School of Dentistry, The University of Adelaide, Adelaide, South Australia, Australia.
J Gastroenterol Hepatol. 2012 Jan;27(1):21-7. doi: 10.1111/j.1440-1746.2011.06945.x.
Numerous case-control and other studies involving confirmation of gastroesophageal reflux disease (GERD) by esophageal pH-metry and the assessment of dental erosions have shown significant associations between the two conditions in both adults and children. By contrast, when asked to vote on whether GERD may cause dental erosions, only 42% of physicians strongly agreed that such an association existed in adults, and just 12.5% strongly agreed for children, respectively in two global consensus reports. Part of this divergence between the perceptions of physicians and the findings of research publications may reflect a general lack of oral health education during medical training, and cursory oral examinations being made under less-than-ideal conditions. Adequate salivary secretions are essential for the protection of the teeth and the oropharyngeal and esophageal mucosa. The quantity and quality of the saliva require monitoring as many drugs, including several of the proton pump inhibitors (PPIs), can cause hyposalivation. In addition, PPIs do not always result in adequate acid suppression. Therefore, collaboration between physicians and dentists is strongly advocated to prevent or ameliorate possible adverse oral effects from both endogenous and exogenous acids, and to promote adequate saliva production in patients with GERD.
许多病例对照研究和其他研究通过食管 pH 监测证实胃食管反流病 (GERD)，并评估牙酸蚀症，均表明在成人和儿童中这两种情况之间存在显著关联。相比之下，当被要求就 GERD 是否可能导致牙酸蚀症进行投票时，只有 42%的医生强烈认为这种关联存在于成人中，而在两项全球共识报告中，只有 12.5%的医生强烈认为这种关联存在于儿童中。医生的看法与研究出版物的发现之间存在部分分歧，这可能反映出医学培训期间普遍缺乏口腔健康教育，以及在不太理想的条件下进行的粗略口腔检查。充足的唾液分泌对牙齿、口咽和食管黏膜的保护至关重要。由于许多药物（包括几种质子泵抑制剂 (PPIs)）会导致唾液分泌减少，因此需要监测唾液的数量和质量。此外，PPIs 并不总能导致足够的胃酸抑制。因此，强烈提倡医生和牙医之间的合作，以预防或改善内源性和外源性酸引起的可能的口腔不良反应，并促进 GERD 患者产生足够的唾液。
