Mental Disturbances: Eating Disorders
Journal Article Summary
Article:
"Eating disorder-induced dental complications: a case report"
Summary:
Eating disorders, both anorexia and bulimia, share a common feature in which there is an immense concern of an individuals weight and appearance. Eating disorders primarily affect women over men. The age of onset for anorexia is slightly younger at about 16 years old, in contrast to bulimia with an onset of about 25 years of age. An individual that is anorexic will deliberately restrict their diet which ultimately causes weight loss. An individual suffering from bulimia may overindulge in food followed by self-induced vomiting or they may regularly engage in the use of laxatives, diuretics, strict dieting or fasting, or vigorous exercise to prevent weight gain. In both diseases, the individual is suffering with an extreme fear of gaining weight even when extremely underweight.
Anorexia and bulimia are two disorders that may be categorized differently, but in actuality they are very interrelated. An individual may be considered anorexic because they consistently restrict food intake, but they may also have episodes of binge eating followed with vomiting. An individual that is bulimic may frequently binge and purge, but may also experience periods of severe food restriction. Even though these two disorders may be closely related, it is important to differentiate one from the other because the recovery rate of an individual with anorexia is 12-22% and in bulimics is 37%. Anorexic patients can also be classified as having either restrictive anorexia nervosa or bulimic anorexia nervosa. Restrictive anorexia is the loss of weight solely by the restriction of food. It is characterized by a reduction of more than 10% below the ideal body weight of the patient. Bulimic anorexia nervosa is the combination of self-induced vomiting with the abuse of laxatives and is also characterized by a reduction of more than 10% below the ideal body weight of the patient. In general, most individuals with anorexia look thin; whereas an individual that is bulimic may not seem to have a problem from their appearance.
Oral manifestations of eating disorders vary depending on the length of time the person has had the eating disorder, the degree and frequency of pathological eating behaviors and the diet and oral hygiene care. Typically, there are four oral conditions that are seen in individuals with an eating disorder: dental erosion, caries, salivary gland hypertrophy, and xerostomia. Damage to the oral mucosa and moderate periodontal destruction has also been noted. The cause of dental erosion is the presence of the stomach acids in the oral cavity from self-induced vomiting; the acid erodes and demineralizes the enamel. Most often, enamel erosion is seen on the lingual aspect of the maxillary anterior teeth. Hypersensitivity may a result from the dental erosion. The rate of dental caries in patients with eating disorders depends on the frequency of the bulimic behavior, and the diet and oral hygiene care. Salivary gland hypertrophy has been estimated to occur in 10-50% of cases and includes enlargement of the parotid gland and occasionally the submandibular salivary gland; the enlargement usually follows an episode of binging and purging. Vomiting and the misuse of diuretics and laxatives cause an overall decreased fluid volume, therefore causing a decreased salivary flow. Anorexic patients seen to have poor oral hygiene compared to bulimic patients, including higher plaque indices and gingivitis, where as bulimic patients are often very concerned with their appearance so they are much more meticulous with their oral hygiene care. The oral mucosa, especially in individuals that binge and purge, can be affected due to rapid intake of large amounts of food and by the force of regurgitation. Trauma of the palate, pharynx and posterior tongue may also be present due to self-induced vomiting using their fingers or other items.
The article then goes to discuss a case report of a 20 year old female. In this report, the female initially presented to the dental office with dental hypersensitivity. She was showing the beginning signs of enamel erosion and accounted it to frequent intake of acidic juice. After composite restorations were placed, she did not come back for three years. Once she came back, she was showing more advanced acid erosion in more areas of the mouth as well as occlusal caries. Restorations were placed and anorexia was carefully brought up to the patient but she denied that there was a problem. Six years later the patient came back with recurring hypersensitivity and needed more extensive restorations. After completion of the restorative treatment, she finally admitted that she had a long standing eating disorder.
Personal Reflection:
I chose to find a journal article on eating disorders because it has always been a disorder that is so sad to me. I feel like it was just yesterday that I was in high school and your weight and body image meant the world to you. I know multiple people that were trying diet pills, and had tried to restrict food intake or induce vomiting at some point or another. I feel like there is so much pressure in the society to be thin that even if some people don’t physically have the disorder, they mentally are always criticizing themselves about their weight or appearance. I feel like this topic is important to the dental hygienist because often times the dental health care professional may be the first person to notice the signs of an eating disorder. This is because individuals with eating disorders rarely seek treatment from health care providers. If this situation presents itself to me in my future career, I hope that I will be able to create an open conversation with the individual to build a rapport with them so they feel comfortable enough to speak with me about their condition; that way I will be able to effectively offer all of my services and knowledge to them.
Citation:
De Moor, R. G. (2004). Eating disorder-induced dental complications: a case report. Journal Of Oral Rehabilitation, 31(7),
725-732. doi:10.1111/j.1365-2842.2004.01282.x
Additional Information:
-ANAD is the national association of anorexia nervosa and associated disorders, inc. and offers a lot of important information on the prevention and alleviation of eating disorders. http://www.anad.org/
-NEDA is the national eating disorders association and offers a lot of information and access to help for someone with an eating disorder. http://www.nationaleatingdisorders.org/
**Images retrieved from google.com/images**
Article:
"Eating disorder-induced dental complications: a case report"
Summary:
Eating disorders, both anorexia and bulimia, share a common feature in which there is an immense concern of an individuals weight and appearance. Eating disorders primarily affect women over men. The age of onset for anorexia is slightly younger at about 16 years old, in contrast to bulimia with an onset of about 25 years of age. An individual that is anorexic will deliberately restrict their diet which ultimately causes weight loss. An individual suffering from bulimia may overindulge in food followed by self-induced vomiting or they may regularly engage in the use of laxatives, diuretics, strict dieting or fasting, or vigorous exercise to prevent weight gain. In both diseases, the individual is suffering with an extreme fear of gaining weight even when extremely underweight.
Anorexia and bulimia are two disorders that may be categorized differently, but in actuality they are very interrelated. An individual may be considered anorexic because they consistently restrict food intake, but they may also have episodes of binge eating followed with vomiting. An individual that is bulimic may frequently binge and purge, but may also experience periods of severe food restriction. Even though these two disorders may be closely related, it is important to differentiate one from the other because the recovery rate of an individual with anorexia is 12-22% and in bulimics is 37%. Anorexic patients can also be classified as having either restrictive anorexia nervosa or bulimic anorexia nervosa. Restrictive anorexia is the loss of weight solely by the restriction of food. It is characterized by a reduction of more than 10% below the ideal body weight of the patient. Bulimic anorexia nervosa is the combination of self-induced vomiting with the abuse of laxatives and is also characterized by a reduction of more than 10% below the ideal body weight of the patient. In general, most individuals with anorexia look thin; whereas an individual that is bulimic may not seem to have a problem from their appearance.
Oral manifestations of eating disorders vary depending on the length of time the person has had the eating disorder, the degree and frequency of pathological eating behaviors and the diet and oral hygiene care. Typically, there are four oral conditions that are seen in individuals with an eating disorder: dental erosion, caries, salivary gland hypertrophy, and xerostomia. Damage to the oral mucosa and moderate periodontal destruction has also been noted. The cause of dental erosion is the presence of the stomach acids in the oral cavity from self-induced vomiting; the acid erodes and demineralizes the enamel. Most often, enamel erosion is seen on the lingual aspect of the maxillary anterior teeth. Hypersensitivity may a result from the dental erosion. The rate of dental caries in patients with eating disorders depends on the frequency of the bulimic behavior, and the diet and oral hygiene care. Salivary gland hypertrophy has been estimated to occur in 10-50% of cases and includes enlargement of the parotid gland and occasionally the submandibular salivary gland; the enlargement usually follows an episode of binging and purging. Vomiting and the misuse of diuretics and laxatives cause an overall decreased fluid volume, therefore causing a decreased salivary flow. Anorexic patients seen to have poor oral hygiene compared to bulimic patients, including higher plaque indices and gingivitis, where as bulimic patients are often very concerned with their appearance so they are much more meticulous with their oral hygiene care. The oral mucosa, especially in individuals that binge and purge, can be affected due to rapid intake of large amounts of food and by the force of regurgitation. Trauma of the palate, pharynx and posterior tongue may also be present due to self-induced vomiting using their fingers or other items.
The article then goes to discuss a case report of a 20 year old female. In this report, the female initially presented to the dental office with dental hypersensitivity. She was showing the beginning signs of enamel erosion and accounted it to frequent intake of acidic juice. After composite restorations were placed, she did not come back for three years. Once she came back, she was showing more advanced acid erosion in more areas of the mouth as well as occlusal caries. Restorations were placed and anorexia was carefully brought up to the patient but she denied that there was a problem. Six years later the patient came back with recurring hypersensitivity and needed more extensive restorations. After completion of the restorative treatment, she finally admitted that she had a long standing eating disorder.
Personal Reflection:
I chose to find a journal article on eating disorders because it has always been a disorder that is so sad to me. I feel like it was just yesterday that I was in high school and your weight and body image meant the world to you. I know multiple people that were trying diet pills, and had tried to restrict food intake or induce vomiting at some point or another. I feel like there is so much pressure in the society to be thin that even if some people don’t physically have the disorder, they mentally are always criticizing themselves about their weight or appearance. I feel like this topic is important to the dental hygienist because often times the dental health care professional may be the first person to notice the signs of an eating disorder. This is because individuals with eating disorders rarely seek treatment from health care providers. If this situation presents itself to me in my future career, I hope that I will be able to create an open conversation with the individual to build a rapport with them so they feel comfortable enough to speak with me about their condition; that way I will be able to effectively offer all of my services and knowledge to them.
Citation:
De Moor, R. G. (2004). Eating disorder-induced dental complications: a case report. Journal Of Oral Rehabilitation, 31(7),
725-732. doi:10.1111/j.1365-2842.2004.01282.x
Additional Information:
-ANAD is the national association of anorexia nervosa and associated disorders, inc. and offers a lot of important information on the prevention and alleviation of eating disorders. http://www.anad.org/
-NEDA is the national eating disorders association and offers a lot of information and access to help for someone with an eating disorder. http://www.nationaleatingdisorders.org/
**Images retrieved from google.com/images**