medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-544medsovet-9757Research ArticleГАСТРОЭНТЕРОЛОГИЯGASTROENTEROLOGYСпектр стоматологических проявлений гастроэзофагеальной рефлюксной болезни и подходы к их верификацииSpectrum of dental manifestations of GERD and approaches to their verificationhttps://orcid.org/0000-0002-6581-7017ЛивзанМ. A.LivzanM. A.

Ливзан Мария Анатольевна, чл.корр. РАН, д.м.н., профессор, заведующая кафедрой факультетской терапии и гастроэнтерологии, ректор

644099, Омск, ул. Ленина, д. 12

Scopus Author ID: 24341682600

Mariya A. Livzan, Сorr. Member RAS, Dr. Sci. (Med.), Professor, Head of the Department of Faculty Therapy and Gastroenterology, Rector

12, Lenin St., Omsk, 644099

mlivzan@yandex.ruhttps://orcid.org/0000-0001-9370-4768ГаусО. В.GausO. V.

Гаус Ольга Владимировна, д.м.н., доцент, профессор кафедры факультетской терапии и гастроэнтерологии, Омский государственный медицинский университет

644099, Омск, ул. Ленина, д. 12

Scopus Author ID: 56598554900

Olga V. Gaus, Dr. Sci. (Med.), Associate Professor, Professor of the Department of Faculty Therapy and Gastroenterolog

12, Lenin St., Omsk, 644099

gaus_olga@bk.ruhttps://orcid.org/0000-0003-4580-9826ГурьевскаяО. А.GuryevskayaO. A.

Гурьевская Ольга Анатольевна, к.м.н., ассистент кафедры стоматологии дополнительного последипломного образования, Омский государственный медицинский университет; врач – стоматолог-терапевт, Стоматологическая клиника «Элита»

644099, Омск, ул. Ленина, д. 12,

644012, Омск, ул. Малиновского, д. 18/1

Olga A. Guryevskaya, Cand. Sci. (Med.), Assistant of the Department of Аdditional Postgraduate Education, Omsk State Medical University; Dentist-Therapist, Dental Clinic “Elite”

12, Lenin St., Omsk, 644099,

18/1, Malinovsky St., Omsk, 644012

drsavinova@mail.ruhttps://orcid.org/0000-0001-5245-7190ГавриленкоД. А.GavrilenkoD. A.

Гавриленко Дарья Александровна, ассистент кафедры факультетской терапии и гастроэнтерологии

644099, Омск, ул. Ленина, д. 12

Scopus Author ID: 58911289800

Darya A. Gavrilenko, Assistant Professor, Department of Faculty Therapy and Gastroenterology

12, Lenin St., Omsk, 644099

gavrilenko_darya17@bk.ruОмский государственный медицинский университетРоссияOmsk State Medical UniversityRussian FederationОмский государственный медицинский университет; Стоматологическая клиника «Элита»РоссияOmsk State Medical University; Dental Clinic “Elite”Russian Federation2025220120260238491Copyright © Ливзан М.A., Гаус О.В., Гурьевская О.А., Гавриленко Д.А., 20262026Ливзан М.A., Гаус О.В., Гурьевская О.А., Гавриленко Д.А.Livzan M.A., Gaus O.V., Guryevskaya O.A., Gavrilenko D.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9757

Гастроэзофагеальная рефлюксная болезнь (ГЭРБ) относится к числу наиболее распространенных заболеваний в терапевтической практике. Нередко у пациентов, помимо классических жалоб, встречаются и внепищеводные симптомы, что может затруднять диагностику ГЭРБ и требует реализации междисциплинарного подхода к курации с привлечением смежных специалистов. К таковым относятся стоматологические проявления ГЭРБ, которые условно можно разделить на поражение мягких тканей ротовой полости (красная кайма губ, слизистая оболочка ротовой полости, язык, ткани пародонта) и твердых тканей зуба (эмаль и дентин). Эпидемиологические данные о распространенности тех или иных стоматологических проявлений ГЭРБ достаточно ограничены и неоднородны. Рассматривается ряд патогенетических факторов, объясняющих причинно-следственную связь поражений ротовой полости и зубов с ГЭРБ, включая прямое повреждающее действие агрессивных молекул рефлюксата, изменение физико-химических свойств слюны в виде снижения ее буферной емкости, уменьшения секреции муцинов, факторов роста и антимикробных пептидов, а также бруксизм. С практической точки зрения установить связь между ГЭРБ и возможными стоматологическими проявлениями достаточно сложно из-за гетерогенности и неспецифичности последних. При подозрении на ГЭРБ у пациентов с поражением ротовой полости и/или зубов целесообразно использование опросника GERDQ, эзофагогастродуоденоскопии, а в ряде случаев – 24или 48-часовой pH-импедансометрии и манометрии высокого разрешения. Потенциальную перспективу в качестве скрининга для выделения когорты лиц, нуждающихся в дальнейшем обследовании, могут представлять тест-системы для определения уровня пепсина и желчных кислот в слюне.

Gastroesophageal reflux disease (GERD) ranges among the most common diseases in therapeutic practice. In addition to the classic complaints, patients often experience extraesophageal symptoms, which can complicate the diagnosis of GERD and require a multidisciplinary approach to the patient management with the assistance of related specialists. These include dental manifestations of GERD, which can be conveniently classified into lesions affecting the soft tissues (vermillion border of the lips, tunica mucosa of mouth, tongue, periodontal tissues) and the dental hard tissues (enamel and dentin) in the oral cavity. Epidemiological data on the prevalence of these or other dental manifestations of GERD are limited and heterogeneous. The article considers a number of pathogenetic factors that explain the cause-and-effect relationship between oral/dental lesions and GERD, including the direct damaging effects of aggressive refluxate molecules, changes in the physicochemical properties of saliva expressed as a decrease in its buffering capacity, reduction in secretion of mucin, growth factors, and antimicrobial peptides, and bruxism. From a practical perspective, it is quite difficult to find a link between GERD and possible dental manifestations due to the heterogeneity and nonspecificity of the latter. If GERD is suspected in patients with oral and/or dental lesions, it is reasonable to use the GERDQ questionnaire, esophagogastroduodenoscopy, and, in some cases, 24or 48-hour pH-impedance measurements and high-resolution manometry. The salivary pepsin and bile acid tests may be used as a potential screening tool to identify a cohort of individuals requiring further examination.

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The authors declare that there are no conflicts of interest present.