Int J Clin Pediatr

International Journal of Clinical Pediatrics, ISSN 1927-1255 print, 1927-1263 online, Open Access

Article copyright, the authors; Journal compilation copyright, Int J Clin Pediatr and Elmer Press Inc

Journal website https://ijcp.elmerpub.com

Original Article

Volume 15, Number 1, March 2026, pages 16-25

Oral Health Status and Salivary Pepsin Levels in Children With Gastroesophageal Reflux Disease Surgery: A Postoperative Evaluation

↓ **Table 1.** Abbreviations and Definitions of the Indices Employed to Assess Oral Health
Abbreviation	Definition
dmft	decayed, missing, and filled teeth (primary dentition)
dmfs	decayed, missing, and filled surfaces (primary dentition)
DMFT	decayed, missing, and filled teeth (permanent dentition)
DMFS	decayed, missing, and filled surfaces (permanent dentition)
PI	plaque index
GI	gingival index
BEWE	basic erosive wear examination

↓ Table 1. Abbreviations and Definitions of the Indices Employed to Assess Oral Health

Abbreviation

Definition

dmft

decayed, missing, and filled teeth (primary dentition)

dmfs

decayed, missing, and filled surfaces (primary dentition)

DMFT

decayed, missing, and filled teeth (permanent dentition)

DMFS

decayed, missing, and filled surfaces (permanent dentition)

plaque index

gingival index

BEWE

basic erosive wear examination

↓ **Table 2.** Distribution Statistics of the Indices Indicating the Oral Health Status and Salivary Parameters of the Children in the Operated for GERD and Healthy Groups Participating in the Study
	Operated for GERD (n = 14)^a	Healthy (n = 26)^a
^aMeasurements were made in patients whose teeth had fully erupted in the oral cavity. ^bMann-Whitney U. ^cIndependent sample t-test. BEWE: basic erosive wear examination; GERD: gastroesophageal reflux disease; GI: gingival index; IQR: interquartile range; PI: plaque index; SD: standard deviation.
dmft	1.50 ± 3.61	0 (1)	0–13	3.85 ± 4.22	2 (7)	0–13	0.028^b
dmfs	4.00 ± 8.95	0 (2)	0–29	9.77 ± 11.85	4 (20)	0–37	0.033^b
DMFT	1.86 ± 4.45	0 (1)	0–16	2.38 ± 3.92	0.5 (3)	0–17	0.194^b
DMFS	2.43 ± 5.47	0 (1)	0–19	4.08 ± 7.44	0.5 (6)	0–32	0.154^b
PI	2.01 ± 0.80	1.79 (1.63)	1–3	1.303 ± 0.37	1.37 (0.64)	0–1.91	0.014^b
GI	1.98 ± 0.57	2 (0.73)	1.16–3	1.294 ± 0.25	1.29 (0.32)	0–1.85	0.000^b
BEWE	2.93 ± 3.36	2 (4)	0–9	0.77 ± 1.21	0 (1)	0–4	0.094^b
Saliva parameters
pH	6.913 ± 0.3304	6.9 (0.5)	6.2–7.5	6.985 ± 0.3209	7.0 (0.5)	6.4–7.6	0.488^c
Buffering capacity	4.94 ± 2.205	4.5 (4)	2–10	5.54 ± 2.775	5 (5)	1–11	0.467^c
Flow rate (mL/min)	0.5181 ± 0.396	0.465 (0.48)	0.03–1.35	0.438 ± 0.340	0.275 (0.51)	0.06–1.22	0.543^b
Pepsin (pg/mL)	95.219 ± 154.250	0 (136.9)	0–512.85	104.923 ± 193.869	31.55 (124.3)	0.0–751.70	0.803^b

↓ Table 2. Distribution Statistics of the Indices Indicating the Oral Health Status and Salivary Parameters of the Children in the Operated for GERD and Healthy Groups Participating in the Study

Operated for GERD (n = 14)^a

Healthy (n = 26)^a

Mean ± SD

Median (IQR)

Minimum–Maximum

Mean ± SD

Median (IQR)

Minimum–Maximum

^aMeasurements were made in patients whose teeth had fully erupted in the oral cavity. ^bMann-Whitney U. ^cIndependent sample t-test. BEWE: basic erosive wear examination; GERD: gastroesophageal reflux disease; GI: gingival index; IQR: interquartile range; PI: plaque index; SD: standard deviation.

dmft

1.50 ± 3.61

0 (1)

0–13

3.85 ± 4.22

2 (7)

0–13

0.028^b

dmfs

4.00 ± 8.95

0 (2)

0–29

9.77 ± 11.85

4 (20)

0–37

0.033^b

DMFT

1.86 ± 4.45

0 (1)

0–16

2.38 ± 3.92

0.5 (3)

0–17

0.194^b

DMFS

2.43 ± 5.47

0 (1)

0–19

4.08 ± 7.44

0.5 (6)

0–32

0.154^b

2.01 ± 0.80

1.79 (1.63)

1–3

1.303 ± 0.37

1.37 (0.64)

0–1.91

0.014^b

1.98 ± 0.57

2 (0.73)

1.16–3

1.294 ± 0.25

1.29 (0.32)

0–1.85

0.000^b

BEWE

2.93 ± 3.36

2 (4)

0–9

0.77 ± 1.21

0 (1)

0–4

0.094^b

Saliva parameters

6.913 ± 0.3304

6.9 (0.5)

6.2–7.5

6.985 ± 0.3209

7.0 (0.5)

6.4–7.6

0.488^c

Buffering capacity

4.94 ± 2.205

4.5 (4)

2–10

5.54 ± 2.775

5 (5)

1–11

0.467^c

Flow rate (mL/min)

0.5181 ± 0.396

0.465 (0.48)

0.03–1.35

0.438 ± 0.340

0.275 (0.51)

0.06–1.22

0.543^b

Pepsin (pg/mL)

95.219 ± 154.250

0 (136.9)

0–512.85

104.923 ± 193.869

31.55 (124.3)

0.0–751.70

0.803^b

↓ **Table 3.** The Relationship Between Some Salivary Parameters of Children in the GERD Group Participating in the Study
	dmft	dmfs	DMFT	DMFS	PI	GI	BEWE
Spearman’s rho correlation. P < 0.05. *P < 0.01. BEWE: basic erosive wear examination; GI: gingival index; PI: plaque index.
dmft	r	1.000	0.998**	0.092	0.119	−0.023	−0.179	0.207
	p	.	0.000	0.755	0.684	0.942	0.558	0.477
dmfs	r		1.000	0.119	0.149	0.007	−0.160	0.174
	p		.	0.684	0.611	0.981	0.602	0.552
DMFT	r			1.000	0.998**	0.282	−0.056	0.099
	p			.	0.000	0.351	0.856	0.737
DMFS	r				1.000	0.300	−0.033	0.082
	p				.	0.320	0.914	0.780
Plaque index (PI)	r					1.000	0.813**	−0.374
	p					.	0.001	0.208
Gingival index (GI)	r						1.000	−0.509
	p						.	0.075
BEWE	r							1.000
	p							.

↓ Table 3. The Relationship Between Some Salivary Parameters of Children in the GERD Group Participating in the Study

dmft

dmfs

DMFT

DMFS

BEWE

Spearman’s rho correlation. *P < 0.05. **P < 0.01. BEWE: basic erosive wear examination; GI: gingival index; PI: plaque index.

dmft

1.000

0.998**

0.092

0.119

−0.023

−0.179

0.207

0.000

0.755

0.684

0.942

0.558

0.477

dmfs

1.000

0.119

0.149

0.007

−0.160

0.174

0.684

0.611

0.981

0.602

0.552

DMFT

1.000

0.998**

0.282

−0.056

0.099

0.000

0.351

0.856

0.737

DMFS

1.000

0.300

−0.033

0.082

0.320

0.914

0.780

Plaque index (PI)

1.000

0.813**

−0.374

0.001

0.208

Gingival index (GI)

1.000

−0.509

0.075

BEWE

1.000

↓ **Table 4.** The Relationship Between Some Oral Dental Health Findings of the Children in the GERD Group Participating in the Study (Spearman’s rho)
GERD Spearman’s rho		pH	Buffering capacity	Flow rate (mL/min)	Pepsin (pg/mL)
Spearman’s rho correlation. P < 0.05. *P < 0.01. GERD: gastroesophageal reflux disease.
pH	r	1.000	0.135	0.685**	−0.642**
	P	.	0.618	0.003	0.007
Buffering capacity	r		1.000	0.208	0.084
	P		.	0.440	0.758
Flow rate (mL/min)	r			1.000	−0.477
	P			.	0.062
Pepsin (pg/mL)	r				1.000
	P				.

↓ Table 4. The Relationship Between Some Oral Dental Health Findings of the Children in the GERD Group Participating in the Study (Spearman’s rho)

GERD Spearman’s rho

Buffering capacity

Flow rate (mL/min)

Pepsin (pg/mL)

Spearman’s rho correlation. *P < 0.05. **P < 0.01. GERD: gastroesophageal reflux disease.

1.000

0.135

0.685**

−0.642**

0.618

0.003

0.007

Buffering capacity

1.000

0.208

0.084

0.440

0.758

Flow rate (mL/min)

1.000

−0.477

0.062

Pepsin (pg/mL)

1.000

↓ **Table 5.** Comparison of Oral Health Indices and Salivary Parameters Between Children Operated for GERD and Healthy Controls
	Operated for GERD (n = 14)	Healthy (n = 26)	P
GERD: gastroesophageal reflux disease; NS: no significant difference.
dmft/dmfs	↓ lower	↑ higher	< 0.05
DMFT/DMFS	↓ lower	↑ higher	> 0.05
Plaque index	↑ higher	↓ lower	< 0.05
Gingival index	↑ higher	↓ lower	< 0.001
Oral hygiene (tooth brushing)	Poor (50% not brushing)	Better (73.1% self-brushing)	–
Dental visits	50%	84.6%	–
Salivary parameters (pH, buffering, flow, pepsin)	No significant difference	No significant difference	NS

↓ Table 5. Comparison of Oral Health Indices and Salivary Parameters Between Children Operated for GERD and Healthy Controls

Operated for GERD (n = 14)

Healthy (n = 26)

GERD: gastroesophageal reflux disease; NS: no significant difference.

dmft/dmfs

↓ lower

↑ higher

< 0.05

DMFT/DMFS

↓ lower

↑ higher

> 0.05

Plaque index

↑ higher

↓ lower

< 0.05

Gingival index

↑ higher

↓ lower

< 0.001

Oral hygiene (tooth brushing)

Poor (50% not brushing)

Better (73.1% self-brushing)

–

Dental visits

50%

84.6%

–

Salivary parameters (pH, buffering, flow, pepsin)

No significant difference