1
|
Cooper J, Ryder O, Barry S. Undergraduate perspectives of the awareness, diagnosis and management of patients with eating disorders. Br Dent J 2024; 236:894-899. [PMID: 38877260 DOI: 10.1038/s41415-024-7459-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/22/2023] [Accepted: 01/07/2024] [Indexed: 06/16/2024]
Abstract
Introduction Patients with eating disorders (EDs) may present with potentially life-threatening complications due to missed and late diagnoses. Dentists can play a fundamental role in the early identification and signposting of patients with suspected EDs.Aims To investigate the awareness of final-year dental students of the aetiology, diagnosis and management of EDs.Methods An anonymous electronic questionnaire was distributed to final-year dental students at the University of Manchester. Respondents reported their knowledge, confidence and education related to the management of patients with EDs.Results Over 50% of students felt they had an above average awareness of the clinical signs and oral manifestations of EDs. The majority of students lacked confidence in discussing a suspected ED diagnosis with patients (75%) and referring them to appropriate services (71%). Additionally, 58% were not confident in planning treatment for and treating a patient with an ED. In total, 100% of students reported that they would benefit from further teaching related to the management of patients with EDs.Conclusion Participants highlighted the need for further teaching related to the diagnosis and management of patients with EDs. This study supports the development of an educational resource of undergraduate dental students.
Collapse
Affiliation(s)
- Jessica Cooper
- University Dental Hospital of Manchester, Manchester, UK; University of Manchester, Manchester, UK.
| | | | - Siobhan Barry
- University Dental Hospital of Manchester, Manchester, UK; University of Manchester, Manchester, UK
| |
Collapse
|
2
|
Muley A, Deshmane A, Mahajan A, Shah J. Eating Disorders: Assessing Its Prevalence and Pattern Among Adults With Type 2 Diabetes. Cureus 2024; 16:e52425. [PMID: 38371141 PMCID: PMC10870338 DOI: 10.7759/cureus.52425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Eating disorders (EDs) are severe and multifaceted mental health issues that affect a person's perception of their body weight in relationship with food. Existing evidence shows that EDs significantly affect the physical and emotional health of individuals with Type-2 Diabetes (T2D) and are associated with impaired metabolic control and a high risk of medical complications, including higher mortality rates. However, there is a paucity of research looking into the prevalence of EDs. OBJECTIVE A cross-sectional study was conducted to map the prevalence of EDs and to assess its pattern among adults with T2D from Ahmedabad City, Gujarat, India. METHODOLOGY Two hundred fifty-four T2D individuals aged 30-60 were enrolled in the study. A questionnaire was developed using the Sick, Control, One, Fat, Food (SCOFF) questionnaire and a five-question screening tool intended to identify the possibility of EDs as well as the Eating Disorder Examination-Questionnaire (EDEQ), which is used to identify the pattern of EDs with subscales like Restraint, Eating Concern, Shape Concern, and Weight Concern. Written informed consent was obtained from all participants. Descriptive statistics, Pearson's Correlation, and Logistic Regression analysis were used. A p-value of < 0.05 was considered significant. RESULTS The results revealed that 90 (35%) of the total participants were at a high risk of EDs. Among these, 54 (21% of the total population) were males, and 36 (14% of total participants) were females. There was a mild statistically significant negative correlation between age and exercise with the presence of ED (r = -0.151, p = 0.016 and r = -0.186, p = 0.003, respectively), while education showed a significant positive correlation (r = 0.150, p = 0.017). Males had significantly higher scores for eating concerns than females (19.75±4.88 vs 17.88±5.92; p = 0.008). The logistic regression model revealed that education was a significant predictor of EDs (OD = 1.47, 95% CI 1.00-2.16 and p = 0.04). CONCLUSION The study identified that people with T2D are at risk of EDs, and eating concerns worry them the most. Thus, counseling sessions should focus on identifying the determinants of EDs and educating the patients regarding quality eating. This will have implications in addressing the other morbidities as well as health risks related to BMI; especially obesity as it is more prevalent in the T2D population.
Collapse
Affiliation(s)
- Arti Muley
- Nutrition and Dietetics, Symbiosis Institute of Health Sciences, Symbiosis International (Deemed University), Pune, IND
| | - Aditi Deshmane
- Nutrition and Dietetics, Symbiosis Institute of Health Sciences, Symbiosis International (Deemed University), Pune, IND
| | - Anu Mahajan
- Nutrition and Dietetics, Symbiosis Institute of Health Sciences, Symbiosis International (Deemed University), Pune, IND
| | - Jeel Shah
- Nutrition and Dietetics, Symbiosis Institute of Health Sciences, Symbiosis International (Deemed University), Pune, IND
| |
Collapse
|
3
|
Kim IH, Hong WW, Mupparapu M. A Patient Diagnosed with Bulimia Reports to the Dental Office Seeking Cosmetic Dental Work. Dent Clin North Am 2023; 67:699-702. [PMID: 37714628 DOI: 10.1016/j.cden.2023.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Abstract
Bulimia nervosa (BN) is a serious psychiatric illness that typically occurs in adolescents and young adults. It is characterized by recurring episodes of consuming large amounts of food with an inappropriate compensatory behavior of purging to prevent weight gain. The purging behavior results in oral manifestations such as dental erosion, dental caries, sialadenosis, and oral mucosal trauma. Medical complications include electrolyte imbalances, esophageal rupture, and renal and cardiovascular failure. Treatment of BN involves psychosocial and psychopharmacologic approaches. Dentists are in a unique position to recognize patients with BN and help patients with BN and other eating disorders.
Collapse
Affiliation(s)
- Irene H Kim
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Penn Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA
| | | | - Mel Mupparapu
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Penn Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA.
| |
Collapse
|
4
|
Cuadrado-Ríos S, Huamán-Garaicoa F, Cruz-Moreira K. Anorexia and bulimia nervosa in the practice of the paediatric dentist. EUROPEAN EATING DISORDERS REVIEW 2023; 31:9-23. [PMID: 35962774 DOI: 10.1002/erv.2944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/29/2022] [Accepted: 07/18/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This systematic review aimed to highlight the usefulness of the clinical examination of the oral cavity for the diagnostic suspicion of anorexia (AN) and bulimia nervosa (BN), being of main interest to the paediatric dentist and paediatrician due to the early onset of symptoms in Eating Disorders (EDs). METHOD A systematic search, applying PICO question, was carried out in biomedical and other electronic databases from 2005 to 2020. Both case reports and case series of patients under 65 years of age with AN and BN were included. Data were extracted and statistically analysed. RESULTS A sample of 111 studies was obtained (n = 192; 92.78% female). The most prevalent diagnosis was restrictive type AN (n = 110; 57.29%). Only 16 (8.33%) patients had been clinically examined at the oral cavity, indicating the presence or absence of oral manifestations (OM) and showing dental erosion (n = 10) as the most frequent. CONCLUSION There is a lack of information about the oral examination of anorexic and bulimic patients. Dental erosion and other oral manifestations can help us to make an early ED diagnosis. Clinical observation and basic erosive wear examination (BEWE) Index are necessary steps to detect and record any anomaly in oral cavity during the evaluation of these patients.
Collapse
Affiliation(s)
| | - Fuad Huamán-Garaicoa
- Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.,Instituto Oncológico Nacional "Dr. Juan Tanca Marengo". SOLCA, Guayaquil, Ecuador
| | - Karla Cruz-Moreira
- Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.,Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| |
Collapse
|
5
|
Rangé H, Colon P, Godart N, Kapila Y, Bouchard P. Eating disorders through the periodontal lens. Periodontol 2000 2021; 87:17-31. [PMID: 34463986 PMCID: PMC8637500 DOI: 10.1111/prd.12391] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Hélène Rangé
- Department of Periodontology, Université de Paris, U.F.R. d'Odontologie-Garancière, Paris, France.,Service d'Odontologie, Hôpital Rothschild, AP-HP.Sorbonne Université, Paris, France.,UR 2496 Laboratory of Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Paris, France
| | - Pierre Colon
- Service d'Odontologie, Hôpital Rothschild, AP-HP.Sorbonne Université, Paris, France.,Department of Restorative Dentistry and Endodontics, U.F.R. d'Odontologie-Garancière, Université de Paris, Paris, France.,Laboratoire Multimatériaux et Interfaces, Université Claude Bernard Lyon 1, UMR CNRS, Villeurbanne, France
| | - Nathalie Godart
- Service Hospitalo-Universitaire de Santé Mentale pour les Adolescents et Jeunes Adultes, Fondation Santé des Etudiants de France, Paris, France.,U.F.R. Simone Veil, Université Versailles Saint Quentin en Yvelynes (UVERSUSQ), Montigny-Le-Bretonneux, France.,Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Hôpital Paul Brousse, Villejuif, France
| | - Yvonne Kapila
- Department of Orofacial Sciences, University of California San Francisco, School of Dentistry, San Francisco, California, USA
| | - Philippe Bouchard
- Department of Periodontology, Université de Paris, U.F.R. d'Odontologie-Garancière, Paris, France.,Service d'Odontologie, Hôpital Rothschild, AP-HP.Sorbonne Université, Paris, France.,UR 2496 Laboratory of Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Paris, France
| |
Collapse
|
6
|
Hermont AP, Pordeus IA, Ramos-Jorge J, Paiva SM, Auad SM. Acidic food choice among adolescents with bulimic symptomatology: a major risk factor for erosive tooth wear? Eat Weight Disord 2021; 26:1119-1127. [PMID: 32929621 DOI: 10.1007/s40519-020-01008-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 09/02/2020] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Evaluate dietary habits and the presence of erosive tooth wear (ETW) among female adolescents with varying severity of bulimic symptomatology. METHODS An explanatory study was conducted with 72 female school adolescents with bulimic symptomatology, aged 15-18 years in Southeastern Brazil. Dietary habits were evaluated through a food frequency questionnaire. Bulimic symptomatology was evaluated and classified (mild, moderate and severe) according to the Bulimic Investigatory Test of Edinburgh. ETW examinations were performed. Data analysis involved descriptive statistics, bivariate analysis, Kruskal-Wallis/Mann-Whitney tests and Poisson regression. Ethical approval and informed consents were obtained. RESULTS The final population consisted of 62 participants. The prevalence of ETW differed among adolescents with mild, moderate and severe bulimic symptomatology (p = 0.001), corresponding to 5.9%, 8.0% and 45.0%, respectively. Adolescents with severe bulimic symptomatology presented higher daily consumption of acidic food: citric fruits (p < 0.005), diet soda (p < 0.009) and ketchup (p = 0.004). No difference related to vomiting practices was observed between groups (p = 0.060). The adjusted regression model showed that a higher prevalence of ETW was associated with self-induced vomit at least once a week (PR = 2.42, 95% CI = 1.00-5.86, p = 0.05) and higher frequencies of consumption of citric fruits (PR = 7.96, 95% CI = 1.50-42.11, p = 0.015) and diet soda (PR = 2.32, 95% CI = 1.09-4.91, p = 0.029). CONCLUSION It was the food choices (acidic food) and not purging practices that differed among adolescents with varying severity of bulimic symptomology. Likewise, higher consumption of citric fruits was the main factor associated with higher prevalence of ETW. LEVEL OF EVIDENCE III case-control analytic study.
Collapse
Affiliation(s)
- Ana Paula Hermont
- Department of Pediatric Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Isabela Almeida Pordeus
- Department of Pediatric Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Joana Ramos-Jorge
- Department of Pediatric Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Saul Martins Paiva
- Department of Pediatric Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Sheyla Márcia Auad
- Department of Pediatric Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| |
Collapse
|
7
|
Hasan S, Ahmed S, Panigrahi R, Chaudhary P, Vyas V, Saeed S. Oral cavity and eating disorders: An insight to holistic health. J Family Med Prim Care 2020; 9:3890-3897. [PMID: 33110784 PMCID: PMC7586628 DOI: 10.4103/jfmpc.jfmpc_608_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 06/10/2020] [Accepted: 06/25/2020] [Indexed: 02/06/2023] Open
Abstract
Oral health is vital to the general well being and is a time-tested indicator of the systemic health of an individual. Oral cavity may be the primary site affected in endocrine disorders, renal disorders, gastrointestinal, cardiovascular, hematological, autoimmune cutaneous disorders, and psychosomatic disorders. Eating disorders (primarily Anorexia nervosa and bulimia) are psychosomatic disorders having multifaceted etiology, and characterized by abnormal eating patterns. In many cases, the oral cavity may be the only site of the manifestations of eating disorders. An oral physician may often unveil the mystery of this underlying systemic pathology by a vigilant and meticulous examination of the oral cavity. This not only helps in nabbing the disease in its early course but also prevents the patients from the appalling consequences due to the disease. This article aims to highlight the etiopathogenesis and various oral features in eating disorders. The oral physician should be familiar with the bizarre oral features of eating disorders and should work in close connection with other healthcare physicians to prevent the psychosomatic and systemic consequences.
Collapse
Affiliation(s)
- Shamimul Hasan
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Sameer Ahmed
- Department of Periodontology, Darshan Dental College and Hospitals, Udaipur, Rajasthan, India
| | - Rajat Panigrahi
- Department of Oral Medicine and Radiology, Institute of Dental Sciences, SOA University, Bhubaneswar, Odisha, India
| | - Priyadarshini Chaudhary
- Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Vijeta Vyas
- Department of Periodontology, Darshan Dental College and Hospitals, Udaipur, Rajasthan, India
| | - Shazina Saeed
- Amity Institute of Public Health, Amity University, Noida, Uttar Pradesh, India
| |
Collapse
|
8
|
Wohlrab T, Flechtenmacher S, Krisam J, Saure D, Wolff D, Frese C. Diagnostic Value of the Basic Erosive Wear Examination for the Assessment of Dental Erosion on Patients, Dental Photographs, and Dental Casts. Oper Dent 2019; 44:E279-E288. [PMID: 31034351 DOI: 10.2341/18-127-c] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim of this trial was to investigate the diagnostic value of the basic erosive wear examination (BEWE) in clinical use, on dental photographs, and on dental casts over a two-year follow-up period (2013-2015). According to the main hypothesis for longitudinal monitoring of dental erosion, the BEWE is equally reproducible by the three assessment methods. METHODS AND MATERIALS The clinical assessment included intraoral photographic documentation, dental impressions, oral examination, and assessment of BEWE. Clinical assessment of BEWE was done by one blinded examiner, whereas assessment on photographs and dental casts was performed by three calibrated examiners and repeated after 14 days. The three assessment methods were analyzed separately by longitudinal agreement and inter- and intrarater reliability (intraclass correlation coefficient) alongside 95% confidence intervals (CIs). RESULTS Comparing the longitudinal data of the years 2013-2015, clinical use and photographs showed no significant difference (p=0.0681-0.9963), whereas the statistical analysis showed a significant difference for dental casts by comparing data from 2013 vs 2014 (p=0.0266) as well as data from 2013 vs 2015 (p=0.0001). Statistical evaluation of overall BEWE showed an intrarater reliability of 0.79-0.91 for photographs and 0.60-0.87 for dental casts. The interrater reliability was 0.77 (95% CI=[0.69; 0.84]) for photographs and 0.63 (95% CI=[0.52; 0.72]) for dental casts. CONCLUSION This investigation showed that in longitudinal clinical monitoring, the assessment of the BEWE on patients and dental photographs yielded comparable results. In addition, based on these findings, the assessment of the BEWE on dental casts showed moderate reproducibility. Therefore, dental casts may be better used for laboratory assessment techniques.
Collapse
|
9
|
Donovan TE, Marzola R, Murphy KR, Cagna DR, Eichmiller F, McKee JR, Metz JE, Albouy JP, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2018; 120:816-878. [DOI: 10.1016/j.prosdent.2018.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 09/24/2018] [Indexed: 02/08/2023]
|
10
|
Schildbach S, Schildbach C. Prevalence of psychiatric disorders in detainees serving imprisonment as an alternative punishment for failure to pay penalty fees: A longitudinal study. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2018; 58:105-109. [PMID: 29853000 DOI: 10.1016/j.ijlp.2018.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 03/25/2018] [Accepted: 03/26/2018] [Indexed: 06/08/2023]
Abstract
In Germany, Austria and Switzerland, lawbreakers who are unwilling or unable to pay a fine for committing a criminal offence can face imprisonment. The length of compensation imprisonment corresponds to the amount of the fee the convicted was sentenced to pay. Every tenth German prisoner serves this kind of sentence. Recent meta-analyses indicated that inmates are several times more likely to suffer from psychosis and major depression and are more than ten times more likely to exhibit antisocial personality disorders than the general population. This study set out to assess the levels of mental disorders in the population of compensation prisoners in the German capital Berlin in 1999, 2004, 2010 and 2017. The four study populations, consisting of 100 participants each, showed a high prevalence of mental disorders and were therefore mostly unable to apply for serving voluntary work as alternative to imprisonment. As the prevalence of mental disorders was largely consistent over the investigation timeframe, it seems advisable to make a psychopathological diagnosis at the start of imprisonment in order to filter out those detainees that would benefit from social training in order to enhance their competency to solve problems, strengthen their social skills and enhance their quality of life outside of the penal institution. In addition, as the compensation prisoners exhibited a high degree of substance abuse, it would be recommendable to assess the presence of substance abuse at the beginning of imprisonment. Then, appropriate measures could be taken to reduce the number of reoffenders and enable the temporary detainees to reintegrate successfully into society.
Collapse
Affiliation(s)
| | - Carola Schildbach
- Praxisgemeinschaft für Psychosomatik, Bahnhofplatz 88, 9056 Gais, Switzerland
| |
Collapse
|