methods
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000863:Antacids; D054328:Proton Pump Inhibitors; D000077402:Pantoprazole