title: Gastroesophageal reflux is not associated with dental erosion in children.
abstract: OBJECTIVE
  Dental erosion is a complication of gastroesophageal reflux (GER) in adults; in children, it is not clear if GER has a role in dental pathologic conditions. Dietary intake, oral hygiene, high bacterial load, and decreased salivary flow might contribute independently to GER development or dental erosion, but their potential involvement in dental erosion from GER is not understood. We investigated the prevalence of dental erosion among children with and without GER symptoms, and whether salivary flow rate or bacterial load contribute to location-specific dental erosion.
  
  
  METHODS
  We performed a cross-sectional study of 59 children (ages, 9-17 y) with symptoms of GER and 20 asymptomatic children (controls); all completed a questionnaire on dietary exposure. Permanent teeth were examined for erosion into dentin, erosion locations, and affected surfaces. The dentist was not aware of GER status, and the gastroenterologist was not aware of dental status. Stimulated salivary flow was measured and salivary bacterial load was calculated for total bacteria, Streptococcus mutans, and Lactobacilli.
  
  
  RESULTS
  Controlling for age, dietary intake, and oral hygiene, there was no association between GER symptoms and dental erosion by tooth location or affected surface. Salivary flow did not correlate with GER symptoms or erosion. Erosion location and surface were independent of total bacteria and levels of Streptococcus mutans and Lactobacilli.
  
  
  CONCLUSIONS
  Location-specific dental erosion is not associated with GER, salivary flow, or bacterial load. Prospective studies are required to determine the pathogenesis of GER-associated dental erosion and the relationship between dental caries to GER and dental erosion.
authors.affiliation: Department of Pediatrics, University of California, San Francisco, California 94143-0136, USA.
authors.forename: Yvette K
authors.initials: YK
authors.lastname: Wild
authors.forename: Melvin B
authors.initials: MB
authors.lastname: Heyman
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.forename: Deepal H
authors.initials: DH
authors.lastname: Dalal
authors.forename: Janet M
authors.initials: JM
authors.lastname: Wojcicki
authors.forename: Ann L
authors.initials: AL
authors.lastname: Clark
authors.forename: Beate
authors.initials: B
authors.lastname: Rechmann
authors.forename: Peter
authors.initials: P
authors.lastname: Rechmann
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications*; D006801:Humans; D007778:Lactobacillus / Q000302:isolation & purification; D008297:Male; D009910:Oral Hygiene; D015995:Prevalence; D012307:Risk Factors; D012463:Saliva / Q000382:microbiology / Q000502:physiology; D013295:Streptococcus mutans / Q000302:isolation & purification; D014077:Tooth Erosion / Q000453:epidemiology*