Which medications are most closely linked to dental erosions due to gastric reflux?

• A. Progesterone, nitrates, beta blockers, and calcium channel blockers
• B. Nifedipine
• C. Phenytoin
• D. Caries

Answer: (A)

Dental erosions from gastric reflux happen when stomach acid repeatedly contacts the teeth. Some medicines can increase reflux by relaxing the lower esophageal sphincter or altering gastric motility, letting more acid reach the mouth. Progesterone and nitrates are known to relax smooth muscle, including the sphincter, while calcium channel blockers also lower LES tone and can slow gastric emptying. Beta blockers may influence esophageal motility in some cases, contributing to reflux risk. Because this group includes several drug classes that can promote acid reflux and thus enamel erosion, they’re most closely linked to the observed dental erosions.

Phenytoin is more typically associated with gingival overgrowth, not erosion from reflux; caries results from bacterial decay rather than reflux; and focusing on a single drug like nifedipine doesn’t capture the broader reflux-related effect seen with the combination of medications in that option.