Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
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 by the 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
ARTICLE HIGHLIGHTS
Research background

Heartburn is a typical symptom of gastroesophageal reflux disease (GERD) and other functional gastrointestinal diseases. To diagnose them, detailed esophageal function tests are required. Oral manifestations are also common in patients with GERD. The dental evaluation is cheap and widely available.

Research motivation

This study raised the hypothesis that dental evaluation (dental erosions, periodontal diseases) in patients with heartburn may be useful in the differential diagnosis of GERD and functional heartburn (FHB).

Research objectives

To evaluate the prevalence of oral manifestations in patients with heartburn and their association with GERD and FHB.

Research methods

We enrolled 116 [M/F: 51/65, mean age: 54 (17-80) years] consecutive patients with heartburn for detailed esophageal function tests and dental evaluation.

Research results

The prevalence of dental diseases in patients with heartburn was about 89%. Compared with heartburn patients without any dental diseases, heartburn patients with both DE and PD had more significant pathological reflux, higher grade of esophagitis, and significantly different mean impedance curves. Compared to FHB, GERD had a higher prevalence of DE and PD, especially when they coexisted. When evaluating the mean impedance curve, the trend of patients with both PD and DE was similar to those with GERD. The results of the study confirmed the abovementioned hypothesis experimentally.

Research conclusions

The co-existence of PD and DE is more likely to have pathological reflux, and the severity of esophagitis is higher than that of other groups. This study provides a new, inexpensive, widely available, and useful method for the differential diagnosis of GERD and FHB.

Research perspectives

On the one hand, our aim is to expand the study multicentrally in the direction of patients with heartburn presenting in primary care, and thereby reach a larger number of cases. On the other hand, this would probably also enable the inclusion of patients with reflux hypersensitivity, which is defined as a special borderline area between GERD and FHB in the Rome IV criteria system, which may help to decide whether this group of patients is more similar to patients GERD or FHB based on the oral status.