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Thyroid UK
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gastroscopy and dental damage

I've had an appointment made by my doctor for a gastroscopy because I've recently been suffering from acid reflux/heartburn. She had put me on lanzaprazole for a month which worked very well, however once prescription finished it has come back again. She is loathe to prescribe long term until it is known what is causing the problem. I had suggested it might be actually low acid due to my levo (I had RAI last November for hyperthyroid, now on a 50mg levo script, blood tests every 6 weeks by endo who seems happy with my levels for now) but doctor says if it was low acid causing my reflux, then the lanzaprazole wouldn't have worked. Anyway, I digress, I received my appointment and also a little booklet describing the procedure. It informs that a common side effect is dental damage. As I have a front dental bridge, I'm now really concerned. Does anyone have experience of this? Should I ask for a barium test instead?

28 Replies

I don't think your GP is right about PPI's not working when you have low acid. They do work but long term will destroy what stomach acid you do have. Betaine Pepsin (available OTC) is recommended for low acid but you should probably check with your GP before taking them. In the meantime raw apple cider taken in fruit juice with a quarter/half teaspoon of bicarb is an effective remedy for reflux and should be taken in fruit juice before meals.



I'm sorry I can't help you re the gastroscopy.

1 like

They have to put these warnings on any test, even if there's the slightest chance ofit happening. I have dental work and asthma, and they took great care with me when I had my gastroscopy, and had no problems. Am surprised gp din't give anther script though.


one possibility is you have a hiatus hernia this is common in hypothyroid patients

2nd possibility is helicobactor infection

3rd possibility is salminella

my Hypoythyroid husband has had all 3

thankfully the infections were treated and his hiatus hernia is a sliding one so unless he does a lot of streching up to pick apples or similar he is fine unless he eats very spicy foods

yes he had a gastroscopy and yes he has crowns etc but thankfully there was no damage


In the meantime, you could try drinking water with lemon squeezed in it (through a straw to protect your teeth) as surprisingly lemon juice has a neutralising effect rather than acidic (I use it for this) also prop yourself up in bed while you sleep. Hope you find answers soon :)


Do you think your dose of Levo is high enough? Have you copies of latest blood tests with reference ranges to post here? If the problem has only arisen since your RAI, I would suspect it is a low thyroid issue. 50mcg is a low dose. Do you still have thyroid left working or was it all destroyed? My guess is definitely look at thyroid and don't have the gastroscopy until you are sure levels are optimum.


I think the thyroid must be still intact. As you say 50mcg is just a maintenance dose and I feel normal(ish). I had multinodular goitre, one fairly obvious nodule at the bottom of my throat and the RAI seems to have been 'grabbed' by that, it has practically disappeared.


Thank you all.

I had tried the lemon juice, it didn't work at all. If anything, it made symptoms worse so probably it isn't low acid causing the problem.

My blood tests show TSH of just under 1, T4 well in range. I had lost a good half stone whilst hyper, back on again now and weight pretty stable although I'd love to blame my new spare tire on being hypo, I think it's my love of custard creams :)

I had the helicobactor infection test, came back negative.

The thing is I have had two experiences of dental damage during intubation for surgery so am concerned I am one of the 1 in however many who might be unfortunate to get it during a gastroscopy.

Has anyone had the barium test instead?


Please read thread, test low/high stomach acid and link where to buy Betaine HCl + Pepsin 600mg capsules, which I have taken for some time and never been better stomach acid wise: healthunlocked.com/thyroidu...


Are you aware that acid reflux medications deplete your B12?

Have you had your B12 and vitamin D tested?

I had teeth problems which I put down to vit d deficiency.

Ideally your b12 would be above 500.




Hi Suze - I'm new here but thanks for sharing this info - I had no idea acid reflux meds could affect B12 levels!


HI Suze, interesting to know that acid reflux meds deplete B12 , I have a hiatus hernia and have been on meds for the problem for years, wonder if I should increase my B12. Thanks Bev.


Have you had your B12 tested? If not I would ask your GP. Ideally your B12 would be above 500.


The last time I had my B12 tested was Dec2012, it was 250, range 190-660. Next time I see my GP I'm going to ask for another blood test for this. Many thanks for the info Bev.


250 is too low! Look at b12d.org

I got my level from 289 to 1000. I take Jarrows b12 lozenges but if your level is any lower then I would push for injections. Read through the info on the website above and you will see how important it is.


Suze, how long and on what dose did that raise in levels take? My first test wasn't quite that bad but was below 500. Also, do you have to stop taking it before restesting? Thanks x


I wouldn't take a b12 supplement before being tested. If it's not below the lab range then NHS will not prescribe b12 injections. It took around 6 months to get my level up. I just have a b12 lozenge a couple of times each week now :-)


Thanks, I thought you had to be off it for some time before retesting, but I don't suppose my GP will bother to do it again anyway!


I don't stop taking mine before blood tests, I want to know what my level is with taking it.

However, for people who don't supplement, it is better to have your B12 tested as you may be prescribed B12 injections if your level is below the lab range.

B12 deficiency does affect a lot of us with thyroid disease. There is also a more accurate B12 test .... which I cannot find a link to at the moment


Thanks, it wasn't below range but was well below 500. I've seen that test somewhere, I'll hunt it out :-)


Thanks for the info , very interesting. Bev .


I've had one done and did not suffer any ill-effects.

It's not the most pleasant experience but it's over quickly.


Sorry to hijack this thread but I am interested with regard to my husband who has acid reflux. He takes Lanzoprazole but only when absolutely necessary. His mother has stomach cancer and has been told it is a direct result of having low B12/ Pernicious Anaemia.

I was very interested in what The Bear said about lemon juice, but then as it didn't help BillieSt it got me thinking whether acid reflux really is always due to low stomach acid. Years ago I made my hubby take cider vinegar and he has never let me for get it because he was in agony!!

PS: We have found that fresh coriander is very effective.


Just to confirm my mum's B12, which was already low, was made worse by these meds. When she had a gastroscopy last week, she just mentioned her dental work at the front and they took extra care. They put a fitting over the mouth first, then pass the tube through. Every time I have an operation, they tell me that there is a risk they will knock my teeth out, but they haven't yet - I think as someone says above, it is standard to say what the risks are. When ever an anaesthetist says this now, I ask how many teeth they have knocked out in the past and they usually reply, "None!" S


Should also say that consistent, untreated acid reflux can damage the lining of the oesophagus, so if you are having the meds for the right reason, it is important, but do monitor B12 levels if you need to take them longer term. Good luck with the procedure, which hopefully will get to the bottom of the problem (my mum had hiatus hernia)S


Thank you all for your responses, very helpful and thought provoking. I have been back to my doctor this morning, she reiterated she doesn't think this is down to low acid. Actually now I think about it, I take my calcium medication each morning (I have osteoporosis), which is a sachet of fizzy powder and always burp almost immediately, so presumably this passes the similar bicarb test.

I did enquire about switching to barium swallow and she advised that this isn't used as often these days because the results aren't as comprehensive as a gastroscopy, also there is a much faster 'direct line' for the results to get back to GPs, as opposed to having to be referred to a consultant (4/6 weeks), treatment (another 4/6 weeks) and then having to be seen back at consultant's clinic for results.


Unfortunately what you have received is the "damage limitation" information so that no one is to blame if they damage your expensive bridge. It is certainly NOT a common side effect, if the procedure is done carefully there should be no problems. I have had several of these procedures and have a mouth full of bridges and crowns and so far all OK. The Doctors don't want to damage your teeth but of course we all know that there are good and bad in all professions. A bit of advice I can give is, if you contact the nurse/sister in charge of the Endoscopy unit where you are going, you can ask her who are the good practitioners, sometimes you will get an honest answer. It has worked for me in the past and I have been able to change from the person I was originally down for (who rushed his patients and wasn't particularly sympathetic) to a much nicer kinder consultant who was recommended by the Sister. You can only try this. Have you got your Bridge Insured, it's really worth it.


Thank you Phoebs. I voiced this concern with my GP this morning, and have also spoken to the unit at the cottage hospital where I'm having the procedure. In the past I had two experiences of dental damage, the first time a fractured root on a crown, the second time a good few years later, the bridge that replaced my crown was damaged, so you can see why I'm concerned ... After the second time, at a well known private hospital, the consultant anaesthetist sent me a letter to warn about any future general anaesthesia needing extra care because I have something called a 'Cormack and Lehane grade 3 with an epiglottis which was adherent to the posterior pharyngeal wall' , sounds scary! He advised that any future endotracheal intubation must be attempted with great care.

It was explained today that intubation is a much more intrusive procedure than gastroscopy.

The nurse on the unit said that nothing they will do during the procedure is likely to damage teeth, but that some people may bite down strongly on the mouthguard and this can cause a problem for someone with a bridge or crowns. They've told me to bring along a copy of the letter when I go for the procedure and if I was down have the treatment by a nurse, it is likely they would call in a specialist to carry it out.


I had both procedures as part of referral to Gastro for chest pain and a choking sensation. (Running an ECG or checking my thyroid levels would have been far too obvious for my doc!) Gastroscopy was seriously unpleasant but I had no dental damage despite my front two teeth being crowned. Barium makes you poo rocks which can be impossible to flush as they are so heavy. Also I believe gives you rather hefty x-ray dose with attendant cancer risk. I was diagnosed with acid reflux and given PPIs like you. I initially thought they worked but then found I could still be getting reflux after taking them for several days.

Fortunately I saw Dr P who suggested it was far more likely (being hypo) that I had low stomach acid and suggested taking Nutrigest. I think he was right as the Nutrigest works much better for me. Worth trying this first as it will do no harm. Or you could take Apple cider vinegar before a meal which is cheaper.

The giveaway for me is eating soup (the blended not consome with lumps variety), as soup is harder than solid food plus water to digest as the soup dilutes your stomach acid and enzymes more so you need more of them to digest it. Plain water with a meal runs straight through while solids are held back which is why ordinary food is less of a problem. More than one bowl of soup invariably gives me reflux and indigestion unless I take Nutrigest (I take 2 if I'm going to have soup now). If you notice a problem having soup when the same ingredients as solid food don't give you a problem (or less of one) I would say this points more to low stomach acid. Also if you ever get sick because you feel that your food is sitting undigested in your stomach and not moving on, so you eventually throw it up I would say that is down to low acid too.


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