Impact of gastroesophageal reflux disease severity on dental caries and erosive tooth wear: a case control study

Abstract Background Gastroesophageal reflux disease (GERD) is linked to several extraesophageal complications, including adverse effects on oral health. This study evaluated the relationship between GERD severity, dental caries, and erosive tooth wear. Methods A cross-sectional case–control study was conducted between January and June 2025 at Tanta University Hospital, Egypt, involving adults with GERD ( n  = 100), diagnosed by upper gastrointestinal endoscopy, and age- and gender-matched healthy controls ( n  = 100). GERD severity was classified using the Los Angeles (LA) system. Dental caries and enamel defects were assessed using the DMFT index, BEWE score, and plaque index. Salivary pH, flow rate, and routine laboratory parameters were also measured. Associations between GERD severity and oral health indicators were examined using Chi-square tests, Fisher’s exact tests, ANOVA, and multivariate regression analysis. Results GERD patients reported significantly higher intake of acidic beverages, greater use of proton pump inhibitors, and more frequent dry-mouth symptoms. They also showed a significantly higher prevalence of dental caries and erosive tooth wear, along with lower salivary pH and flow rates compared with healthy controls ( p  < 0.001). The severity of GERD (Grades A–D and Barrett’s esophagus) was positively correlated with worsening oral findings. Logistic regression identified GERD severity and low salivary pH as independent risk factors for erosive tooth wear. Conclusions GERD is significantly associated with increased dental caries and erosive tooth wear, particularly in individuals with more advanced disease and Barrett’s esophagus. These findings support the need for routine oral health screening and preventive care in patients diagnosed with GERD.