What many dentists don’t ask is, “have you ever suffered from GERD”, or “do you snore?”. These are follow-up questions that can give us insight into a potentially life-threatening disorder called obstructive sleep apnea (OSA). Studies show that about half of all patients with GERD have significant tooth wear and erosion over healthy people.
In the second phase, the use of an occlusal splint to reestablish vertical dimension and control the muscular pain was indicated. The third phase was the esthetic functional rehabilitation with direct resin-based composite restorations, with definitive reestablishment of previously determined vertical dimension and anterior guidance. Occlusal adjustment and a second occlusal splint, comprising the last phase, are essential for good clinical longevity. Acid reflux caused by gastro-oesophageal reflux disease is common, the acid pools in the mouth by night and cause erosion. The disappearance of the tooth material can be fast, especially with the combination of drinking acidic drinks, having acid reflux and clenching/ grinding the teeth.
Bruxism is often found in patients suffering from sleep apnea possibly as an unconscious response to the collapsed airways by tightening the jaw muscles to prevent restrictions of airflow. We conducted a case-control study involving 1522 consecutive adult patients with chronic TMD and 1522 matched controls from 2 hospitals in China.
All participants were aged between 18 and 70 years and were recruited from July 2017 to April 2018 Chronic TMD was diagnosed by trained dentists using the criteria in the Orofacial Pain Prospective Evaluation and Risk Assessment Study. Trained gastroenterologists made blinded diagnoses of GERD according to the Montreal definition and classification (at least 2 d of mild symptoms, or 1 d of moderate or severe symptoms per week).
In addition, she was warned about her destructive bruxism habit and counseled to control it consciously during waking hours, as much as possible. After these simple initial counseling, the patient was referred to a gastroenterologist for medical consultation that confirmed GERD diagnosis. Endoscopy examination showed a hiatus hernia. The gastroenterologist prescribed Omeprazole 40 mg/day to the patient and suggested her to elevate the head of her bed during sleeping and avoid acid, fatty and spicy food, especially right before bedtime.
The fluctuations of bruxism symptoms and signs and the unreliability of subjective response should be considered in the explication of the findings . Acid reflux can wear away the enamel on the inside surfaces of your teeth, as well as the chewing surfaces.
If enough of the tooth is worn away or decayed, the tooth will effectively be weakened, and may fracture under the increased forces that occur in bruxism. Through a retrospective chart review, Dr. Subramanian and his colleagues, from the Baylor College of Medicine, Houston, TX, assessed the prevalence of bruxism and gastroesophageal reflux (GERD) in 150 men and 150 women with OSA. Each group consisted of 50 Caucasians, 50 African-Americans, and 50 Hispanics.
Extensive tooth wear into dentin was identified, especially on the palatal superficies of upper incisors and canines (pointers). The present case-control study indicates that GERD, especially long-term GERD, is a risk factor of bruxism. According to the companion cross-sectional study, GERD is associated with tooth wear in patients with bruxism.
Patient Care & Health Info
Spear Education advises that patients should brush their teeth after using inhalers for an extended period of time. Sleep Bruxism is the grinding or clenching of teeth during sleep, which is preceded by sleep arousals. Sleep Arousal is a naturally occurring 3-10 second shift occurring during deep sleep, which is accompanied by an increase in muscle tone.