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Reflux and Teeth: Many Unhappy Returns

Acids can damage teeth by wearing away the tooth surface. This is sometimes referred to as erosion. Often this damage occurs as a result of the acids children consume in foods such as fruits, fruit flavoured soft and hard sweets, fruit flavoured chewy vitamins, vinegar, pickles, salt and vinegar crisps and ketch-up. Another important source of acid in the mouth is from the stomach. Dental erosion caused by reflux is something dentists are seeing more commonly and it is often linked to lifestyle and dietary habits.

Although everyone has reflux on occasion, it is the chronic (over time) condition that results in oesophagitis and tooth erosion. Some of the causes are: inadequate muscle tone of the lower oesophageal sphincter, hiatal hernia, and oesophageal contractions. Some of the contributing factors for this type of reflux in children are: premature birth, high acid diet, overeating, eating too close to bedtime, cerebral palsy, obesity, attention deficit/hyperactivity disorder

Up to age 12 months, babies have poor muscle tone around the stomach and acid can find its way into the mouth. This is why they need to be burped. Many people suffer from reflux on occasion and this is normal. Children can suffer from reflux or stomach acid coming up into the mouth without complaining of any symptoms. Sometimes, the first signs of the problem will be evidence of acid wearing the surface of the teeth. It is important to pick this up early because chronic acid exposure is not healthy and can lead to more serious problems later in life including cancerous changes in the cells of the oesophagus. This can lead to sensitivity, poor appearance and in some cases the wear travels all the way into the nerve of the tooth. Occasionally this leads to pain and infection and the need to extract the tooth.

Signs that your child may be suffering from reflux include:

  • Burning or acidic taste in mouth

  • “Hot burps” or “baby vomit”

  • Child reports burning in the area of their heart or a stomach ache

  • Belching after meals

  • Acidic odour especially in the morning before breakfast

  • Continuously coughing during sleep

  • Hoarseness

  • Pain swallowing

  • Neck stretching

The first recommendation should be to eliminate acidic drinks and foods including, skittles and star bursts, pickles, mint, citrus juices, lemons, carbonated drinks, super sizing, fried foods. Chewing gum with Xylitol such as Orbit can sometimes help to protect teeth by stimulating saliva. There are some other tips which are specifically for reflux:

  • Wait two hours after eating before lying down

  • Elevate the head of the bed or sleep propped up by a wedge (from the waist up)

  • Finally, do not discount the affects of stress. Many families have busy, hectic lifestyles with interfamily conflicts being common. Children may respond to this with negative internal adaptors rather than be able to use more healthful alternatives. We need to be aware of this to consider more relaxing activities and lifestyles.

The majority of children who have reflux are unaware of the problem because they have no symptoms or the sensations they have become normal to them. When teeth become worn and the enamel layer is worn away, teeth are more vulnerable to dental decay. It is often only as a result to routine dental check-ups and an appropriate medical referral that the problem is detected. So remember, keep little teeth happy and visit the dentist early!

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