Dental and periodontal health in adults with eating disorders: A case-control study

Abstract

Objectives: This study evaluates dental and periodontal health in anorexia nervosa and bulimia nervosa patients.

Methods: Seventy females with eating disorders (36 anorexia nervosa) attending a public hospital Psychiatry and Addiction unit were compared with age-matched controls (n = 70). Full-mouth examination and oral hygiene behaviours were recorded for all participants.

Results: More frequent dental attendance and toothbrushing were observed in patients with eating disorders than in controls (p < 0.01), while lower plaque index and bleeding on probing were observed in controls than in patients (p ≤ 0.03). Percentages of sites with gingival recession >2 mm were higher in patients with eating disorders than in controls (2.3 ± 4.1 versus 0.0 ± 0.1, p < 0.01). The BEWE score >2 was significantly more frequent in bulimia nervosa patients than in anorexia nervosa patients (76.5% versus 41.7%, p < 0.01). Regarding periodontal parameters, mean plaque index, bleeding on probing and clinical attachment loss were increased in anorexia nervosa patients compared to bulimia nervosa patients.

Conclusions: The present data suggest different oral health approaches in eating disorder patients according to diagnosis type.

Clinical significance: Periodontal and dental health should be considered rigorously in patients with eating disorders. Personalized oral hygiene recommendations and treatments can be delivered according to the type of eating disorder.

Keywords: Anorexia nervosa; Bulimia nervosa; Eating disorders; Erosive tooth wear; Gingival recession; Gingivitis.