Corrêa Maria Carolina Canteras Scarillo Falotico, Lerco Mauro Masson, Cunha Maria de Lourdes Ribeiro de Sousa da, Henry Maria Aparecida Coelho de Arruda
General Surgery Bases, Department of Surgery and Orthopedy, Botucatu School of Medicine, State University of São Paulo, Brazil.
Arq Gastroenterol. 2012 Jul-Sep;49(3):214-8. doi: 10.1590/s0004-28032012000300009.
In the gastroesophageal reflux disease (GERD), a highly prevalent digestive disorder, gastric content may return to the esophagus and reach the mouth, thus leading to a small number of carious lesions and high incidence of dental erosion. Since saliva plays a major role in oral homeostasis, evaluating salivary parameters is necessary in attempting to explain such outcome.
This study aimed at analyzing salivary parameters (salivary flow, pH and buffering capacity), bacterial count, caries index and dental erosion in patients with GERD.
Sixty patients were studied, and of these, 30 had GERD (group 1), and 30 were controls (group 2). Gastroesophageal reflux disease diagnosis confirmation was achieved by means of endoscopy, manometry and pH metric esophageal monitoring. The above mentioned salivary parameters were evaluated in patients from groups 1 and 2.
The number of erosions in patients with GERD (group 1) was larger than in controls (P<0.001). The number of carious teeth was smaller in group 1 than in group 2 (P<0.001). Salivary flow (non-stimulated and stimulated) and pH did not show differences between the 2 groups (P = 0.49; P = 0.80 and P = 0.85, respectively). Salivary buffering capacity in patients with GERD showed lower values in controls (P = 0.018). The number of bacteria (Lactobacilli and Streptococci) was smaller in patients with gastroesophageal reflux disease than in controls (P = 0.0067 and P = 0.0017, respectively).
It was concluded that the large number of erosions must be a result of GERD patients reduced salivary buffering capacity. The reduced number of caries of patients in group 1 can be explained by the low prevalence of bacteria (Lactobacilli and Streptococci), observed in the saliva of patients with chronic reflux.
胃食管反流病（GERD）是一种高度常见的消化系统疾病，胃内容物可能反流至食管并到达口腔，从而导致少量龋齿病变和较高的牙侵蚀发生率。由于唾液在口腔内环境稳定中起主要作用，因此在试图解释这种结果时，评估唾液参数是必要的。
本研究旨在分析胃食管反流病患者的唾液参数（唾液流量、pH值和缓冲能力）、细菌计数、龋齿指数和牙侵蚀情况。
对60名患者进行了研究，其中30名患有胃食管反流病（第1组），30名作为对照（第2组）。通过内镜检查、测压和pH值食管监测来确诊胃食管反流病。对第1组和第2组患者的上述唾液参数进行了评估。
胃食管反流病患者（第1组）的侵蚀数量多于对照组（P<0.001）。第1组的龋齿数量少于第2组（P<0.001）。两组之间的唾液流量（非刺激性和刺激性）和pH值没有差异（分别为P = 0.49；P = 0.80和P = 0.85）。胃食管反流病患者的唾液缓冲能力低于对照组（P = 0.018）。胃食管反流病患者的细菌数量（乳酸杆菌和链球菌）少于对照组（分别为P = 0.0067和P = 0.0017）。
得出的结论是，大量侵蚀一定是胃食管反流病患者唾液缓冲能力降低的结果。第1组患者龋齿数量减少可以用慢性反流患者唾液中观察到的细菌（乳酸杆菌和链球菌）低患病率来解释。
