Knowledge of Oral and Physical Manifestations of Anorexia Nervosa Among Polish Dentists: A Cross-Sectional Study

Abstract

Background: Anorexia nervosa is a psychosomatic disorder and is commonly associated with impaired oral health. Dentists can play a relevant role in the early diagnosis of anorexia nervosa. With the help of intra- and extraoral examinations and anamnesis, the dentist can detect characteristic signs and symptoms of this eating disorder. The purpose of this study was to determine the knowledge regarding the oral and physical manifestations of anorexia nervosa among general dental practitioners and specialist dentists of Poland.Material and Methods: A pretested online questionnaire consisting of a first part asking for the characteristics of the participant and a second part with 22 specific questions on their general knowledge of anorexia nervosa and knowledge of physical and oral manifestations of this eating disorder was used.Results: A total of 369 dentists completed the questionnaire. The Polish dentists in this study reported sufficient knowledge regarding anorexia nervosa. However, younger dentists and general dental practitioners had relatively lower knowledge scores than other groups. The dentists mainly had difficulties with the oral symptoms of anorexia nervosa.Conclusion: Despite Polish dentists having sufficient knowledge about anorexia nervosa in relation to the general symptoms of anorexia, there are deficits with regard to oral manifestations. Therefore, there is a need to increase continuing education in this field, which can improve early diagnosis of this disease by dental practitioners and referral to specialists for treatment.

El Rol de los Trastornos de Conducta Alimentaria sobre la Periodontitis: Breve Revisión Sistemática de Estudios Observacionales

“…En la actualidad la bulimia y anorexia se consideran grandes problemáticas de salud mundial producto de sus grandes repercusiones sobre la tasa de mortalidad y morbilidad, siendo reportadas algunas manifestaciones orales desde etapas tempranas durante el transcurso de ambas patologías, donde muchas veces la identificación y/o diagnóstico son fundamentales para la generación de una pronta derivación y recuperación medica vinculada a las manifestaciones orales relacionadas con la erosión dental producto de la deshidratación generada por el vómito o el agrandamiento de las glándulas parótidas asociadas a la estimulación colinérgica, mientras que la anorexia comúnmente reporta una higiene bucal deficiente junto a patrones de conducta alimentaria inadecuados como el consumo excesivo de bebidas azucaradas y alimentos ricos en carbohidratos que predisponen cuadros orales dolorosos que pueden conllevar la perdida de piezas dentarias (Lo Russo et al, 2008;Krukowska-Zaorska et al, 2021;Lin et al, 2021;Chiba et al, 2022). No obstante, la mayor tendencia de caries en pacientes con TCA es un comportamiento aún contradictorio debido a que algunos pacientes pueden exhibir un alto nivel de higiene bucal como forma compensatoria al vomito compulsivo, mientras que otros reportan un comportamiento independiente al diagnóstico clínico y conducta vomitiva producto de la etiología multifactorial (Kisely et al, 2015;Krukowska-Zaorska et al, 2021).…”

Why does patient mental health matter? Part 4: non-carious tooth surface loss as a consequence of psychiatric conditions

“…13 The literature can be conflicted, but generally decayed, missing and filled teeth (DMFT) scores are worsened in those with self-induced vomiting. 11 In our scenario the patient has no active dental caries.…”

“…Such oral symptoms of anorexia nervosa, in addition to xerostomia and enamel erosion, can be seen as early as six months into the course of the disease. 11 The patient was last seen two years ago, so a presentation of poor oral health because of anorexia nervosa is plausible. There is no evidence of caries despite overall poor oral health; this is often recognised in the literature which reports that dental caries may be less prevalent due to 'obsessive personality traits and fastidious oral hygiene'.…”

“…As a group, eating disorders encompass anorexia nervosa, bulimia nervosa, binge eating disorder (BED) and OSFED/EDNOS. 6,11 BED is a condition characterised by cyclic binge eating causing marked distress, with absence of compensatory behaviours to prevent weight gain, including purging, exercise or starvation. 9 Patients with the condition are often female, but older in age, overweight and do not engage in self-induced vomiting, meaning it is unlikely to play a role in the patients' presentation.…”

Potential of CPP-ACP and cranberry proantho-cyanidin chewing gum for remineralization of perimylolysis in eating disorders patients

“…In more chronic cases, erosion occurs on the maxillary teeth' palatal margins and the mandibular molars' occlusal surfaces. Occasionally, perimylolysis is the only oral symptom observed in a patient who induces vomiting [11].…”