Salivary changes and dental erosion in bulimia nervosa

Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology (Impact Factor: 1.46). 10/2008; 106(5):696-707. DOI: 10.1016/j.tripleo.2008.07.003
Source: PubMed


Our aim was to study if bulimia nervosa (BN) has an impact on salivary gland function and if such changes are related to dental erosion.
Twenty women with BN and twenty age- and gender-matched controls participated. Flow rate and composition of whole and glandular saliva, as well as feeling of oral dryness were measured. Dental erosion was measured on casts.
Compared with control subjects, unstimulated whole saliva (UWS) flow rate was reduced in persons with BN, primarily owing to intake of medication (P = .007). No major compositional salivary changes were found. In the BN group, the dental erosion score was highest and complaints of oral dryness were more frequent.
The BN persons had impaired UWS, mainly owing to medication; increased feeling of oral dryness; and more dental erosion. Dental erosion was related to the duration of eating disorder, whereas no effect of vomiting frequency or intake of acidic drinks on reduced UWS was observed.

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    • "This finding is in accordance with results from Johansson et al. [15] and Altshuler et al. [25], who found a significant association between the duration of the ED and the prevalence of dental erosions. In addition, Dynesen et al. [14] showed that the duration of the ED had a significant influence on the severity grade of the erosive lesions. However, other studies did not find any association between frequency, duration of vomiting and dental erosion [9,10]. "
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    ABSTRACT: Background In individuals suffering from eating disorders (ED) characterized by vomiting (e.g. bulimia nervosa), the gastric juice regularly reaches the oral cavity, causing a possible risk of dental erosion. This study aimed to assess the occurrence, distribution and severity of dental erosions in a group of Norwegian patients experiencing self-induced vomiting (SIV). Methods The individuals included in the study were all undergoing treatment at clinics for eating disorders and were referred to a university dental clinic for examinations. One calibrated clinician registered erosions using the Visual Erosion Dental Examination (VEDE) system. Results Of 72 referred patients, 66 (63 females and three males, mean age 27.7 years) were or had been experiencing SIV (mean duration 10.6 years; range: 3 – 32 years), and were therefore included in the study. Dental erosions were found in 46 individuals (69.7%), 19 had enamel lesions only, while 27 had both enamel and dentine lesions. Ten or more teeth were affected in 26.1% of those with erosions, and 9% had ≥10 teeth with dentine lesions. Of the erosions, 41.6% were found on palatal/lingual surfaces, 36.6% on occlusal surfaces and 21.8% on buccal surfaces. Dentine lesions were most often found on lower first molars, while upper central incisors showed enamel lesions most frequently. The majority of the erosive lesions (48.6%) were found in those with the longest illness period, and 71.7% of the lesions extending into dentine were also found in this group. However, despite suffering from SIV for up to 32 years, 30.3% of the individuals showed no lesions. Conclusions Dental erosion commonly affects individuals with ED experiencing SIV, and is more often found on the palatal/lingual surfaces than on the buccal in these individuals, confirming a common clinical assumption.
    BMC Oral Health 07/2014; 14(1):92. DOI:10.1186/1472-6831-14-92 · 1.13 Impact Factor
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    • "EDs in combination with vomiting (bulimia nervosa) are at high risk for often associated with regurgitation of gastric contents into the mouth and dental erosion.[78] Dental complications due to eroding effects of repeated self-induced vomiting are objective signs of bulimia.[910] This suggests that other parameters than the duration of ED may contribute to severity and progression of dental erosions seen in persons with bulimia. "
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    ABSTRACT: Objective: The purpose of this study was to evaluate the prevalence, distribution and associated factors of dental wear among patients with eating disorders (EDs). Materials and Methods: An epidemiological cross-sectional survey was conducted by trained, calibrated examiners, using the dental wear index. The sample was composed of 30 patients with EDs (experimental group – G1) and 30 control patients without current or previous history of EDs (G2). A questionnaire was used to assess the etiological factors of dental wear. The univariate analyses using the Chi-square (χ2) test were used to compare the tooth wear prevalence between groups according to the surface and tooth (P > 0.05). Results: The dental wear was similar for both group; however, the G1 presented more moderate wear in molars when compared with G2 (P = 0.048). The majority of EDs patients related have one or more oral habits (n = 26; 86.6%) and only 13.4% (n = 4) affirmed did not have oral habits. The etiological factors of tooth wear related with dental wear were biting objects (P = 0.04) and pain in temporomandibular disorders (P = 0.03). Conclusion: The highest prevalence of dental wear was observed in the molars teeth. Differences in the extent and pattern of dental wear were found in an individual, emphasized the relevance of clinical parameter.
    European journal of dentistry 03/2014; 8(1):68-73. DOI:10.4103/1305-7456.126246

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