Helle K, Árok AZ, Ollé G, Antal M, Rosztóczy A. Dental evaluation is helpful in the differentiation of functional heartburn and gastroesophageal reflux disease. World J Gastroenterol 2023; 29(31): 4774-4782 [PMID: 37664156 DOI: 10.3748/wjg.v29.i31.4774]
Corresponding Author of This Article
András Rosztóczy, MD, PhD, Associate Professor, Department of Internal Medicine, Division of Gastroenterology, University of Szeged, 57 Kálvária Sugárút, Szeged 6725, Hungary. rosztoczy.andras@med.u-szeged.hu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Aug 21, 2023; 29(31): 4774-4782 Published online Aug 21, 2023. doi: 10.3748/wjg.v29.i31.4774
Dental evaluation is helpful in the differentiation of functional heartburn and gastroesophageal reflux disease
Krisztina Helle, Anna Zsófia Árok, Georgina Ollé, Márk Antal, András Rosztóczy
Krisztina Helle, Georgina Ollé, András Rosztóczy, Department of Internal Medicine, Division of Gastroenterology, University of Szeged, Szeged 6725, Hungary
Anna Zsófia Árok, Márk Antal, Department of Operative and Esthetic Dentistry, University of Szeged, Szeged 6725, Hungary
Author contributions: Antal M and Rosztóczy A contributed tools and further data; Ollé G contributed help in the research; Rosztóczy A designed the research study; Árok AZ and Helle K performed the research; Helle K analyzed the data and wrote the manuscript; and all authors have read and approved the final manuscript.
Supported bythe University of Szeged Open Access Fund, No. 6373.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the University of Szeged.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflict of interest to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: András Rosztóczy, MD, PhD, Associate Professor, Department of Internal Medicine, Division of Gastroenterology, University of Szeged, 57 Kálvária Sugárút, Szeged 6725, Hungary. rosztoczy.andras@med.u-szeged.hu
Received: June 20, 2023 Peer-review started: June 20, 2023 First decision: July 10, 2023 Revised: July 19, 2023 Accepted: July 27, 2023 Article in press: July 27, 2023 Published online: August 21, 2023 Processing time: 58 Days and 23.4 Hours
Abstract
BACKGROUND
Heartburn is identically the key symptom of both, gastroesophageal reflux disease (GERD) and functional heartburn (FHB), making the differential diagnosis resource-intensive. Oral manifestations of GERD can be easily examined; therefore, their exploration might be a cheap, widely available, and useful tool in the differentiation of GERD and FHB.
AIM
To evaluate the prevalence of dental erosions (DE) and periodontal diseases (PD) in patients with heartburn and their association with GERD and FHB.
METHODS
A total of 116 [M/F: 51/65, mean age: 54 (17-80) years] consecutive patients with heartburn were enrolled for detailed esophageal function and orodental examinations.
RESULTS
Dental disorders were detected in 89% (103/116). Patients with PD + DE had significantly more often pathologic reflux (90.0% vs 27.8%; P < 0.05), higher esophagitis scores (1.8 vs 0.9; P < 0.05), and a significantly different mean impedance curve (P = 0.04) than those without any dental diseases. The opposite approach established that patients with GERD had significantly higher prevalence of DE and PD, especially if both were present (28.9% vs 2.0%; P < 0.01), more severe PD (1.5 vs 1.0; P < 0.01), and longer history of heartburn (15 years vs 9 years; P < 0.01) than those with FHB.
CONCLUSION
The dental evaluation of patients with heartburn seems to be useful in the differential diagnosis of GERD and FHB. Among the studied parameters, the co-appearance of DE and PD seems to be the best predictor of GERD, whereas the absence of dental disorders was mostly observed in FHB.
Core Tip: Heartburn is identically the key symptom of gastroesophageal reflux disease (GERD) and functional heartburn (FHB), making the differential diagnosis resource-intensive. Oral manifestations of GERD can be easily examined to differentiate GERD and FHB. A total of 116 consecutive patients with heartburn were enrolled to evaluate the prevalence of dental erosions (DE) and periodontal diseases (PD). The dental evaluation of patients with heartburn seems to be useful in the differential diagnosis of GERD and FHB. The co-appearance of DE and PD seems to be the best predictor of GERD, while the absence of dental disorders was mostly observed in FHB.
