A comprehensive review of eating disorders and their implications on oral health
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In today’s world, eating disorders are plaguing adolescent women at alarming rates. Anorexia nervosa and bulimia nervosa are the two most common disorders and differ in their symptoms and prognoses. While the symptoms of these diseases are not readily visible in systemic health, deteriorating oral health can be a positive indication of abnormal eating habits. Anorexia nervosa and bulimia nervosa result in declining systemic health due to resulting nutritional imbalances and physical harm that patients exert upon themselves. Malnutrition results in altered endocrine function and consequent loss of menstruation, abnormal hair growth, and decreased peak bone mass. Although risk factors for anorexia nervosa and bulimia nervosa vary, the resulting nutritional impoverishment produces the similar systemic effects. In addition to systemic health degradation, symptoms of anorexia and bulimia commonly manifest in the oral cavity. Chemically, salivary composition may be altered resulting in lower pH values. Patients may also exhibit temporary bilateral parotid gland swelling as a result of repeated purge episodes. The most critical oral effect of repeated purge episodes is loss of permanent enamel and is defined as perimolysis. Presently, research does not agree on whether or not eating disorders elevate the risk of dental carries. Although current literature unanimously agrees on the importance of early oral health detection and diagnosis of eating disorders, most dentist are not trained to properly identify and diagnose the manifestations of AN and BN within the oral cavity. Dental school and dental hygiene curriculums lack emphasis on the severity of eating disorders in general and do not allot adequate teaching hours for this matter. Sadly, even when dentists suspect the presence of eating disorders, they are not likely to intervene. Fortunately, full recovery is possible in eating disorder patients if proper therapy and medical attention is provided in a timely manner. Damaged dentition may also be fully restored with the use of crowns, composite fillings, and porcelain veneers. However, if disordered eating habits persist after dental restoration, the dentition will once again erode and deteriorate accordingly. Anorexia nervosa and bulimia nervosa are serious diseases that need proper attention and medical intervention. Their severity should not be minimized as they may ultimately result in grave side effects and eventual death. Dental health practitioners have the ability of observe the presence of these diseases before others as obvious symptoms may present in the oral cavity. Dentists and dental hygienists need to be educated on the oral manifestations of eating disorders and proper protocol regarding timely intervention. With proper education and knowledge, dental health practitioners can reduce the severity of disease, resulting in better prognoses for patients.