Eating disorders are a potentially life-threatening group of mental disorders, which affect a patient's relationship with food and their body. This manifests itself through chaotic and disordered eating habits. One such eating disorder is bulimia nervosa, which has a lifetime prevalence of 1%. While there is consensus that bulimic behaviour directly causes dental erosion due to vomiting and acidic food choices, there is less clear evidence for a direct link between bulimia nervosa and dental caries, although there does still appear to be an association. Reduced salivary flow rate is a common feature among bulimics, but this is often due to anti-depressant medication rather than dietary habits or vomiting, and the effects are largely limited to unstimulated whole salivary flow rate and don't affect stimulated whole salivary flow rate. Parotid enlargement is present in a number of cases but this tends to be a minority. Further research is required given the limitations of current studies, especially gender imbalances among the populations studied and a lack of clear focus on bulimia nervosa.

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Body dysmorphic disorder (BDD) is a psychiatric disorder in which the individual has a disproportionate concern about a particular body part. With the increasing demand for aesthetic treatments, it is likely that individuals with BDD may present for orthodontic or combined orthodontic and orthognathic treatment. In this review, we shall outline the features of BDD and its prevalence, before discussing the best way for clinicians to identify and manage individuals with this disorder.

Body Dysmorphic Disorder (BDD) is a relatively common psychiatric condition in which the individual is disproportionately concerned about an aspect of his/her appearance. People with BDD are highly likely to seek cosmetic dental treatment. However, the provision of such treatment is contra-indicated. This article will identify simple techniques for practitioners to screen for and manage patients with BDD. CPD/Clinical Relevance: This article addresses the management of patients with a specific psychiatric illness who are likely to present for cosmetic dental treatments.