Gastroesophageal reflux, dental erosion, and halitosis in epidemiological surveys: a systematic review

Eur J Gastroenterol Hepatol. 2013 Feb;25(2):135-41. doi: 10.1097/MEG.0b013e32835ae8f7.


In published studies, it has been suggested that dental wear is associated with gastroesophageal reflux disease (GERD). This systematic review was carried out to evaluate the association of GERD, dental erosion, and halitosis and to compare the indices adopted in epidemiological surveys. The Medline database (until October, 2011) was searched systematically to identify studies evaluating the prevalence of oral alterations, such as dental erosion and halitosis, in patients with GERD symptoms. Two reviewers analyzed all reports and the selected studies were evaluated according to the quality of evidence, using the validated Newcastle-Ottawa Quality Assessment Scale. Full-text copies of a total of 32 publications were obtained in duplicate. Sixteen publications were identified among the citations in the Bibliographic lists of studies that fulfilled the exclusion/inclusion criteria and quality of evidence. The relationship between dental erosion and GERD patients was significant in only seven studies. According to three studies, halitosis could be one of several extraesophageal symptoms or manifestations in GERD patients. In one study, it was found that the mucosa of GERD patients was significantly more acidic in comparison with that of the control group. This systematic review showed that there is a relationship between GERD and oral diseases (dental erosion and halitosis). The epidemiological surveys used different indices to analyze GERD and dental erosion. Further research could investigate the best method for assessing the two diseases.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Gastroesophageal Reflux / complications*
  • Gastroesophageal Reflux / epidemiology
  • Halitosis / epidemiology
  • Halitosis / etiology*
  • Humans
  • Tooth Erosion / epidemiology
  • Tooth Erosion / etiology*