Liquid antacids that contain substances, including calcium carbonate, used to ease gastrointestinal conditions like acid reflux may significantly damage dental restorations. The report was published recently in BMC Oral Health.
Antacids can ruin the surfaces of restorations, specifically those made of glass ionomer and composite, or giomer resin, affecting their longevity and aesthetics, the authors wrote.
"The active ingredients added to gastric syrups to produce an antacid effect significantly change the surface roughness and microhardness of restorative materials,” wrote the authors, Fikri Öcal and Burak Dayi of Inonu University in Turkey (BMC Oral Health, January 24, 2025, Vol.25:135)
Gastroesophageal reflux disease, or GERD, in which stomach contents flow upward into the esophagus and oral cavity affects 18% to 28% of individuals in the U.S. GERD can damage the lining of the esophagus and tooth enamel. To seek relief, many reach for antacids, medications made with calcium carbonate, sodium bicarbonate, and magnesium carbonate, to neutralize the acid that causes burning and discomfort.
While studies have shown that acid-neutralizing materials in toothpastes can damage enamel, no study has analyzed liquid antacids' effect on tooth enamel, the authors wrote.
Therefore, to evaluate the effect of liquid antacids on the roughness and microhardness of composite material, the researchers created 50 samples each of nanohybrid, microhybrid, and giomer composites that were treated with a mylar matrix, light-cured, and polished. Samples were submerged in 10-ml solutions of calcium carbonate, sodium bicarbonate, magnesium carbonate, and distilled water for up to two minutes daily at 24-hour intervals for 28 days. This cycle aimed to replicate two years of antacid use. The samples' surface roughness and hardness were then measured on days seven, 15, and 28.
The microhardness and roughness of giomer composites showed significant degradation compared to nanohybrid and microhybrid materials.
After 28 days, the surface roughness decreased significantly (p < 0.05) for the giomer composite. However, the surface roughness of microhybrid and nanohybrid composites increased slightly but not significantly (p > 0.05).
For microhybrid and giomer composites, the microhardness value showed a significant decrease (p < 0.05), the authors wrote.
Furthermore, the researchers attribute the increased roughness of giomer composites to the abrasive effects of antacid ingredients while decreases in microhardness were likely due to the glass ionomer structure of the samples and mechanical weakness due to water absorption and the dissolution of monomers, the researchers said.
Microhybrid composite groups. The first group is the control group. The other groups are AFM images after 28 days of experimentation with GL, GD, RDc and MF antacid syrups, respectively. Images and captions courtesy of Ă–cal and Dayi. Licensed under CC BY ND 4.0.
Nanohybrid composite groups. The first group is the control group. The other groups are AFM images after 28 days of experimentation with GL, GD, RD, and MF antacid syrups, respectively.
Giomer composite groups. The first group is the control group. The other groups are AFM images after 28 days of experimentation with GL, GD, RD, and MF antacid syrups, respectively.
There were limitations to the study, including that the composite types differed with the filler type, size, and matrix composition, the authors wrote. Future studies should use more homogenous materials, account for more realistic results, and use a longer time frame, they wrote.
"The study emphasizes the need for caution in restorative material selection and care protocols in patients using antacid gastric syrups," Ă–cal and Dayi concluded.
