Intertwined paths: exploring the link between oral diseases and eating disorders. A comprehensive narrative review

Eating disorders (ED) are psychiatric conditions with profound impacts on physical health, emotional well-being and quality of life. They are associated with reduced employment participation and increased healthcare costs, representing a significant public health concern. Major ED, including anorexia nervosa, bulimia nervosa, binge-eating disorder and other specified feeding and eating disorders, are closely linked to oral health complications, which serve as both diagnostic markers and therapeutic targets in ED management. This narrative review explores twenty-two studies, organised around transdiagnostic behavioural and physiological risk factors, including caloric restriction, purging behaviours, binge episodes and oral hygiene neglect. Evidence indicates that malnutrition, vomiting-induced acid exposure, high intake of cariogenic foods and inconsistent hygiene practices contribute to the deterioration of dental and periodontal health. The review highlights the diagnostic and therapeutic potential of oral assessments in ED management, underscoring the importance of early detection. A dedicated section addresses the role of dental professionals, proposing individualised care pathways and the use of clinical indices such as the Basic Erosive Wear Examination and Schiff air index, alongside emerging tools like tele dentistry. The findings advocate for a multidisciplinary approach, incorporating nutritional support, psychological therapy and targeted dental treatment, which is crucial for developing comprehensive care plans. Such collaboration enhances the effectiveness of interventions, addressing both the physiological and psychological dimensions of ED to improve patient outcomes.