Risk of Dental Caries and Erosive Tooth Wear in 117 Children and Adolescents' Anorexia Nervosa Population—A Case-Control Study

Abstract

IntroductionRestrictive type of anorexia nervosa (AN) is still one of the most severe eating disorders worldwide with an uncertain prognosis. Patients affected by AN should be encouraged to undertake psychiatric care and psychotherapy, but whether they should necessarily be included in careful dental care or not may still be questionable. Even though there is a constantly increasing number of AN studies, there are just a few data about the youngest group of AN children and adolescents aged < 18.MethodologyThis case-control study aimed to compare the dental health and gingival inflammation level in female adolescent inpatients affected by severe AN restrictive subtype vs. controls. Based on clinically confirmed 117 AN cases (hospitalized in years 2016–2020 in public Psychiatric Unit, BMI < 15 kg/m2, mean age 14.9 ± 1.8), the dental status has been examined regarding the occurrence of caries lesions using Decay Missing Filling Teeth (DMFT), erosive wear as Basic Erosive Wear Examination (BEWE), gingival condition as Bleeding on Probing (BOP) and plaque deposition as Plaque Control Record (PCR). The results were compared with age-matched 103 female dental patients (BMI 19.8 ± 2.3 kg/m2, age 15.0 ± 1.8, p = 0.746) treated in a public University dental clinic.ResultsAN patients were found to present a higher incidence of oral-related complications according to dental status (DMFT 3.8 ± 4.5 vs. 1.9 ± 2.1, p = 0.005), erosive tooth wear (BEWE 18.9 vs. 2.9%, p < 0.001), less efficient in controlling plaque (PCR 43.8 vs. 13.7%, p < 0.001) and gingival inflammation (BOP 20.0 vs. 3.9%, p < 0.001) compared with female adolescents. In the AN group, a significant correlation between BOP, BEWE, and duration of AN disease (p < 0.05), similarly to the number of decayed teeth D, filled teeth F and PCR were detected (p < 0.05).ConclusionsAlthough the obtained results did not reveal any severe oral status, our findings indicated impaired dental and gingival conditions in young anorexics. Considering AN's potential role in oral health, it is essential to monitor dental treatment needs and oral hygiene levels in their present status to prevent forward complications in the future.

Oral Health and Behavior Patterns of Women with Eating Disorders—A Clinical Pilot Study

“…Caries experience in ED patients was higher than in healthy individuals [10,28,39]. In this study, the DMFT index and number of filled teeth in the ED group were more than double those of the control group (Table 1).…”

Risk factors of tooth wear in permanent dentition: A scoping review

“…Medical history was the second most frequently studied factor (67% of included studies; n = 183), 2,3,5,22–24,26–35,38,40,42–44,47,49–51,53,56–58,60–64,68–70,74,75,77,78,80,81,83,85,87,90–92,94–96,98,101,102,104–108,110,111,113,114,119–130,132,136–138,140–144,147,148,151,153–157,159,161,162,166,167,169,172,173,176–178, 180,181,185,188–190,194,196,197,199–256 and 27 studies were exclusively dedicated to this topic. The influence of the presence of GORD, stomach upset or heartburn was the most studied factor from this category, with 35.2% of studies included in this scoping review (96 out of 273).…”

Eating disorders and oral health: a scoping review

“…Despite starvation and anorexia development, salivary key enzymes show physiological activity. This indicates a partial adaptation of the organism to severe conditions during malnutrition Paszynska [ 49 ] Poland To establish the oral status regarding caries incidence, tooth wear, gingival inflammation, and oral hygiene levels among severely ill adolescent inpatients diagnosed with AN Case–control cross‐sectional survey, clinical examination of dental wear N = 220 AN Study findings indicate impaired dental and gingival conditions in young people with anorexia. Considering AN’s potential role in oral health, it is essential to monitor dental treatment needs and oral hygiene levels in their present status to prevent forward complications in the future Rangé [ 51 ] France To design a questionnaire to identify risk factors and symptoms of oral diseases and to test its reliability as a self-report form among people with AN Self-report questionnaire, face-to-face repeat questionnaire administered by dentist N = 69 AN The study authors developed and tested a questionnaire that identifies risk factors and symptoms of oral diseases in anorexia nervosa.…”

“…Forty-four studies were retained for inclusion (Table 2). Of these 44 studies, seventeen related specifically to oral health professionals [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35], twenty addressed the impact of eating disorders on oral health [36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55], and seven focused on patient experiences and perspectives [56][57][58][59][60][61][62].…”