Salivary changes and dental erosion in bulimia nervosa

Dynesen, Anja Weirsøe; Bardow, Allan; Petersson, Birgit; Nielsen, Lene Rindal; Nauntofte, Birgitte

doi:10.1016/j.tripleo.2008.07.003

Cited by 67 publications

(55 citation statements)

References 42 publications

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“…Several studies [4], [19]–[21], [31]–[35] which were conducted in different settings and using different methods showed similar findings related to the possible causal relationship between EDs and TE. Specificity, temporality, and dose-response relationships were also observed.…”

Section: Discussionmentioning

confidence: 72%

Tooth Erosion and Eating Disorders: A Systematic Review and Meta-Analysis

et al. 2014

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BackgroundEating disorders are associated with the highest rates of morbidity and mortality of any mental disorders among adolescents. The failure to recognize their early signs can compromise a patient's recovery and long-term prognosis. Tooth erosion has been reported as an oral manifestation that might help in the early detection of eating disorders.ObjectivesThe aim of this systematic review and meta-analysis was to search for scientific evidence regarding the following clinical question: Do eating disorders increase the risk of tooth erosion?MethodsAn electronic search addressing eating disorders and tooth erosion was conducted in eight databases. Two independent reviewers selected studies, abstracted information and assessed its quality. Data were abstracted for meta-analysis comparing tooth erosion in control patients (without eating disorders) vs. patients with eating disorders; and patients with eating disorder risk behavior vs. patients without such risk behavior. Combined odds ratios (ORs) and a 95% confidence interval (CI) were obtained.ResultsTwenty-three papers were included in the qualitative synthesis and assessed by a modified version of the Newcastle-Ottawa Scale. Fourteen papers were included in the meta-analysis. Patients with eating disorders had more risk of tooth erosion (OR = 12.4, 95%CI = 4.1–37.5). Patients with eating disorders who self-induced vomiting had more risk of tooth erosion than those patients who did not self-induce vomiting (OR = 19.6, 95%CI = 5.6–68.8). Patients with risk behavior of eating disorder had more risk of tooth erosion than patients without such risk behavior (Summary OR = 11.6, 95%CI = 3.2–41.7).ConclusionThe scientific evidence suggests a causal relationship between tooth erosion and eating disorders and purging practices. Nevertheless, there is a lack of scientific evidence to fulfill the basic criteria of causation between the risk behavior for eating disorders and tooth erosion.

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Section: Discussionmentioning

confidence: 72%

Tooth Erosion and Eating Disorders: A Systematic Review and Meta-Analysis

et al. 2014

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“…This finding is in accordance with results from Johansson et al [15] and Altshuler et al [25], who found a significant association between the duration of the ED and the prevalence of dental erosions. In addition, Dynesen et al [14] showed that the duration of the ED had a significant influence on the severity grade of the erosive lesions. However, other studies did not find any association between frequency, duration of vomiting and dental erosion [9,10].…”

Section: Discussionmentioning

confidence: 99%

“…Levels of amylase, immunoglobulin and electrolytes have also been investigated, but the findings differ substantially [32]. Several studies have shown a significantly lower unstimulated salivary flow in bulimic patients than in controls [11,14,19]. Many ED patients are prescribed antidepressants or other psychopharmaceutical medication, that are known to reduce salivary flow, and Dynesen et al [14] showed that xerogenic medication significantly lowered unstimulated flow rate in this patient group.…”

Section: Discussionmentioning

confidence: 99%

“…Considering that one third of the participants with EDs in a study by Rytomaa et al [11] had decreased unstimulated saliva secretion, and hence decreased protection against dental erosion, this might have been an interesting addition to the study. However, Dynesen et al [14] found that although individuals with vomiting had a significantly lower unstimulated salivary flow rate compared to a control group, this did not significantly influence dental erosion.…”

Section: Discussionmentioning

confidence: 99%

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Self-induced vomiting and dental erosion – a clinical study

et al. 2014

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BackgroundIn individuals suffering from eating disorders (ED) characterized by vomiting (e.g. bulimia nervosa), the gastric juice regularly reaches the oral cavity, causing a possible risk of dental erosion. This study aimed to assess the occurrence, distribution and severity of dental erosions in a group of Norwegian patients experiencing self-induced vomiting (SIV).MethodsThe individuals included in the study were all undergoing treatment at clinics for eating disorders and were referred to a university dental clinic for examinations. One calibrated clinician registered erosions using the Visual Erosion Dental Examination (VEDE) system.ResultsOf 72 referred patients, 66 (63 females and three males, mean age 27.7 years) were or had been experiencing SIV (mean duration 10.6 years; range: 3 – 32 years), and were therefore included in the study. Dental erosions were found in 46 individuals (69.7%), 19 had enamel lesions only, while 27 had both enamel and dentine lesions. Ten or more teeth were affected in 26.1% of those with erosions, and 9% had ≥10 teeth with dentine lesions. Of the erosions, 41.6% were found on palatal/lingual surfaces, 36.6% on occlusal surfaces and 21.8% on buccal surfaces. Dentine lesions were most often found on lower first molars, while upper central incisors showed enamel lesions most frequently. The majority of the erosive lesions (48.6%) were found in those with the longest illness period, and 71.7% of the lesions extending into dentine were also found in this group. However, despite suffering from SIV for up to 32 years, 30.3% of the individuals showed no lesions.ConclusionsDental erosion commonly affects individuals with ED experiencing SIV, and is more often found on the palatal/lingual surfaces than on the buccal in these individuals, confirming a common clinical assumption.

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“…[78] Dental complications due to eroding effects of repeated self-induced vomiting are objective signs of bulimia. [910] This suggests that other parameters than the duration of ED may contribute to severity and progression of dental erosions seen in persons with bulimia. The oral manifestation of EDs were mucosal lesions, periodontal lesion and salivary manifestations.…”

Section: Introductionmentioning

confidence: 99%

Prevalence, severity and etiology of dental wear in patients with eating disorders

et al. 2014

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Objective:The purpose of this study was to evaluate the prevalence, distribution and associated factors of dental wear among patients with eating disorders (EDs).Materials and Methods:An epidemiological cross-sectional survey was conducted by trained, calibrated examiners, using the dental wear index. The sample was composed of 30 patients with EDs (experimental group – G1) and 30 control patients without current or previous history of EDs (G2). A questionnaire was used to assess the etiological factors of dental wear. The univariate analyses using the Chi-square (χ2) test were used to compare the tooth wear prevalence between groups according to the surface and tooth (P > 0.05).Results:The dental wear was similar for both group; however, the G1 presented more moderate wear in molars when compared with G2 (P = 0.048). The majority of EDs patients related have one or more oral habits (n = 26; 86.6%) and only 13.4% (n = 4) affirmed did not have oral habits. The etiological factors of tooth wear related with dental wear were biting objects (P = 0.04) and pain in temporomandibular disorders (P = 0.03).Conclusion:The highest prevalence of dental wear was observed in the molars teeth. Differences in the extent and pattern of dental wear were found in an individual, emphasized the relevance of clinical parameter.

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Salivary changes and dental erosion in bulimia nervosa

Cited by 67 publications

References 42 publications

Tooth Erosion and Eating Disorders: A Systematic Review and Meta-Analysis

Tooth Erosion and Eating Disorders: A Systematic Review and Meta-Analysis

Self-induced vomiting and dental erosion – a clinical study

Prevalence, severity and etiology of dental wear in patients with eating disorders

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