GERD Linked to Higher Risk of Dental Caries and Tooth Erosion: Study

A new study published in the journal of BMC Oral Health showed that patients with severe gastroesophageal reflux disease (GERD) and Barrett's esophagus are most at risk for dental caries and erosive tooth wear.

Gastric acid regurgitation into the esophagus and mouth cavity is the hallmark of GERD, a persistent digestive illness. While its major symptoms are gastrointestinal, the illness has a profoundly important influence on dental health that remains usually disregarded. The mouth cavity is exposed to more acidic stomach contents both in volume and frequency as GERD severity rises. This seriously upsets the mouth's normal pH equilibrium.

The highly acidic environment directly accelerates erosive tooth wear, chemically dissolving the protective enamel layer. Additionally, this demineralization process significantly increases a patient's vulnerability to dental caries by seriously compromising structural integrity. Understanding the clear association between GERD severity and the advancement of both dental erosion and tooth decay is vitally crucial for doctors to adopt effective preventive dentistry measures. This study assessed the connection between erosive tooth wear, dental caries, and the severity of GERD.

Between January and June 2025, cross-sectional case-control research was carried out at Tanta University Hospital in Egypt with 100 persons with upper gastrointestinal endoscopy-diagnosed GERD and 100 healthy controls who were matched for age and gender. The Los Angeles (LA) method was used to categorize the severity of GERD. The DMFT index, BEWE score, and plaque index were used to evaluate dental caries and enamel flaws. Additionally assessed were salivary pH, flow rate, and standard laboratory parameters. Chi-square tests, Fisher's exact tests, ANOVA, and multivariate regression analysis were used to look for relationships between GERD severity and dental health markers.

Patients with GERD reported using proton pump inhibitors more frequently, consuming far more acidic drinks, and experiencing dry mouth more frequently.

In addition, they had lower salivary pH and flow rates (p < 0.001) and a considerably greater frequency of dental caries and erosive tooth wear.

Worsening oral findings were positively linked with GERD severity (Grades A–D and Barrett's esophagus).

Low salivary pH and severe GERD were found to be independent risk factors for erosive tooth wear using logistic regression.

Overall, increased dental caries and erosive tooth wear are strongly linked to GERD, especially in those with Barrett's esophagus and more severe illness. These results confirm that people with GERD should get preventative therapy and regular dental health screenings.

Reference:

Ali, A. N., Tawfik, E. A., Aboelmaaty, M., Sayed, M. H., Shahzad, M., Tawfik, M. A., & El-Marhomy, A.-Z. M. (2026). Impact of gastroesophageal reflux disease severity on dental caries and erosive tooth wear: a case control study. BMC Oral Health, 26(1). https://doi.org/10.1186/s12903-026-08940-0