Topic > Oral Complications as a Consequence of Bulimia Nervosa and Anorexia Nervosa

Index IntroductionDiscussion of the EvidenceConclusionImplications for PracticeImplications for TrainingImplications for ResearchImplications for Personal PracticeSummaryReferencesIntroductionEating disorders are a subgroup of psychiatric disorders that have significant consequences on the body. Eating disorders are characterized by a psychopathology fixated on the individual's eating behavior, weight, shape and efforts to control them. Anorexia nervosa and bulimia nervosa are recognized as the two main types of eating disorders commonly found in adults. Anorexia nervosa (AN) is divided into two groups; restrictive type and purgative type. As for the restrictive type, weight loss occurs by reducing food intake, fasting, and excessive exercise. Additionally, the purgative type is defined as the use of laxatives, diuretics, vomiting inducers, and appetite suppressants. Bulimia nervosa (BN) is defined as recurrent episodes of binge eating. It can also be divided into restrictive or purgative. The purgative aspect of BN and AN is where eating disorders begin to pose a major problem in the oral cavity. Complications resulting from deletion could include; caries, dental erosion, dental hypersensitivity, periodontal disease, xerostomia, etc. Therefore, I wonder, are adults with anorexia nervosa and bulimia nervosa more likely to develop oral health problems than adults who do not suffer from anorexia nervosa and bulimia nervosa? We say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an Original Essay Discussion of the Evidence Each article shares similar conclusions that eating disorders are a problem when it comes to oral health. Additionally, each article shared some differences in findings, as each article studied different aspects of oral health. In the European study, elevated salivary concentrations of ASAT and total protein were found in patients with erectile dysfunction, as well as increased xerostomia. In the Portuguese study, an association between reduced salivary flow and lower buffering capacity leads to a lower salivary pH within the oral cavity. Both studies concluded that eating disorders can affect the biochemical composition of saliva, as well as salivary flow. However, the European study found no significant difference in buffering capacity between the ED group and the control group. Regarding xerostomia, the British study further verified that vomiting and starvation could lead to hyposalivation and xerostomia. The European study said it found enlargement of the parotid gland in 31 percent of patients with erectile dysfunction, but no such findings in the control group. Second, DMFT and DMFS were both used in the British and Portuguese study to evaluate the client's dentition. The British study found that eating disorder patients had significantly more decayed, missing and filled surfaces than controls, as well as increased DMFT. The Portuguese study confirmed that patients with eating disorders had significantly higher DMFT, DMFS and caries scores than controls. Additionally, the British study found that dental erosion was five times more likely to occur in patients with erectile dysfunction than in those without. Patients with self-induced vomiting were more likely to have erosion with an odds ratio of 7.32. While those without vomiting had an odds ratio of 3.10. The studyPortuguese also explained that patients in the eating disorder group showed significantly higher levels of dental erosion. This study also found a correlation between the severity of erosion and dentinal hypersensitivity. Both studies agree that dental erosion occurs most often on the lingual surfaces of the dentition. Due to the fact that these surfaces are left unprotected by the tongue and soft tissue during bleeding episodes. The American article was the only article that touched on perimylolysis, a uniform erosion of tooth enamel, resulting in a loss of enamel and dentin on the lingual surfaces of the dentition, caused by frequent vomiting. Furthermore, the British study explained that poor dental health can have serious consequences for patients with eating disorders that include impairment, pain and discomfort. In the Brazilian study, groups B and C (Group B - Anorexia Nervosa Elimination Subtype, Group C - Bulimia Nervosa), had the greatest complaints of frequent facial pain. Group B measured 52.6% and group C 56.3%, these results were significant compared to the control group. The Brazilian study was also able to find that reduced salivary flow could interfere with swallowing and cause increased strain on the infrahyoid muscles and digastric muscle. In addition to this study, a higher prevalence of myofascial masticatory pain and pain disorders was found in patients with eating disorders compared to healthy subjects. Conclusion Each study concluded that patients with anorexia nervosa and bulimia nervosa experienced more oral health problems, compared to healthy patients. Each article agreed that reduced salivary flow/xerostomia has been shown to be more prevalent in patients with eating disorders. The European study was the only one to delve into the biochemical composition of saliva in patients suffering from eating disorders. While the Brazilian study was the only one to correlate reduced salivary flow to pain. Each article was able to cover the significance of eating disorders on oral complications such as dental erosion, tooth decay, pain, xerostomia, etc. Each article was relevant as the authors had dental and medical backgrounds. The articles are also peer-reviewed, credible and published within the last 5 years. Some weaknesses of the trials were the small sample size and gender distribution. The Portuguese study conducted research only on women. While the European study conducted research on 50 women and 4 men. Therefore, for the research to be more reliable, it should improve the sample size, gender distribution, and monitor the effects of eating disorders on the oral cavity for longer periods of time. Implications for Practice In practice, oral health professionals may notice the signs and symptoms of an eating disorder present in a client. A screening question that asks the client if they have problems with eating or weight maintenance is recommended. It is important not to be confrontational with the client and to bring any oral problems to his attention. The client may not admit to having an eating disorder when asked. It is essential to ask follow-up questions at each appointment and provide adequate references. The doctor should also provide the client with oral hygiene instructions to try to mitigate the effects that ED has had on the oral cavity. It may also be important to educate the client about the serious complications that an eating disorder can have on the body. The clinician should always approach the situation gently and otherwise/26429686