05 May 2020

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Eating disorders and Oral health: is there any correlation?

Alessandra Abbà

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Eating disorders (ED), such as Anorexia or Bulimia, are serious psycho-social illnesses that affect adults and adolescents mainly. Individuals affected by eating disorders can also have additional health diseases including diabetes, metabolic, cardiovascular and endocrine issues. These latter lead to xerostomia and other oral disorders like dental caries and dental erosion deriving from respectively lack of saliva together with bad dietary habits and self-induced vomit.
Periodontal diseases are associated with eating disorders too. In fact individuals suffering from eating disorders show a lack of oral hygiene.     
Eating disorders are correlated to the self-perception of the patients and oral diseases may impact on their ability to socialize, leading to a deteriorations in their conditions. In this regard, an adequate oral care education became of primary importance. The hypothesis of Johansson's study is that diet and other behavioral habits differs among eating disorders patients depending on their disease state.

Materials and Methods
This study includes 54 patients (50 women and 4 men with a mean age 21.5 years) who initiated treatment in an eating disorders clinic during 1 year. For the control group 54 sex-and age-matched partecipants were selected from a public dental health clinic. Each patient completed a comprehensive questionnaire of 196 questions on sociodemographic factors, general and oral health including dietary and oral hygiene habits. The same question was always given twice by the eating disorders group, according to the self-perception of the patients, when they were feeling “relatively good” (ED-good) and “bad” (ED-bad).  

Results
-  Soft drink: The ED-good patients reported significantly higher intake of caffeine-containing, and cola light soft drinks and both Ed-good and ED-bad groups reported a lower intake of sweetened carbonated drinks compared to controls;     
- Meal and sweet: ED-bad reported significantly lower intake of meal and sweet;
- Oral hygiene: both study groups brushed their teeth more frequently than controls but ED patients went less often to the dentist for checkups than controls;      
- Awareness of risk related to bad diet: there is no difference between patients and controls;         
- Vomiting ED patients differed in several of the parameters related to dietary and other behaviors compared to no vomiting subjects.

Conclusions
Eating disorders patients’ dietary habits in combination with the disease expression may be harmful for their oral health. According to the results of this study, the hypothesis that diet and other behavioral habits differ among eating disorders patients depending on their disease state was verified. Hence, it can be concluded that oral care education program should integrate to eating disorders patients’ therapy even for the acquisition of better self-image perception. 

For additional information:  Diet and behavioral habits related to oral health in eating disorder patients: a matched case-control study