BARIATRIC SURGERY IMPACT ON GASTROESOPHAGEAL REFLUX AND DENTAL WEAR: A SYSTEMATIC REVIEW

ABSTRACT Introduction: Several oral problems may be perceived in individuals who were submitted to bariatric surgery, due to metabolic and behavioral changes relative to diet and oral hygiene. Tooth wear appears to suffer impact after bariatric surgery, because there may be an increase in gastroesophageal reflux. Objective: To systematically review the literature regarding the impact of bariatric surgery on gastroesophageal reflux and tooth wear. Method: The following databases were accessed by two independent, calibrated examiners: PubMed, Medline, Lilacs, Scielo and Cochrane using the following descriptors: “bariatric surgery” AND “dental erosion” OR “bariatric surgery” AND “dental erosion” AND “gastroesophageal reflux disease”. After excluding duplicate studies, 12 studies were initially evaluated by the title and abstract. The excluded studies were those without relevance to the present research, literature review studies and case reports. Thus, four articles were included in this study. All the articles evaluated indicated high association between gastroesophageal reflux and tooth wear in patients submitted to bariatric surgery. Association of these outcomes was more evident six months after the surgical procedure. Conclusion: Patients submitted to bariatric surgery showed higher prevalence of gastroesophageal reflux and tooth wear.

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Interfaces between bariatric surgery and oral health: a longitudinal survey

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502011000800015 ◽

2011 ◽

Vol 26 (suppl 2) ◽

pp. 79-83 ◽

Cited By ~ 20

Author(s):

Juliane Avansini Marsicano ◽

Patrícia Garcia de Moura Grec ◽

Lídia Barbieri Belarmino ◽

Reginaldo Ceneviva ◽

Sílvia Helena de Carvalho Sales Peres

Keyword(s):

Quality Of Life ◽

Bariatric Surgery ◽

Oral Health ◽

Tooth Wear ◽

Salivary Flow ◽

Lifestyle Changes ◽

Dental Wear ◽

Bariatric Patients ◽

The Impact

PURPOSE: To evaluate oral changes, such as dental caries, periodontal disease, dental wear and salivary flow in bariatric patients. Fifty four obese patients who underwent bariatric surgery were studied before (n=54), up after 3 months (n=24) and 6 months (n=16). METHODS: Indices for evaluating oral conditions were: DMFT, CPI, DWI and salivary flow. OIDP questionnaire was used to assess the impact of oral health on quality of life. ANOVA and Spearman correlation were used (p<0.05). RESULTS: DMFT was 17.6±5.7, 18.4±4.1 and 18.3±5.5 (P>0.05), presence of periodontal pockets in 50%, 58% and 50% of patients (p>0.05), tooth wear in dentin present in 81.5%, 87.5% and 87.5% before, 3 and 6 months after surgical treatment respectively. There were differences between the three periods for prevalence and severity of dental wear (p = 0.012). Salivary flow was 0.8±0.5 ml/min before surgery, 0.9±0.5 ml/min for 3 months and 1.1±0.5m/min for 6 months (p>0.05). The impact of oral health on quality of life decreased with time after bariatric surgery (p= 0.029). CONCLUSION: The lifestyle changes after bariatric surgery and these changes may increase the severity of pre-existing dental problems. However, these alterations in oral health did not influence the quality of life.

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ORAL HEALTH PROMOTION IN PATIENTS WITH MORBID OBESITY AFTER GASTROPLASTY: A RANDOMIZED CLINICAL TRIAL

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-672020190001e1437 ◽

2019 ◽

Vol 32 (2) ◽

Cited By ~ 5

Author(s):

Ilma Carla de Souza PORCELLI ◽

Nathalia Maciel CORSI ◽

Marina de Lourdes Calvo FRACASSO ◽

Renata Corrêa PASCOTTO ◽

Alexandrina Aparecida Maciel CARDELLI ◽

...

Keyword(s):

Bariatric Surgery ◽

Health Promotion ◽

Oral Health ◽

Tooth Wear ◽

Salivary Flow ◽

Health Promotion Program ◽

Control Group ◽

Oral Health Promotion ◽

Oral Conditions ◽

The Impact

ABSTRACT Background: The bariatric surgery may have negative repercussions on oral conditions. Aim: To evaluate the impact of oral health educational/preventive program developed with patients submitted to gastroplasties. Method: The sample consisted of 109 patients randomly allocated to two groups: intervention group (IG), where they participated in the oral health promotion program that include multiple educational-preventive approaches; control group (CG), where they received usual care from the bariatric clinic staff, without participation in the program. The oral conditions investigated in the pre-operative and postoperative periods of one month (1M) and six months (6M) were: dental caries, periodontal disease, tooth wear, dental plaque and salivary flow. Results: After bariatric surgery, patients in IG presented: fewer changes in enamel (6M: p=0.004), dentin (6M: p=0.005) and gingival bleeding (6M: p<0.0001), reduction in plaque index (1M, 6M: p<0.0001) and increased salivary flow (6M: p=0.039), when compared with CG. Incipient tooth wear was recorded in both groups (6M: p=0.713). Conclusion: There was a positive impact of the implemented program in the prevention of the main oral health problems in patients who underwent gastroplasties, contributing to their quality of life.

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Evaluation of oral health status and salivary flow rate in obese patients after bariatric surgery

European Journal of Dentistry ◽

10.1055/s-0039-1698950 ◽

2012 ◽

Vol 06 (02) ◽

pp. 191-197 ◽

Cited By ~ 22

Author(s):

Juliane A Marsicano ◽

Arsenio Sales-Peres ◽

Reginaldo Ceneviva ◽

Silvia H de C Sales-Peres

Keyword(s):

Bariatric Surgery ◽

Tooth Wear ◽

Control Group ◽

Obese Patients ◽

Dental Wear ◽

Significant Difference ◽

Severely Obese ◽

Dmft Index ◽

The Mean ◽

Saliva Flow

ABSTRACTObjectives: The aim of this study was to identify the prevalence of dental caries, periodontal diseases and tooth wear in bariatric patients, and relate the oral health conditions to saliva flow.Methods: Fifty-two patients who had undergone bariatric surgery (Roux-en-Y gastric bypass) and 50 severely obese patients indicated for bariatric surgery were submitted to clinical examinations with regard to dental caries (DMFT index), periodontal condition (CPI index), dental wear (DWI index – Dental wear index) and saliva flow. The data were statistically analyzed by the Student’s-t , Mann- Whitney, Spearman Correlation and Chi-square (χ2) tests at 5% significance level.Results: The DMFT index was 16.11±5.19 in the surgical group and 16.06±6.29 in the control group (P>.05). The mean CPI was 3.05±0.84 for the operated group and 2.66±1.25 for the obese patients with no significant difference between them (P>.05). There was statistically significant difference between the groups for the presence of periodontal pockets (P=.021). All the patients presented some degree of tooth wear, however, with no significant difference between the two groups (P=.82). The mean saliva flow values of the surgical group and control group were 0.64±0.46 mL/min and 0.66±0.49 mL/min, respectively. There was no significant difference in saliva flow and all oral conditions analyzed (P>.05).Conclusion: The prevalence of oral diseases was similar in severely obese patients who were candidates for bariatric surgery and in patients who had been submitted to bariatric surgery. Nevertheless, there was higher prevalence of periodontal pockets in the operated group. (Eur J Dent 2012;6:191-197)

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Prosthetic Rehabilitation of a Patient With Gastroesophageal Reflux Disease: Five-Year Follow-up

Operative Dentistry ◽

10.2341/14-297-o ◽

2016 ◽

Vol 41 (2) ◽

pp. 132-137 ◽

Cited By ~ 5

Author(s):

G Moretto ◽

YM Pupo ◽

ALN Bueno ◽

FO Araujo

Keyword(s):

Gastroesophageal Reflux ◽

Tooth Wear ◽

Salivary Flow ◽

Dental Erosion ◽

Erosion Processes ◽

Incisal Edge ◽

Mechanical Attrition ◽

Unbalanced Diet ◽

Laminate Veneers

SUMMARY Tooth wear is a multifactorial process that is a growing concern in dentistry. This phenomenon can be caused by mechanical (attrition, abrasion, or abfraction) or chemical (erosion) processes. Etiologic factors in dental erosion can be due to changes in behavior, an unbalanced diet, or gastrointestinal disorders such as acid regurgitation, which may influence the salivary flow rate and buffering capacity of saliva. This case report describes an esthetic rehabilitation of a patient with gastroesophageal reflux and dental erosion, with a treatment rationale that includes the use of a diagnostic template and five-year follow-up. This technique, presented here in a clinical case with moderate enamel loss, integrates an additive wax-up and a direct intraoral bis-acryl resin mock-up. Lithium disilicate glass-ceramic (IPS e.max Press, Ivoclar Vivadent) laminate veneers were fabricated with the heatpress technique. They were veneered with a layering ceramic (IPS e.max Ceram, Ivoclar Vivadent) to improve the appearance of the incisal edge. The case demonstrated the success of veneers as an effective, conservative, and esthetic treatment for patients with this pathology.

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Dental Erosion in Obese Patients before and after Bariatric Surgery: A Cross-Sectional Study

Journal of Clinical Medicine ◽

10.3390/jcm10214902 ◽

2021 ◽

Vol 10 (21) ◽

pp. 4902

Author(s):

Cui Yang ◽

Frederik Johannes Hammer ◽

Christoph Reissfelder ◽

Mirko Otto ◽

Georgi Vassilev

Keyword(s):

Bariatric Surgery ◽

At Risk ◽

Vitamin D ◽

Dental Erosion ◽

Soft Drinks ◽

Control Group ◽

Obese Patients ◽

Dental Wear ◽

Surgery Group ◽

Before And After

Obese patients are at risk of dental erosion due to micronutrient deficiency, consumption of soft drinks, gastric reflux disease and vomiting. The present study evaluates the presence of dental erosion in obese patients before and after bariatric surgery using the BEWE (basic erosive wear examination) scoring system. A total of 62 patients with severe obesity were included in the analysis, 31 in the control group (without bariatric surgery) and 31 in the surgery group (after bariatric surgery). BEWE scores did not vary between groups. Vitamin D deficiency was detected in 19 patients in the control group and three in the surgery group (p < 0.001). The serum calcium and vitamin D values were significantly higher in the surgery group (p = 0.003, p < 0.001 consecutively). All patients after bariatric surgery showed compliance with supplements, including vitamin D and calcium daily. Patients after bariatric surgery were less likely to drink soft drinks regularly (p = 0.026). Obese patients, before or after bariatric surgery, are at risk for erosive dental wear. However, with sufficient education prior to surgery and consistent intake of vitamin and mineral supplements, significant erosive dental wear after bariatric surgery could be avoided. Regular dental examination should be included in the check-up and follow-up program.

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The Impact of Patient and Operative Factors on the Development of Gastroesophageal Reflux Disease after Bariatric Surgery

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2016.08.198 ◽

2016 ◽

Vol 223 (4) ◽

pp. e76

Author(s):

Hatim A. Alsulaim ◽

Robin D. Megill ◽

Joseph K. Canner ◽

Aslam Ejaz ◽

Leigh A. Peterson ◽

...

Keyword(s):

Bariatric Surgery ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

The Impact

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Dietary Vitamin and Stability of Oral Anticoagulation: Proposal of a Diet with Constant Vitamin K1 Content

Thrombosis and Haemostasis ◽

10.1055/s-0038-1655997 ◽

1997 ◽

Vol 77 (03) ◽

pp. 504-509 ◽

Cited By ~ 47

Author(s):

Sarah L Booth ◽

Jacqueline M Charnley ◽

James A Sadowski ◽

Edward Saltzman ◽

Edwin G Bovill ◽

...

Keyword(s):

Dietary Intake ◽

Vitamin K ◽

High Performance ◽

Case Reports ◽

Food Composition ◽

Dietary Guidelines ◽

Dietary Vitamin ◽

Vitamin K1 ◽

The Stability ◽

The Impact

SummaryCase reports cited in Medline or Biological Abstracts (1966-1996) were reviewed to evaluate the impact of vitamin K1 dietary intake on the stability of anticoagulant control in patients using coumarin derivatives. Reported nutrient-drug interactions cannot always be explained by the vitamin K1 content of the food items. However, metabolic data indicate that a consistent dietary intake of vitamin K is important to attain a daily equilibrium in vitamin K status. We report a diet that provides a stable intake of vitamin K1, equivalent to the current U.S. Recommended Dietary Allowance, using food composition data derived from high-performance liquid chromatography. Inconsistencies in the published literature indicate that prospective clinical studies should be undertaken to clarify the putative dietary vitamin K1-coumarin interaction. The dietary guidelines reported here may be used in such studies.

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