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Associations among Bruxism, Gastroesophageal Reflux Disease, and Tooth Wear.

ABSTRACT: The relationship between bruxism and tooth wear is contentious in the literature. The pathophysiological processes of tooth wear may be complicated by the relationship between bruxism and gastroesophageal reflux disease (GERD). The objective of this study was to evaluate the associations among bruxism, GERD, and tooth wear. Two complementary studies were performed: a case-control study to verify the linkage between GERD and bruxism and a cross-sectional study on the same cohort to establish the connection between GERD and tooth wear in bruxism patients. A cohort of 363 consecutive bruxism patients and 363 matched control participants were recruited. Gastroesophageal reflux disease was diagnosed in accordance with the Montreal criteria. Tooth wear was scored based on the index recommended by Smith and Knight. Logistic regression analyses were performed. After adjustment, GERD was identified as a risk factor of bruxism. Bruxism with reflux symptoms for extensive time-periods was associated with severe tooth wear for the whole dentition (odds ratio, 4.70, 95% confidence interval, 2.04?10.83). Increased odds ratios for severe tooth wear were also found in all tooth locations and palatal/lingual and occlusal/incisal surfaces of bruxism patients with GERD for extensive time-periods. In conclusion, strong associations were identified among bruxism, GERD, and tooth wear.

SUBMITTER: Li Y

PROVIDER: S-EPMC6262381 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Associations among Bruxism, Gastroesophageal Reflux Disease, and Tooth Wear.

Li Yuanyuan Y Yu Fan F Niu Lina L Hu Wei W Long Yong Y Tay Franklin R FR Chen Jihua J

Journal of clinical medicine 20181106 11

The relationship between bruxism and tooth wear is contentious in the literature. The pathophysiological processes of tooth wear may be complicated by the relationship between bruxism and gastroesophageal reflux disease (GERD). The objective of this study was to evaluate the associations among bruxism, GERD, and tooth wear. Two complementary studies were performed: a case-control study to verify the linkage between GERD and bruxism and a cross-sectional study on the same cohort to establish the ...[more]

PMID: 30404150

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Project description:BackgroundApproximately 60% of patients presenting to dentists with erosive tooth wear have significant gastroesophageal reflux (GERD), despite minor reflux symptoms. No longitudinal studies of reflux-associated erosive tooth wear and of reflux characteristics have been reported to date. The aim of this study was to characterize the longitudinal course of GERD and of associated erosive tooth wear, as well as factors predictive of its progression, in a large group of patients.MethodsSeventy-two patients presenting to dentists with clinically significant erosive tooth wear and increased esophageal acid exposure by 24-h multichannel intraluminal pH-impedance measurement (MII-pH) were re-assessed clinically and by MII-pH after 1 year treatment with esomeprazole 20 mg twice-daily. Predictive factors for erosive tooth wear were assessed by logistic regression.ResultsAt follow-up, no further progression in erosive tooth wear was observed in 53 (74%) of patients. The percentage of time with a pH < 4, the number of acid reflux episodes and the percentage of proximal esophageal reflux off-PPI did not change significantly after one year, but the number of weakly acidic reflux episodes decreased significantly in the large subgroup without progression. None of the baseline demographic, clinical, endoscopic or esophageal acid exposure characteristics were significantly associated with progression of erosive tooth wear at follow-up.ConclusionsIn this longitudinal study in patients with erosive tooth wear and oligosymptomatic GERD receiving esomeprazole for one year, erosive tooth wear did not progress further in the majority of patients. Background acidic esophageal reflux exposure appeared stable over time, whereas weakly acidic exposure decreased significantly in patients without erosion progression. MII-pH measurements on-PPI and with healthy controls will be useful in the further elucidation of the causal role of reflux in erosive tooth wear.Trial registrationClinicalTrials.gov , retrospectively registered: NCT02087345 .

Project description:The pathogenesis of gastroesophageal reflux disease (GERD) is complex and poorly understood. We aim to investigate the association of various circulating peptide hormones with heterogenous manifestations of GERD.One hundred and four patients that had experienced typical GERD symptoms (heartburn and/or acid regurgitation) for at least 3 episodes per week in the past 3 months were enrolled. All patients received a baseline assessment of symptom severity and frequency with the Reflux Disease Questionnaire and an upper endoscopy to classify GERD into erosive esophagitis (EE, n = 67), non-erosive esophagitis (NE, n = 37), and Barrett's esophagus (BE, n = 8). Fifty asymptomatic subjects with an endoscopically normal esophagus were recruited as the control group. Complete anthropometric measures and blood biochemistry were obtained and fasting serum levels of adipocytokines (adiponectin and leptin) and gut hormones (ghrelin and peptide YY (PYY)) were determined by enzyme-linked immunosorbent assay in all subjects.All circulating peptide hormone levels were not statistically different between the GERD and control groups. However, GERD patients appeared to have lower PYY levels [median (25th-75th percentile), 80.1 (49.8-108.3) vs. 99.4 (65.8-131.9) pg/ml, p = 0.057] compared with control subjects. Among the GERD patients, ghrelin levels were inversely associated with the frequency and severity of acid regurgitation. In male GERD patients, EE was associated with significantly higher PYY levels [107.0 (55.0-120.8) vs. 32.8 (28.7-84.5) pg/ml, p = 0.026] but lower adiponectin levels [6.7 (5.6-9.3) vs. 9.9 (9.6-10.6) μg/ml, p = 0.034] than NE. Patients with BE had significantly lower adiponectin levels [6.0 (5.1-9.2) vs. 9.2 (7.1-11.2) μg/ml, p = 0.026] than those without BE.Humoral derangement of circulating peptide hormones might participate in inflammation and symptom perception in patients suffering from GERD. Further studies to clarify the exact role of these hormones in the pathogenesis of GERD are warranted.

Dataset Information

Associations among Bruxism, Gastroesophageal Reflux Disease, and Tooth Wear.

Publications

Associations among Bruxism, Gastroesophageal Reflux Disease, and Tooth Wear.

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