Alharthi R., Moazzez R., Bartlett D., Jafari J. Risk factors for Erosive Tooth Wear in patients with Gastroesophageal Reflux Disease (GORD) symptoms: a prospective cross-sectional case control study. P1982. UEG Journal,2019,V.7(8S)iv.Abstract issue,p.988

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Авторы: Alharthi R. / Moazzez R. / Bartlett D. / Jafari J.


Risk factors for Erosive Tooth Wear in patients with Gastroesophageal Reflux Disease (GORD) symptoms: a prospective cross-sectional case control study

Alharthi R.1,2, Moazzez R.1, Bartlett D.1, Jafari J.3

Перевод на русский язык: Факторы риска эрозивного износа зубов у пациентов с симптомами гастроэзофагеальной рефлюксной болезни: проспективное перекрестное исследование


1 King’s College London, Centre of Oral, Clinical & Translational Sciences, London, United Kingdom,
2 Pirincess Noura bnt Abdulrahman University, Riyadh, Saudi Arabia,
3 Guy’s and St Thomas Hospital, London, United Kingdom

Contact E-Mail Address: rasha.alharthi (a) kcl.ac.uk

Introduction: The most common oral manifestations of patients with GORD symptoms is erosive toot wear (ETW). It is not clear why a group of patients with GORD symptoms develop ETW whereas others don’t. The aim of this study is to assess the risk factors associated with developing ETW in patients with GORD symptoms, and to identify the predictive factors for ETW.

Aims & Methods: Consecutive patients referred for assessment of GORD to the Oesophageal Laboratory at Guy’s Hospital were recruited (REC Ref 18/NE/0099). After consenting, validated self-reported Reflux Symptom Questionnaire 7-day recall (RESQ-7) was used to assess the frequency and intensity of GORD symptoms. Patients underwent 24hr impedance-pH reflux monitoring; acid exposure times (AET), symptoms index (SI) and symptoms association probability (SAP) were reported.

A clinical assessment of ETW was done using Basic Erosive Tooth Wear Examination (BEWE) protocol; a validated index in which the mouth is divided into 6 areas each scored from 0 to 3 (0= no ETW, 1= initial loss of surface texture, 2= loss of hard tissue < 50% of surface area and 3= loss of hard tissue ≥ 50% of surface area). Those with a cumulative score of ≥12 and at least 1 oral area scoring 3 were included in the ETW group (ETW) and the rest were included in the NETW group (No ETW).

Data were analysed using STATA software, mean (SD), t-test analysis and ROC curve analysis were applied. P< o.o5 was considered significant.

Results: 121 patients were recruited: ETW (n=64), NETW (n=57). Patients reported a range of 9 symptoms more commonly: heartburn, chest pain, regurgitation, cough, hoarseness, acid taste, throat burning, belching and epigastric pain. (mean±SD) of intensity and frequency of individual symptoms of heartburn, hoarseness and coughing were significantly higher in ETW group:

Heartburn intensity (ETW: 12.7±0.9 vs NETW: 9.7±0.9; P= 0.03), frequency (ETW: 14.3 ±1.0 vs NETW: 10.3 ±1.0; P= 0.007). Hoarseness intensity (ETW: 2.25±0.2 vs NETW: 1.32 ±0.2; P= 0.004), frequency (ETW: 2.8 ±0.2 vs NETW: 1.5±0.2; P= 0.0004). Coughing intensity (ETW: 3.0 ±0.2 vs NETW: 1.6± 0.2; P= 0.004, frequency (ETW: 3.5 ±0.2 vs NETW: 1.98 ±0.2; P= 0.0001).

ROC curve analysis, considering all symptoms on RESQ-7, showed that patients with total frequency of >25 (54.01% were correctly classified with a specificity of 30.88% and sensitivity of 76.8%) and/or total intensity of >36 (61.36% were correctly classified with a specificity of 81.5% and sensitivity of 41.8%) are more likely to develop ETW amongst GORD patients. 119/121 patients completed impedance-pH testing, total acid exposure time was significantly higher in ETW (1.48± 0.06) patients vs NETW (1.28±0.06); P=0.02. However, there was no significant difference between the two groups when upright and/or supine acid exposure time was considered individually.

Conclusion: This study demonstrates that there are three predictive values of developing ETW in GORD patients:
  1. Heartburn, hoarseness and coughing as opposed to other reflux symptoms. Hoarseness and cough may indicate progression of reflux to proximal oesophagus and oral cavity.
  2. Abnormal total acid exposure time, regardless of the body position or diurnal changes, on reflux monitoring.
  3. Total frequency >25 and/or intensity >36 of all symptoms on RESQ-7; although not yielding in high accuracy.
Disclosure: Nothing to disclose



27-я Объединенная Европейская Гастроэнтерологическая неделя UEG Week 2019Данная публикация — тезисы доклада (abstract) на 27-й Объединённой Европейской Гастроэнтерологической Неделе UEG Week 2019, г. Барселона.

Тезисы (abstracts) всех докладов UEG Week 2019 (pdf, 12,4 Mb): https://www.ueg.eu/publications/abstractbook



См. также: Параскевова А.В. Объединённая Европейская Гастроэнтерологическая Неделя 2019 (United European Gastroenterological Week 2019) // www.gastroscan.ru, 2019.

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