Oral complications in anorexia nervosa

Area of Science:

• Dentistry
• Psychosomatic Medicine
• Gastroenterology

Background:

• Anorexia nervosa (AN) is a psychosomatic disorder impacting primarily young women, characterized by starvation, binge eating, and purging behaviors.
• Oral health complications are significant but often underreported in AN patients.

Purpose of the Study:

• To investigate the prevalence and types of dental issues in patients with anorexia nervosa.
• To explore the relationship between AN, vomiting, and specific oral pathologies like perimylolysis.
• To assess salivary properties in AN patients and their correlation with dehydration and medication.

Main Methods:

• Medical history, dental examinations, and saliva tests were conducted on 39 AN patients (aged 14-42 years) with a history of AN ranging from 1 to 20 years.
• Patients were assessed for dental caries, lingual-occlusal erosion (perimylolysis), buccal erosion, and salivary properties.
• Data were analyzed to identify correlations between AN, vomiting frequency, and observed oral conditions.

Main Results:

• All 39 AN patients exhibited dental caries, often severe, linked to excessive carbohydrate intake.
• Severe lingual-occlusal erosion (perimylolysis) was present in 27 patients with a history of intense vomiting.
• Buccal erosion was more common in vomiting patients, associated with acidic food/drink consumption for thirst.
• Subnormal saliva properties, indicative of dehydration or xerostomia, were prevalent, particularly in patients who vomited.

Conclusions:

• A strong association exists between anorexia nervosa, vomiting, and severe dental erosion (perimylolysis).
• Dental caries and erosion are near-universal findings in AN patients, necessitating comprehensive dental care.
• Salivary dysfunction is common in AN, exacerbating oral health risks, especially in those engaging in purging behaviors.