Comparison of Oral Health Status of Pediatric Patients with Gastroesophageal Reflux and Bile Reflux Disease.

Introduction: Gastroesophageal reflux disease (GERD) and bile reflux disease (BRD) are two distinct conditions that may affect oral health through different mechanisms. This study investigated whether these reflux types lead to differing oral and dental outcomes in pediatric patients, aiming to inform clinical practice and promote interdisciplinary care.

Methods: Patients diagnosed with BRD or GERD between 2017 and 2020 were included. Clinical oral examinations, salivary analyses, and questionnaires on potential etiological factors for erosive tooth wear (ETW) were conducted. Oral health was assessed using the Basic Erosive Wear Examination (BEWE), dental caries experience (DMFT), Silness and Löe plaque index (PI), and gingival index (GI). Salivary pH and flow rates were recorded.

Results: Sixty-six patients (33 with BRD, 33 with GERD; 75.8% female; mean age: 14.9 ± 3.1) were included. BEWE scores were significantly higher in GERD patients (median: 6 vs. 4) (p < 0.001), though both groups were classified as low risk for ETW. GERD patients had higher PI (p = 0.018) and GI scores (p < 0.001), while DMFT scores were similar (p = 0.639). BRD patients exhibited significantly higher median values for unstimulated and stimulated salivary pH (7 vs. 6 and 8 vs. 7, respectively) and flow rates (0.6 vs. 0.36 mL/min and 1.7 vs. 1.22 mL/min, respectively) (all p < 0.001), although stimulated flow in GERD patients remained within normal limits (≥1 mL/min).

Conclusion: GERD was associated with poorer oral health, particularly ETW and gingival status. Early, multidisciplinary intervention may help prevent erosion and promote remineralization.