Diet Traps during Eating Disorders among Dentate Patients at an Oral Health Glance

Abstract

Persons suffering from eating disorders (ED) may often experience a recurrence/persistence symptoms despite the completion of psychiatric therapy. In most cases, their general health status is linked to current nutritional behaviors. Medical professionals, general practitioners (GPs), dieticians, and dentists may see those patients in their practices. At the same time, due to low sense of illness, some patients may delay or never seek professional medical care. The aim of this article is to analyze the main ED types according to dietary behaviors causing oral health problems and discuss oral health complications in affected dentate patients. The second objective is to update oral preventive measures and technological innovations together with active agents for oral hygiene care that might effectively support oral health maintenance during the presence of long-term symptoms. The research method involved a review of clinical reports as a synthesis of the electronic research in the Pubmed, Web of Science, and Google Scholar databases. Based on the research, ED patients were found to present related incidences of oral complications. Studies have reported that the possible course of an ED and comorbidities may be an imbalance in the oral environment. The results showed an association between biological (malnutrition, etc.), behavioral (binge eating episodes, vomiting, acidic diet, poor oral hygiene), and pharmacotherapeutic (addiction, hyposalivation) factors that may threaten oral health. Early diagnosis of the past and present symptoms is essential to eliminate and take control of destructive behaviors. Oral changes need to be tackled with medical insight, and additionally, the perception of dietary interactions is recommended.

Keywords: eating disorders; nutrition; oral health; oral hygiene; risk factors.

Figure 5

A typical example of the Plate-by-Plate Approach.

Figure 1

Division of EDs according to DSM-5 and ICD-11 subtypes.

Figure 2

Palatal surfaces of maxillary teeth affected by erosive tooth wear (Courtsey Amaechi BT, UTHSA, San Antonio, TX, USA).

Figure 3

Occlusal surfaces of mandibular teeth affected by erosive teeth wear (Courtsey Amaechi BT, UTHSA, San Antonio, TX, USA).

Figure 4

EDs’ main symptoms (in yellow) and oral effects (in blue and purple). The following factors may influence any oral complications: subtype of AN, BN, and EDNOS according to nutritional behaviors; vomiting frequency; disease duration; age and sex of the patient; general health status; pharmacotherapy and their side effects to salivation; and psychosocial profile; as well as cariogenic/acidic diet, individual oral hygiene, and remineralization exposure. Abbreviations: ↑↓ means the ED symptoms increase the oral effect/decrease the oral effect.

Figure 6

Counseling relating to the prevention of effects on oral hard and soft tissues (what to avoid but introduce for the patient and professional care).