Investigation of the impact of acid reflux on dental cements

Laryngopharyngeal reflux (LPR) is a form of gastroesophageal reflux disease (GERD), where stomach acids travel into the oral cavity due to malfunctioning esophageal sphincters. LPR impacts 20% of adults and 10% of children in the United States. Among those affected, 24% of adults and 98% of children have dental damage due to gastric acid, requiring treatments such as fillings, crowns, bridges, or orthodontic appliances. Since dental cements securing these treatments to teeth may degrade when exposed to stomach acid, their performance should be evaluated in LPR patients. While many studies have focused on dietary acids, the effects of stomach acids have received less attention. This study explored the effects of hydrochloric acid, the predominant stomach acid, at pH 2, 3, 4, and 5 over a 30-day period at 37°C on two widely used dental cements: glass ionomer cement (GIC) and resin cement (RC). We hypothesized that dental cements exposed to acidic environments like those found in LPR would exhibit increased degradation as pH levels decrease. Our results showed that GIC had significantly increased sorption and solubility with decreasing pH, resulting in degradation of its ionic matrix. For RC, our results showed that sorption remained unaffected by pH changes, but solubility significantly increased as pH decreased, with no observable degradation. Our study suggests that RC is more resistant to hydrochloric acid-based decay, making it potentially a better choice than GIC for LPR patients. This study underlines the importance of careful dental cement selection when treating LPR patients.