Eating disorders part II: Clinical strategies for dental treatment

Department of Restorative Dentistry, School of Dentistry, University of São Paulo, SP, Brazil.
The journal of contemporary dental practice 02/2008; 9(7):89-96.
Source: PubMed


To present the strategies of treatment for dental implications of eating disorders.
A comprehensive review of the literature was conducted with special emphasis on the treatment of the oral implications of anorexia nervosa and bulimia nervosa, dividing the treatment into different parts.
Oral manifestations of eating disorders represent a challenge to the dental practitioner. Dental erosion, caries, xerostomia, enlargement of parotide glands, traumatized oral mucosa, and other oral manifestations may present in anorexic and bulimic patients.
Often the dentist is the first healthcare provider to observe the clinical symptoms of an eating disorder. Dental treatment should be carried out simultaneously with the medical treatment. However, dentists are not aware of the fundamental importance of the dentist's participation in the multidisciplinary treatment and no training is provided with regard to the strategies involved in the dental treatment.
Oral complications of eating disorders are a major concern. The difficulties of recognizing the oral manifestations, and the failure to do so, may lead to serious systemic problems in addition to progressive and irreversible damage to the oral hard tissues. Considering the increasing incidence and prevalence rates of eating disorders, the dentist's participation and dental treatment should be discussed.

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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)
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