Eating disorders. Part I: Psychiatric diagnosis and dental implications.

Department of Restorative Dentistry, University of São Paulo, SP, Brazil.
The journal of contemporary dental practice 02/2008; 9(6):73-81.
Source: PubMed

ABSTRACT The aim of this article is to present a review of the literature on eating disorders and related oral implications in order to provide oral healthcare professionals and psychiatrists with information that will enable them to recognize and diagnose these disorders and render appropriate treatment.
A comprehensive review of the literature was conducted with special emphasis on the oral implications of anorexia nervosa and bulimia nervosa.
Currently, available knowledge that correlates eating disorders with dental implications is supported by data derived from well-conducted psychiatric and psychological literature. However, little is known about the aspects of oral medicine concerned with the subject. Dental erosion, xerostomia, enlargement of the parotid gland, and other dental implications might be present in individuals with eating disorders.
Eating disorders are a serious concern with regard to the oral health of patients. They represent a clinical challenge to dental professionals because of their unique psychological, medical, nutritional, and dental patterns as well as their unique characteristics. However, there is a general lack of awareness of the fundamental importance of the dentist's role in the multidisciplinary treatment of affected patients.
The failure of oral healthcare professionals to recognize dental characteristics of eating disorders may lead to serious systemic problems in addition to progressive and irreversible damage to the hard tissues. Considering the increasing incidence and prevalence rates of eating disorders the participation of oral healthcare professionals in a multidisciplinary team to provide care for affected patients rises to greater importance.


Available from: Ana Cecilia Corrêa Aranha, Feb 27, 2014
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    ABSTRACT: Intraoral disease is a common occurrence in patients with eating disorders, particularly dental erosion, which frequently becomes severe and may hinder daily life. The severity varies from patient to patient. Understanding the underlying mechanisms may help prevent dental erosion in these patients. Accordingly, we investigated the relationship between the severity of erosion and the behavior of patients with eating disorders, with a focus on daily diet and vomiting behavior. A total 71 female eating disorder outpatients from the Clinical Center of Psychosomatic Dentistry of Nippon Dental University Hospital and the Psychosomatic Internal Medicine Department of Kudanzaka Hospital or who were hospitalized at Hasegawa Hospital were enrolled. Dental erosion severity and location were determined by oral examination. Patients who induced vomiting were queried on their behavior during vomiting and on routine diet habits. Patients with dental erosion were further divided into mild and severe groups based on the lesion severity and the groups compared. Dental erosion was observed in 43 of 50 subjects who induced vomiting. Dental erosion was most frequent on the palatal side of the anterior maxillary teeth, occurring in 81.3% of the subjects. There were significant differences observed between the mild and severe groups according to post-vomiting oral hygiene. Significantly more subjects in the mild group consumed large amounts of water before vomiting, and significantly more subjects in the severe group routinely consumed carbonated beverages or sweetened food. While self-induced vomiting is the main cause of dental erosion in eating disorder patients, the erosion severity may be affected by behavior when inducing vomiting or by routine consumption of certain foods and beverages. Addressing these factors may help prevent severe dental erosion in patients who chronically induce vomiting.
    BioPsychoSocial Medicine 11/2014; 8:25. DOI:10.1186/1751-0759-8-25
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    ABSTRACT: Objective To compare the occurrence of tooth erosion (TE) and dental caries (DC) in adolescents with and without risk behavior for eating disorders (EDs). MethodA controlled cross-sectional study involving 1,203 randomly selected female students aged 15-18 years was conducted in Brazil. Risk behavior for EDs was evaluated through the Bulimic Investigatory Test of Edinburgh and dental examinations were performed. ResultsThe prevalence of risk behavior for EDs was 6%. Twenty adolescents (1.7%) were identified with severe risk behavior for EDs and matched to 80 adolescents without such risk. Among the severe risk group, 45% of adolescents were affected by TE and 80% by DC compared with 8.8 and 51.3%, respectively, in the matched group. Adolescents with severe risk had higher chances for TE (OR = 10.04; 95% CI = 2.5-39.4). DiscussionIn this study, a severe risk behavior for EDs was significantly associated with TE, but not with DC. (c) 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2013; 46:677-683)
    International Journal of Eating Disorders 11/2013; 46(7). DOI:10.1002/eat.22132 · 3.03 Impact Factor
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    International Journal of Public Health 01/2009; · 1.97 Impact Factor