[Behavioral eating disorders and their effects on the oral health in adolescence]

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

INTRODUCTION

Restrictive 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.

METHODOLOGY

This 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.

RESULTS

AN 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).

CONCLUSIONS

Although 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.

Relationship between bariatric surgery and dental erosion: a systematic review

BACKGROUND

Bariatric surgery can have several oral repercussions, including tooth erosion due to decreased salivary flow associated with the action of acidic pH and behavioral modifications in the diet that lead to the dissolution of mineralized dental tissues.

OBJECTIVES

This systematic review aimed to evaluate whether bariatric surgery presented a greater risk of dental erosion.

SETTING

Dentistry School, Pernambuco University, Camaragibe, Pernambuco, Brazil.

METHODS

This review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) and registered at the International Prospective Registry of Systematic Reviews (CRD42019124960). A search was performed in the PubMed/MEDLINE, Web of Science, and Cochrane Library databases using the following descriptors: "dental erosion OR tooth wear OR oral health OR dental wear OR tooth erosion OR salivary flow AND bariatric surgery OR gastrectomy OR obesity surgery".

RESULTS

The review included 553 articles (after exclusion of duplicates) submitted for title and abstract reading, of which 24 were selected for full text analysis. Five articles fulfilling the eligibility criteria were included in the qualitative and quantitative analysis review. Because of high heterogeneity of the studies, meta-analysis could not be performed.

CONCLUSIONS

Based on the review, we concluded that patients undergoing bariatric surgery had a higher incidence of dental erosion. All studies presented a high degree of dental erosion in patients submitted to bariatric surgery (P < .05).

Oral profile of eating disorders patients: Case series

Oral alterations in patients diagnosed with eating disorders (ED) are reported in the literature, but few articles demonstrate these changes in a specific population. This study aims to summarize the findings of 26 patients with ED in a Brazilian dental clinic, through analyzing the body mass index and oral conditions (decayed, missing and filled teeth-DMFT, dental wear, salivary flux, xerostomia, oral hygiene-OHI-S, oral lesions, and the prevalence of candidiasis), in order to facilitate recognition and enable accurate diagnosis for the general dentist. Probably, the premature diagnosis of ED resulted in lower DMFT and oral lesions.

Frequência de comportamentos alimentares inadequados e sua relação com a insatisfação corporal em adolescentes

OBJETIVO: Descrever a relação entre a frequência de insatisfação com a imagem corporal e a presença de sintomas de transtornos alimentares em adolescentes. MÉTODOS: O estudo foi realizado com uma amostra de 300 adolescentes, de ambos os sexos, na faixa etária de 10 a 17 anos, estudantes de uma escola pública estadual da cidade do Recife, Brasil. Foram utilizadas as versões brasileiras para adolescentes de três escalas autoaplicativas (EAT-26, BITE e BSQ), além de um questionário contendo dados biodemográficos. RESULTADOS: A frequência de sintomas de transtornos alimentares detectada pelo EAT-26 foi de 32,3%; 2,3% para comportamentos sugestivos de bulimia nervosa, por meio da escala BITE, tendo 36,67% dos alunos apresentado padrão alimentar não usual; 5,6% apresentaram insatisfação com a imagem corporal; 8,6% demonstraram tendência à preocupação com a insatisfação com a imagem corporal e 17,6% apresentaram leve insatisfação, além de 66,3%, que mostraram normalidade em relação à sua forma corporal. CONCLUSÃO: Os adolescentes apresentaram níveis de alteração na autoimagem corporal, com alta frequência de insatisfação da imagem corporal, podendo apresentar associação com comportamentos alimentares inadequados.

Características morfofuncionais do trânsito orofaríngeo na bulimia: revisão de literatura

TEMA: deglutição e bulimia. OBJETIVO: apresentar e discutir os achados científicos descritos na literatura quanto às características orofaríngeas relacionadas à deglutição em portadores de bulimia nervosa do tipo purgativa. CONCLUSÃO: a bulimia nervosa acarreta uma série de alterações em estruturas e funções que compõem o trânsito orofaríngeo, como erosão dentária, hipersensibilidade, enfraquecimento e fratura dos dentes, problemas de oclusão, cáries, doenças periodontais, dessensibilização intra-oral, hipogeusia, úlceras, granulomas, queilite angular, hipertrofia das glândulas parótidas, tosse e odinofagia. Existe um predomínio na literatura científica de relatos sobre alterações morfológicas em detrimento das funcionais. Poucos relatos abordaram diretamente a relação entre a bulimia e deglutição, apenas mencionando superficialmente as possibilidades de desencadeamento da disfagia orofaríngea.

Restoration of Occlusal Vertical Dimension in Dental Erosion Caused by Gastroesophageal Reflux: Case Report

The authors describe a minimally invasive procedure for occlusal rehabilitation in a young patient presenting with mild mandibular prognathism and loss of occlusal vertical dimension caused by dental erosion from chronic gastroesophageal reflux.

Eating disorders in adolescents and their repercussions in oral health

OBJECTIVE

To examine the prevalence of oral alterations related to eating disorders and associated factors.

METHOD

A cross-sectional study including 650 adolescents aged from 12 to 16 was carried out through self-report questionnaires (EAT-26; BITE and self-rating hamilton depression questionnaire, SRHDQ) and dental examination.

RESULTS

Significant associations were observed in mucositis, cheilitis, hypertrophy of salivary glands, and dental erosions. The prevalence of adolescents at risk for eating disorders was of 33.1%, according to EAT-26 and 1.7% (high scores) and 36.5% (medium scores), in BITE, higher among 13-year-old females, with brothers, parents or responsible person who are illiterate, being the youngest child, living in a residence of at most two rooms and who showed depressive symptoms. All these factors showed significant relation to eating disorders.

DISCUSSION

Presence of oral alterations is associated to symptoms of eating disorders, helping precocious detection of sub clinical cases.

Bulimia nervosa as a risk factor for voice disorders--literature review

Bulimia nervosa (BN) is a type of feeding disorder that starts in adolescence and presents a variety of symptoms, recurrent vomiting in the oral cavity that may reach down to the larynx - similarly to gastro-esophageal reflux, causing laryngeal and voice disorder alterations.

AIM

These studies aimed at surveying the literature and investigate the studies that considered BN a risk factor for voice disorders.

RESULTS

of the ninety three papers we found, twenty-three were used as a basis for this review, among them, only three discuss BN as an etiology factor associated with voice changes in adult women, and we did not find any paper associating this with bulimic teenagers.

CONCLUSION

It is necessary to observe laryngeal and vocal signs and symptoms associated with BN, especially in teenagers whose voices are going through a period of change.