title: Salivary parameters and teeth erosions in patients with gastroesophageal reflux disease.
abstract: BACKGROUND
  In the gastroesophageal reflux disease (GERD), a highly prevalent digestive disorder, gastric content may return to the esophagus and reach the mouth, thus leading to a small number of carious lesions and high incidence of dental erosion. Since saliva plays a major role in oral homeostasis, evaluating salivary parameters is necessary in attempting to explain such outcome.
  
  
  OBJECTIVE
  This study aimed at analyzing salivary parameters (salivary flow, pH and buffering capacity), bacterial count, caries index and dental erosion in patients with GERD.
  
  
  METHODS
  Sixty patients were studied, and of these, 30 had GERD (group 1), and 30 were controls (group 2). Gastroesophageal reflux disease diagnosis confirmation was achieved by means of endoscopy, manometry and pH metric esophageal monitoring. The above mentioned salivary parameters were evaluated in patients from groups 1 and 2.
  
  
  RESULTS
  The number of erosions in patients with GERD (group 1) was larger than in controls (P<0.001). The number of carious teeth was smaller in group 1 than in group 2 (P<0.001). Salivary flow (non-stimulated and stimulated) and pH did not show differences between the 2 groups (P = 0.49; P = 0.80 and P = 0.85, respectively). Salivary buffering capacity in patients with GERD showed lower values in controls (P = 0.018). The number of bacteria (Lactobacilli and Streptococci) was smaller in patients with gastroesophageal reflux disease than in controls (P = 0.0067 and P = 0.0017, respectively).
  
  
  CONCLUSIONS
  It was concluded that the large number of erosions must be a result of GERD patients reduced salivary buffering capacity. The reduced number of caries of patients in group 1 can be explained by the low prevalence of bacteria (Lactobacilli and Streptococci), observed in the saliva of patients with chronic reflux.
authors.affiliation: General Surgery Bases, Department of Surgery and Orthopedy, Botucatu School of Medicine, State University of São Paulo, Brazil. mcarolcorrea@hotmail.com
authors.forename: Maria Carolina Canteras Scarillo Falotico
authors.initials: MC
authors.lastname: Corrêa
authors.forename: Mauro Masson
authors.initials: MM
authors.lastname: Lerco
authors.forename: Maria de Lourdes Ribeiro de Sousa da
authors.initials: Mde L
authors.lastname: Cunha
authors.forename: Maria Aparecida Coelho de Arruda
authors.initials: MA
authors.lastname: Henry
mesh_terms: D000293:Adolescent; D000328:Adult; D058491:Bacterial Load; D016022:Case-Control Studies; D003731:Dental Caries / Q000209:etiology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007778:Lactobacillus / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012463:Saliva / Q000737:chemistry / Q000378:metabolism / Q000382:microbiology; D012720:Severity of Illness Index; D013295:Streptococcus mutans / Q000302:isolation & purification; D014077:Tooth Erosion / Q000209:etiology*; D055815:Young Adult