Gastroesophageal Reflux Disease and Tooth Erosion: A Cross-Sectional Observational Study

BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD) is common in children. Recurrent exposure to gastric acid in GERD may contribute to tooth erosion. METHODS: In this prospective study, 54 GERD patients qualified according to endoscopy, pH-metry, and the GERD questionnaire and 58 healthy controls qualified by the GERD questionnaire were assessed. Two groups underwent dental evaluations for the presence, severity, and patterns of erosion and for the stage of dentition using a Tooth Wear Index. The health care providers who performed the dental exams did not know which children had been diagnosed with GERD. RESULTS: A total of 112 children, 3 to 12 years old were enrolled in the study, and 53 of 54 (98.1%) GERD patients and 11 of 58 (19.0%) controls had dental erosions (p<0.0001). In GERD patients, the posterior occlusal surfaces of milk teeth were more affected (p<0.0001). There was no correlation between GERD and the affected surfaces in permanent teeth, nor in the patterns or erosion grades (localized or general). In both groups, milk teeth had more erosions than permanent teeth, but the difference was not statistically significant. CONCLUSIONS: According to this study, there is a positive correlation between GERD and dental erosion. Posterior occlusal surface erosions in milk teeth could indicate GERD.

Role of synbiotics in the treatment of childhood constipation: a double-blind randomized placebo controlled trial

Constipation is a common problem in children. There is some clinical evidence for the role of probiotics and prebiotics in the treatment of constipated children. This is the first study on the therapeutic effect of synbiotics [combination of probiotics and prebiotic] in treatment of childhood constipation. In a double-blind randomized placebo controlled study 102 children aged 4-12 years with functional constipation were assessed according to Rome III criteria for 4 weeks. They were divided into 3 groups: group A, received 1.5 ml/kg/day oral liquid paraffin plus placebo, group B, 1 sachet symbiotic per day plus placebo and group C, 1.5 ml/kg/day oral liquid paraffin plus 1 sachet symbiotic per day. Frequency of bowel movements [BMs], stool consistency, number of fecal incontinence episodes, abdominal pain, painful defecation per week, success of treatment and side effects were determined in each group before and after treatment. The frequency of BMs per week increased in all groups [P<0.001], but it differed between groups and was higher in group C [P=0.03]. Stool consistency increased and number of fecal incontinence episodes, abdominal pain and painful defecation per week decreased in all groups similarly and there was statistically no difference between them. No side effects were reported in group B; the main side effect in group A and C was seepage of oil [P<0.001]. Treatment success was similar in all groups without any significant difference between them [P=0.6]. This study showed that synbiotics have positive effects on symptoms of childhood constipation without any side effects