Can reflux and heartburn be bad for your teeth?

By Paul Ansell – Dentist

Just when you thought it couldn’t get any more complicated, life throws up (pun intended) some more opportunities for tooth destruction. And why it’s a terrible idea to brush your teeth after you get reflux or vomit.

If you have followed us for a while now, you will have succumbed to the ongoing rhetoric that sugar and acid, while often delicious, are the mortal enemy of your teeth… external threats, the bad guys. But what if we told you that one of the most harmful forces comes from within?

All hail stomach acid – the queen of tooth melting. With a pH rating somewhere between pool acid and Coca-Cola, for the purposes of digestion, stomach acid is meant to be kept in the stomach (which has a protective lining) for good reason.

Gastroesophageal reflux disease – or GERD (love it when the name of a disease sounds like the sound you make when experiencing it) is a condition where stomach acid is able to pass back up through the oesophagus (food pipe) and can occasionally reach the mouth.

This can be caused by the sphincters or valves at the top of the stomach not sealing properly and allowing stomach acid to come back up. This will cause irritation of the oesophagus, which can result in a burning feeling, coughing, and general discomfort.

If the acid enters the mouth, you will usually get a sour and bitter taste and you may notice that you start to salivate more. This is your mouth’s way of trying to counteract or buffer the acid. But over the long term, unmanaged reflux can start to dissolve your teeth.

Because the acid is coming from behind the teeth, we typically see premature wear on the tops of the lower molars and on the backs of the front teeth. Your teeth can become thin and brittle and can need extensive work to have them rebuilt.

So managing the acid problems comes first – speak to your GP, but the typical culprits are being overweight, excessive alcohol (consuming alcohol increases stomach acid production) and is associated with sleep apnoea. This can range from prescription medication, over-the-counter antacid tablets, and general health and lifestyle issues.

If you have a big night on the sauce – especially if you are drinking acidic things like wine or premixed cans or bottles – (also FYI drinking premix after the age of 25 is a sign of clinging to your youth when your palate should have matured) then you are attacking your poor teeth from both sides.

It can be tempting to want to brush your teeth after reflux or vomiting to remove the taste, but the issue is that your teeth are softened by the acid, and brushing them will scrub away more enamel. It is best to rinse with water, chew sugar-free gum, or an antacid tablet and wait at least 30 mins before brushing.

You can also help strengthen your enamel, and try to remineralise or repair the surface by using particular dental products.

Don’t accept GERD as a normal part of life and make sure you protect your teeth from some of the nastiest acid out there.

**Takeaway points**

  • Don’t brush your teeth after reflux/vomiting, instead rinse with water or chew sugar-free gum
  • Stomach acid has a pH rating somewhere between pool acid and Coca-Cola
  • Remineralising acid-worn enamel can be achieved with particular dental products
  • See your GP to manage your gastroesophageal reflux disease (GERD)

**References**

  • Clarrett, D. M., & Hachem, C. (2018). Gastroesophageal Reflux Disease (GERD). Missouri Medicine, 115(3), 214-218. PMID: 30228725; PMCID: PMC6140167.
  • Colgate. (2023, January 9). Can tooth enamel be restored? Retrieved from https://www.colgate.com/en-us/oral-health/adult-oral-care/can-tooth-enamel-be-restored
  • Dundar, A., & Sengun, A. (2014). Dental approach to erosive tooth wear in gastroesophageal reflux disease. African Health Sciences, 14(2), 481-486. https://doi.org/10.4314/ahs.v14i2.28 PMID: 25320602; PMCID: PMC4196415.
  • Zimmer, S., Kirchner, G., Bizhang, M., & Benedix, M. (2015) ‘Influence of various acidic beverages on tooth erosion: Evaluation by a new method.’ PLoS One, 10(6), e0129462. doi: 10.1371/journal.pone.0129462. PMID: 26035729; PMCID: PMC4452714.