At NYC Smile Design, we regularly see patients who are surprised to learn that their dental problems may be linked to something happening far beyond their mouths — their digestive system.
Acid reflux, also known as gastroesophageal reflux disease (GERD), is a common condition that often goes unmentioned during dental exams. But it plays a major role in tooth erosion, sensitivity, and sometimes major restorative work. Whether a patient is unaware they have reflux, is under-treating it, or simply didn’t think it mattered to tell their dentist — the consequences for oral health can be significant.
How Common is Acid Reflux?
You’re not alone. GERD affects an estimated 1 in 5 Americans — that's around 20% of the population. It’s even more common among people who are overweight, pregnant, eat late at night, or consume acidic foods and beverages regularly.
How Do You Know If You Have Acid Reflux?
Acid reflux doesn’t always present as heartburn. In fact, many cases are “silent reflux”, meaning the damage is occurring without the classic burning symptoms. Clues you may have GERD include:
- Sour taste in the mouth or frequent bad breath
- Hoarseness or chronic sore throat
- Frequent coughing, especially at night
- Difficulty swallowing
- Eroding or thinning teeth — particularly on the back side of upper front teeth
- Increased sensitivity, especially to sweets or cold
Collaborative Care: Why You Should Talk to Both Your Doctor and Dentist
Dental erosion caused by acid is chemical, not bacterial — which means brushing and flossing won’t fix it.
If your dentist notices erosion patterns typical of reflux, it’s essential to:
- Work with your primary care doctor or gastroenterologist to confirm and manage the reflux medically
- Monitor the progression of enamel wear with your dentist
- Coordinate timing of restorative work to avoid doing restorations while active acid exposure is ongoing
How Acid Reflux Wrecks Your Teeth
When stomach acid enters the mouth (even in microscopic amounts), it softens and gradually wears away the protective enamel layer. Over time, this leads to:
- Thinning enamel — teeth may look translucent or glassy
- Sensitivity to cold, sweets, or even air
- Cupping or denting of chewing surfaces
- Chipping or cracking of weakened teeth
- Yellowing or discoloration as inner dentin becomes exposed
- Increased need for restorative treatments, including veneers, crowns, or even full mouth rehabilitation
Expanded Dental Management Strategies
1. Custom Remineralization Protocols
- Topical fluoride varnishes during cleanings
- Home-use trays with prescription-strength fluoride or calcium phosphate pastes (e.g., MI Paste)
- Daily use of non-abrasive, fluoride toothpaste designed for erosion (e.g., Prevident 5000 Sensitive)
2. Diet and Behavior Counseling
- Avoid brushing for at least 30 minutes after a reflux episode or acidic meal
- Rinse with baking soda and water or fluoride mouth rinse instead
- Reduce intake of acidic foods and drinks: citrus, soda, vinegar, alcohol
- Avoid eating right before bed and elevate the head while sleeping
3. Nightguard or Mouthguard Use
Custom nightguards help protect teeth from grinding (bruxism), which often coexists with reflux and compounds the wear. Certain designs also reduce acid pooling.
4. Regular Monitoring and Imaging
Frequent exams and photographs of affected areas help track erosion progression. In some cases, digital scanning may be used to precisely monitor enamel loss over time.
5. Strategic Restorative Dentistry
- Use stronger, acid-resistant materials (like ceramics or zirconia) for long-term restorations
- Restore in stages if active reflux is ongoing — prioritizing functional or esthetic concerns first
- Rebuild vertical dimension if erosion has altered bite alignment or caused jaw discomfort
Final Thoughts
Acid reflux is a digestive issue with serious dental consequences — but the good news is, with the right team approach, we can detect it early, manage it effectively, and protect your smile.
If you've been diagnosed with GERD, or suspect you may have it, let us know. It’s a vital piece of your health story — and one we can help you manage with precision, compassion, and expertise.
