How Acid Reflux affects Oral Health

Acid reflux is a very common problem in America.  Statistics indicate that about sixty million Americans report symptoms of acid reflux once a month, and more than fifteen million have symptoms every day.  Doctors also refer to acid reflux as Gastro-Esophageal Reflux Disease or GERD.

Reflux causes pain in the center of the chest, usually following a meal, known as heartburn.  It’s called heartburn, but it has nothing to do with your heart.  The acid is damaging to the soft tissue lining your esophagus, which travels from your throat to your stomach.  This irritation of the esophageal soft tissues causes pain or a burning sensation.

Unfortunately, the effects of acid reflux are not limited to the esophagus.  The harsh stomach acid can make its way all the way up into the mouth, and that is the focus of this article.

What is the Effect of Acid Reflux on the Mouth?

Acid reflux involves a malfunctioning of the valve that separates the esophagus from the stomach.  During normal, healthy function, this valve only operates on a one-way basis, letting food pass from the esophagus into the stomach, and preventing stomach acid from moving “backwards” into the esophagus.  Acid reflux means that the valve isn’t doing its job, and stomach acid is moving backwards.

Stomach acid is extremely acidic, ranging from 1.5 to 3.5 on the pH scale.  This low pH helps break down food and continue the process of digestion.  The stomach lining can handle this low pH, but the esophagus and mouth cannot.  In cases of chronic acid reflux, the affected person suffers a low pH in the mouth as well due to the backflow of stomach acid.

The mouth should maintain a pH just above neutral (higher than 7 on the pH scale).  This keeps the soft tissues and teeth healthy.  A recent study showed that the oral pH measurement in GERD patients was significantly lower than the measurement in healthy patients.

How Does Acid Damage the Teeth?

The reason this is such a big concern to dental professionals is due to the potential for serious damage to the teeth.  Enamel is the hardest substance in the human body, harder even than bone.  The one thing that can soften and weaken tooth enamel is acid.  There are two specific ways that an acidic oral pH damages the teeth.

  1. Acid erosion

A chronically low oral pH leads to acid erosion of the enamel.  In cases of acid reflux, we often see a thinning, or gradual wearing away, of the enamel on the back teeth.  As the acid wears away the enamel, the underlying tooth structure, which is a darker yellow color, begins to show through.  This leads to an overall yellowing appearance of the teeth.

As enamel thins, the teeth become weaker and more susceptible to cavities, tooth sensitivity, and cracks.

  1. Increased cavity risk

Having an overall acidic mouth makes it easier for the bacteria living in dental plaque to cause cavities.  The way bacteria penetrate tooth enamel is by producing acid.  They eat sugars and other refined carbohydrates and make acid as the by-product.  This acid slowly wears away a small section of enamel, allowing the bacteria to penetrate and make its way into the tooth.  When the mouth is acidic, the softer enamel makes it easier for bacteria to operate.  An acidic mouth is a happy environment for cavity-causing bacteria.

  1. Medication-induced dry mouth

In order to manage the discomfort of acid reflux, many people take over-the-counter and prescription medications.  While these drugs may alleviate the symptoms of heartburn, they unfortunately also cause dry mouth.  By reducing the amount of saliva produced by your salivary glands, these meds make your risk for cavities even higher.  Saliva is slightly alkaline (above neutral on the pH scale) and can counteract the effects of acid on the mouth.  Patients with acid reflux need a good salivary flow to fight the acid from the stomach.  By causing dry mouth, these medications actually worsen the situation in the mouth.

How Does Acid Affect the Soft Tissue of the Mouth?

Just as the acid causes irritation and pain in the soft tissues lining the esophagus, it can do the same for the soft tissue lining the inside of the mouth.  Patients with chronic acid reflux often report burning or pain in their inner cheeks, lips and tongue.  They are also more likely to experience mouth sores and ulcers.

How Do I Protect my Teeth when I Suffer from Acid Reflux?

If you are one of the millions of Americans who suffer from acid reflux, it is very important that you know these risks and take steps to prevent the oral health problems that acid reflux causes.

  1. Commit to great oral hygiene.

Because of the increased risk of cavities caused by acid reflux, it is important for you to take great care of your teeth at home.  Removing dental plaque with consistent oral hygiene is essential to preventing cavities because it lowers the amount of those acid-loving bacteria.

In your oral hygiene routine, you should avoid using teeth whitening toothpastes.  These are purposefully abrasive, and they may damage already weakened teeth in an acidic mouth.  Protect your enamel by using a non-whitening, fluoride toothpaste.

  1. Never miss a dental visit.

Professional teeth cleanings are essential to removing plaque and tartar buildup that you miss with your home care.  Your dentist and dental hygienist will also monitor the health of your mouth closely and spot any signs of damage from acid reflux.  Following up on any recommended preventive dental care, like professional fluoride treatments, can lower your risk even further!

  1. Take reflux meds only when necessary.

This is a tough one.  We know heartburn hurts.  We do not want anyone to suffer.  However, we also know that many people take their reflux meds on a regular basis whether they are having symptoms or not.  Due to their negative side effects (of which dry mouth is only one of many), it is important to only take these meds as needed.  Talk to your doctor about taking only the lowest effective dose on an as needed basis.

  1. Avoid acidic drinks. Stick to water.

Because acid reflux creates an acidic environment in the oral cavity, you should avoid making it even more acidic by drinking low pH beverages.  What are low pH drinks?  Pretty much everything except still water.  Common acidic drinks include sodas, sports drinks, supplements like Spark, coffee, tea, wine, beer, and even sparkling water.

In order to be safe and keep your mouth at a neutral pH, drink still water.  Better yet, you can purchase alkaline water like Essentia bottled water.

  1. Chew sugar-free gum.

When you chew gum, you stimulate the natural production of saliva.  The stronger the flavor, the more saliva you produce.  Ideally, you should chew sugar-free gum so you are not feeding the cavity-causing bacteria.  By chewing gum and stimulating saliva production, you are raising the pH in your mouth back to neutral in a natural way!

More Questions about Acid Reflux and Its Effects on Your Mouth?

Call your nearest Premier Dental of Ohio location today to schedule a consultation with one of our preventive dentists.  Let us help you prevent cavities and maintain a healthy mouth despite your acid reflux.