Association Between Gastroesophageal Reflux Disease (GERD) Symptoms, Dental Health, and Cariogenic Microorganisms in the Oral Cavities of Children

Background: The acidic nature of gastric refluxate, combined with the enhanced proliferation of Streptococcus mutans and Streptococcus sobrinus in acidic environments, underscores the potential impact of gastroesophageal reflux disease (GERD) on oral health. This study aimed to explore the relationship between dental health status and microbial load in the oral cavity of children diagnosed with GERD symptoms, in comparison to compared with healthy controls. Methods: This case-control study involved 32 children with GERD and 37 healthy children, aged 5 to 11 years. GERD symptoms were assessed using the GERD Assessment of Symptoms in Pediatrics Questionnaire (GASP-Q). Dental health was evaluated using the decayed, missing, and filled teeth (dmft/DMFT) index. Microbial load was measured by sampling the tongue and cheeks with sterile cotton swabs, followed by the quantification of S. mutans and S. sobrinus . Statistical analyses were performed using Chi-square tests, independent T-tests, Pearson correlation coefficients, and logistic regression with SPSS software, at a significance level of 0.05. Results: The mean age of the children was 8.22 ± 1.92 years. No significant differences were observed between the case and control groups in terms of mean age (P = 0.379) or sex distribution (P = 0.126). There was no significant difference in the dmft/DMFT index scores between the two groups (P = 0.410). However, the mean bacterial count was significantly higher in the GERD group compared to the control group (P < 0.001). A significant linear relationship was found between GERD symptoms and bacterial load in children aged 8 years or younger (Beta = 0.645, P < 0.001). Conclusion: While GERD was associated with an increased levels of cariogenic bacteria in the oral cavity, no significant effect on dental caries rates was observed.