What is the Relationship between Reflux and Teeth?

Peptest measures pepsin, an enzyme of gastric refluxate, – stomach acid that bubbles up into the mouth in some patients, causing a lot of damage to teeth.

We use Peptest in the dental office to rule out high rates of tooth decay or dental erosion.

Often, our patients report no history of reflux when they complete their medical forms and may have no symptoms of heartburn or pain typical of the burning sensation experienced with reflux.   This is often referred to as silent reflux.

We look for a specific pattern of tooth wear, or someone who has chronic tooth decay, affecting teeth.  We are starting to detect undiagnosed reflux in patients with no other obvious cause of damage to teeth.

Why is gastric acid a problem?

Gastric acid has a very low pH – in other words, it is highly acidic.  It dissolves tooth enamel, leaving patients with pits and craters on back teeth, hollow areas on biting surfaces, sensitivity, thin or lost enamel at the gum line, and thinning and transparent or chipping front teeth.

In patients with high levels of decay-causing bacteria, it keeps the mouth in an acidic state.  These bacteria thrive in a low pH environment continuing to cause decay in susceptible patients.  If you are constantly getting cavities, have multiple root-filled back teeth, have chalky, decayed or broken back teeth and have a healthy diet, you may have reflux.

Reflux often affects us silently when we are lying down or asleep.  It is surprising how far it will reach, sitting at the back of the mouth, creating pooling of an acid solution around the back teeth, or spreading around the mouth by tongue movements during sleep.

The hidden signs of reflux in a healthy mouth:

• Changing sensitivity and wear patterns with teeth.
• Grooves or notches at the gumline of teeth.
• Hollows, pitting or craters in back teeth.
• Yellowing teeth with thin transparent enamel.
• An otherwise healthy diet.
• An otherwise clean, well maintained mouth.

We also have some patients who suffer from chronic decay, constantly needing fillings.  You may have silent reflux if you have:

• Ongoing high rates of decay and constantly needing fillings or root fillings, especially in back teeth.
• Front teeth often look chalky, and front fillings need regular replacement.

The hidden, less obvious symptoms of reflux include:

• A hoarse, croaky voice or need to clear the throat.
• Post nasal drip.
• An acid taste in the mouth in the mornings.
• Bubbly, frothy saliva at the back of the tongue.
• Chronic cough, without asthma or a chest infection.
• Asthma that isn’t improving.
• A sore throat.
• A chronic lump in the throat.

How can we help?

We will recommend a Peptest if we note signs and symptoms that are associated with reflux and tooth wear or chronic tooth decay.  We provide Peptests in our office and will advise you on the next steps once we have a result.   We will work with you to manage the oral environment to reduce or prevent the chance of damage to teeth.  We will refer you to a gastroenterologist if we confirm pepsin in saliva with a positive Peptest.

NOTE:  You can have tooth wear from reflux without having tooth decay. 

Get diagnosed with Peptest in a few simple steps:

STEP 1:

Make sure you have avoided the following 60 minutes before collecting your sample; caffeinated drinks, carbonated drinks and smoking.

Make sure you have avoided the following 48 hours before collecting your sample; alkaline water, antacids, and alginate suspension medication (e.g. Gaviscon).

STEP 2:

To produce a sample, clear your throat with a cough and spit the resultant saliva/sputum into the universal collection tube provided.

STEP 3:

Repeat this procedure until you have filled the collection tube with saliva to the fill line.

STEP 4:

Replace the lid and shake the collection tube to mix the sample with the reagent inside the collection tube. Store the sample in the fridge. Note: Do not freeze.

STEP 5:

Repeat steps 2 to 4 to produce sample 2 and sample 3. Complete the saliva collection form when you produce your samples.

STEP 6:

Put all saliva samples and tissues into the clear grip seal bag provided. Put this bag into the pre-paid addressed envelope with the completed saliva collection form. Post via NZ post ASAP. Note: You must post within two days of your first sample. Keep samples refrigerated until you are ready to post.