Patients with gastroesophageal reflux disease (GERD) and peptic ulcers may face a higher risk of developing gum disease and tooth decay, according to a recently published review in the Journal of Evidence-Based Dental Practice.
Furthermore, this link may be due to a lower oral pH and weakened saliva buffering ability, leading to enamel demineralization and an oral environment that increases the risk of caries, the authors wrote.
“Evidence suggests that individuals with GERD and peptic ulcers were more likely to have periodontal disease and caries compared to individuals without these conditions,” wrote the authors, led by Maria Cláudia Alves of the Federal University of Minas Gerais School of Dentistry in Brazil (J Evid Based Dent Pract, March 15, 2025, 102268).
The systematic review and meta-analysis investigated the link between GERD, peptic ulcers, and oral health outcomes in adults, including periodontal disease and dental caries. Additionally, it examined how these conditions may affect quality of life and social relationships, its authors wrote.
A literature search of electronic databases was conducted and updated on October 13, 2025. The analysis included observational studies comparing adults with GERD or peptic ulcers to those without these conditions. In total, 19 studies were included, with 10 contributing data to six meta-analyses.
Across six meta-analyses, individuals with GERD had a higher decayed, missing, and filled teeth index than those without GERD (mean difference [MD] = 0.79; 95% confidence interval [CI] = 0 to 1.57). Also, they showed a significantly higher papillary marginal alveolar index (MD = 1; 95% CI = 0.60 to 1.40) and oral hygiene index scores (MD = 1.22; 95% CI = 0.50 to 1.93), they wrote.
Individual studies linked GERD to increased caries rates and periodontal disease, including significantly higher rates of severe periodontitis (p < 0.001). Periodontitis was also more common in GERD patients ages 40 to over 70, in those with comorbidities, and across both chronic and nonchronic forms (all p < 0.001), while peptic ulcers were associated with higher odds of periodontitis (odds ratio = 1.15). Additionally, GERD and peptic ulcer patients had more decayed teeth (p < 0.01; p < 0.001), and caries prevalence was higher in GERD patients (72.2% versus 54.4%).
However, the review was limited by potential publication and database biases, including the exclusion of unpublished or negative-result studies, which may affect the overall findings, the authors added.
“It is important and suggestive that there is a clinical interdisciplinary approach between doctors and dental surgeons, for the adequate treatment of these patients, since there may be a relationship between GERD and periodontal disease,” Alves and colleagues concluded.
