I Bet You Suffer from Acid Reflux & Don't Even Know It

AB: Hello and welcome to SimplifiHealth. My name is Aurelia Byrne. I’m a registered Dental Hygienist at Stonebriar Smile Design, the office of Dr. Jill Wade. Today, Dr. Wade is with us and we’re going to talk about the three things you need to know about acid reflux. Hello, Dr. Wade.

JW: Hello, Aurelia. It’s great to be here today. I’m excited to talk about this. This subject matter—to us in the dental office—is a daily occurence.

AB: Absolutely.

JW: We look at this on almost every single patient. We are trying to decide if we are seeing any signs and symptoms of acid reflux. 

AB: A lot of people are not aware of this issue at all. There are so many things that go along with acid reflux. It’s not just heartburn or, “Oh, I had to take something for my stomach because it hurts,” it’s a whole different ball game.

JW: Agreed. I actually think that most people think they don’t have acid reflux specifically because about 30% of the population actually has what’s called “silent reflux” which means that they don’t have the typical signs and symptoms like acid reflux as far as heartburn, burping, chest pain that is happening, sitting right above your heart, kind of in the middle—that is what we call acid reflux or heartburn.

A lot of people may think that they only feel that when they eat tomato sauce or really late at night and laid down. All those things can cause them to have those types of feelings but there’s a ton of people out there who actually are having acid reflux and they don’t even know it, it’s silent.

AB: Yes. What are the things that we don’t know about acid reflux? Tell me what some of the symptoms are that you would know right away, what is one of them?

JW: I think one of the easiest questions to ask anybody is, “Do you find yourself, first thing in the morning, waking up and feeling like you need to clear your throat?” You kind of have a raspy voice and you’re constantly feeling like you need to clear it, before you start maybe at work when you’re talking to a co-worker or you’re doing a presentation and you’re constantly clearing your throat.

A lot of people will tell me, “No I’m just having post-nasal drip,” or “I’m having allergies today so I’m clearing my throat.” This may be true or may be not true. Perhaps, rather than coming down from post-nasal drip, it’s actually coming up. What they’re feeling is something just back in the throat that is irritating to them and they feel like they need to clear it. 

AB: When we see a patient in our office and they’re laying in our chair and you ask them these questions, what is the percentage that people actually say, “Yeah, I do clear my throat in the morning?”

JW: That’s a great question. I find that they will start to answer, “No,” and then about two or three seconds later they clear their throat. I’m like, “Oh, okay, you don’t clear your throat. That’s great. You just did.”

AB: That’s so funny.

JW: A lot of what we do in office, as you will know, is just observe; observe people, what they’re doing, what they’re saying, but then also looking in the mouth and actually observing all the subtle signs and symptoms that we’re actually seeing in the oral cavity itself. And not to get into too much detail but there are so many different things that we can look at on the teeth and in the mouth to even see that acid reflux is actually actively occurring.

Now, every once in a while, we don’t know if it’s active or if it has been in the past. For example, the really shiny teeth. It’s like the river. A river has water that goes across all the rocks all the time. That shouldn’t be all that abrasive or harsh on the rocks that overtime, as the water washes over the rocks, it makes them very slippery and very smooth. The same exact thing happens in the mouth on the teeth if you have constant and consistent acid reflux, it washes over the teeth, makes them really smooth and really shiny.

AB: Yeah. The clearing of the throat was the one thing, what’s the second thing that a person would need to know if they have acid reflux and they don’t have heartburn?

JW: One of the other clues that I want to talk to everybody about is that if you have never really been prone to having cavities and then all of a sudden somebody is telling you that you have quite a few cavities—especially on the back teeth and what we call interproximal cavities which is in between your teeth where you floss—that is a huge red flag for me that someone has all of the sudden began to have a lot of reflux issues for whatever reason. It may be stomach issues, sleep apnea, all kinds of reasons that they may have started having reflux, or a hernia.

But from going from having no cavities to all of a sudden having a lot of cavities—maybe you had cavities when you’re a teenager then you are very stable for 5, 10 years and then all of a sudden, you go back in and you have new cavities, this is not normal. If you haven’t stopped brushing your teeth and really changed your diet or not really eating or drinking anything that could be the cause of the cavities, then my first go to thought process would be acid reflux. We need to stop that reflux. If we can’t stop the root cause of the problem—because we’re always thinking about what is the root cause of “the cavities” and can we stop that. If we can’t stop it immediately, what we can do to at least counterbalance that acidity is we recommend a lot of stronger toothpaste and rinses that can actually neutralize the acidity until we can get the root cause of the problem stopped.

AB: What are the things that I feel is 

really important about that particular issue as a patient listening to our podcast right now is that if you go to your dentist and they’re diagnosing you with a lot of interproximal caries or cavities—which means in between the teeth—and they can’t give you a reason why because you know you brush your teeth two times a day, and floss maybe once or twice a week, and you’re not gargling with Dr Pepper, you’re doing your due diligence as your preventative care as best as you can because let’s face it, nobody’s perfect. Maybe you hadn’t gone to the dentist for two years but you’re still doing your preventative maintenance, how can you get all these cavities?

The first thing as a patient is always question, “Why do I have all these cavities?” And if your dentist tell you and look at you in a way that, “I don’t know, you just got cavities because you’re prone to them,” there’s a reason, there’s always a reason just like we’re talking about the root cause of the issue. If that dentist is not able to ask you specific questions about what we’re talking about right now, then you’re going to always get those cavities again because you’re never going to stop the problem. Is that correct?

JW: That is absolutely correct. You know I’m a huge believer about really diving down deep to find those root causes. I know here soon, in one of our episodes, we are going to bring in one of our favorite ENT specialists (Ear, Nose, Throat specialist) that we work with, Dr. Mehendale, to continue this conversation about root causes of acid reflux, because hey, if you think, “Why am I going to take my medical advice from a dentist and dental professionals?” I’m going to tell you, don’t then. I’ll bring in medical specialists, physicians, cardiologists, and everything we need to in the future to allow you to have confidence that what we’re talking about is not craziness. We’re science based people who believe that root causes need to be looked up further and we’ll bring in other specialists that aren’t in the dental profession to help you believe that what we’re talking about is true and how that you can then begin to use your dental experiences to actually help you get healthier, help your overall wellness, optimize your overall health and well-being.

AB: Let’s digress a little bit and go to the third clue if you have acid reflux. We talked about interproximal caries and clearing your throat. What’s the third one, Dr. Wade?

JW: I think we touched based on it a few minutes ago, it is about this shininess, this ability to have this acid moving across the teeth all the time. Teeth are strong guys, this is one of the strongest parts of your whole body, even stronger than bone. In order to be able to make it deteriorate, if you want to say, you’ve got to have this acid that’s supposed to stay down in your stomach—your stomach was built for it to stay down in there and to protect itself from that acid, it was never meant to be up into your esophagus or your oral cavity. It doesn’t mean that you’re throwing up or that you’re feeling it, it could be just in vapor form, a burp or a little gargle. It doesn’t have to be as obvious as you may think. But this acid wash, if you want to say, can create this really shiny effect on the teeth and/or thinning.

A lot of people may notice that their teeth are wearing down extremely fast like accelerated wear and tear. We all have wear and tear on our teeth but accelerated wear or this ability to look into the mirror—you know what I’m talking about Aurelia—and see all of a sudden almost like their teeth are thinning right in the front, they get clearer and more translucent right there and then start to see little chips and breaks, this could be a sign of accelerated wear pattern from acid reflux.

AB: Correct. The three things that we talked about that is extremely important for a patient to know is if you’re going to your dentist and you’re experiencing these types of issues, point that out to your dentist so they can hopefully get you to the right specialist—which we’re going to have Dr. Mehendale coming and talk about this on a medical portion—very important, you need to be aware of these things and just be advocate. That’s what we’re trying to promote here, you have to take your health into your own hands and we’re here to help you get educated with our podcast and let you know that these are the things that you need to be looking for, if we’re going to talk about teeth or we’re going to talk about something else with another professional that comes in. 

JW: Exactly.

AB: If you would like to learn more about acid reflux and be your own advocate, we want you to visit our website called youniversityhealth.com, and there, you’re going to be able to download exactly what we were talking about and the details about how to become an advocate. For the dental professionals, if you would like to learn more about what we see in the mouth clinically, you could reach out at relevancehealth.com. Thank you, Dr. Wade.

JW: Thank you, Aurelia.

AB: Thank you for listening everybody.