Depth and Area of Dental Erosions,and Dental Caries,in Bulimic Women

Abstract

Dental caries and the severity (depth) and area of erosions of tooth substance were studied in 11 bulimic subjects and 22 matched controls. Erosions were seen in 69% of the bulimics' teeth and in only 7% of the controls' (p< 0.001). Depth of penetration was greater in the bulimics, extending even into the pulp, and the area of erosion was also larger. Scores for dental caries were higher in bulimics (mean DMFS 27.9, median 36) than in controls (mean DMFS 19.1, median 13.5), although the difference was not statistically significant. This study suggests that when erosions are present on the lingual surfaces of maxillary anterior teeth, as well as on the buccal surfaces of maxillary canines, premolars, and maxillary incisors, a diagnosis of bulimia is likely. Patients with these signs should be referred for medical help.

Get full access to this article

View all access options for this article.

References

Asher, C. and Read, M.J.F. (1987): Early Enamel Erosion in Children Associated with Excessive Consumption of Citric Acid, Br Dent J 162:384-387.

Clark, D.C. (1985): Oral Complication of Anorexia Nervosa and/ or Bulimia, J Oral Med 40:134-138.

Cleaton-Jones, P. ; Hargreaves, J.A. ; Fatti, L.P. ; Chandler, H.D. ; and Grossman, E.S. (1989): Dental Caries Diagnosis Calibration for Clinical Field Studies, Caries Res 23:195-199.

Dreyer, A.G. and Grobler, S.R. (1984): Die Fluoriedgehalte in die Drinkwater van Suid-Afrika en Suidwes-Afrika, J Dent Assoc S Afr 39:793-797.

Garfinkel, P.E. and Garner, D.M. (1982): Anorexia Nervosa. A Multidimensional Perspective . New York: Brunner/Mazel, pp. 1-379.

Hellstrom, I. (1974): Anorexia Nervosa - Odontologiska Problem, Swed Dent J 67:253-269.

Hellstrom, I. (1977): Oral Complications in Anorexia Nervosa, Scand J Dent Res 85:71-86.

Holst, J.J. and Lange, F. (1939): Perimolysis: A Contribution Towards the Genesis of Tooth Wasting from Non-Mechanical Causes, Acta Odontol Scand 1:36-48.

Hurst, P.S. ; Lacey, J.H. ; and Crisp, A.H. (1977): Teeth, Vomiting and Diet. A Study of the Dental Characteristics of Seventeen Anorexia Nervosa Patients, Postgrad Med J 53:298-305.

10.

Jarvinen, V. ; Meurman, J.H. ; Hyvarinen, H. ; Rytomaa, J. ; and Murtomaa, H. (1988): Dental Erosion and Upper GIT Disorders, Oral Surg Oral Med Oral Pathol 63:298-303.

11.

Office Of Population Censuses And Surveys ( 1970): Classification of Obccupations, London : Her Majesty's Stationery Office, pp. 102-119.

12.

Roberts, M.W. and Li, S.H. (1987): Oral Findings in Anorexia Nervosa and Bulimia Nervosa: a Study of 47 Cases, J Am Dent Assoc 115:407-410.

13.

Schaaf, J.E. (1984): Anorexia Nervosa and Bulimia: Disorders with Oral Implications, lnd Univ Sch Dent Alumni Bull 93:14-16.

14.

Schlemmer, L. and Stopforth, P. (1979): A Guide to the Coding of Occupations in South Africa, Fact Paper No. 4, Centre for Applied Social Sciences, Durban: University of Natal, pp. 1-65.

15.

Shaw, L. and Murray, J.J. (1975): Inter-Examiner and Intra-Examiner Reproducibility in Clinical and Radiographic Diagnosis, Int Dent J 25:280-288.

16.

Simmons, M.S. and Thompson, D.C. (1987): Dental Erosion Secondary to Ethanol Induced Emesis , Oral Surg Oral Med Oral Pathol 64:731-733.

17.

Statistical Analysis System (1985): SAS User's Guide: Basics, Version 5ed., Cary, NC: SAS Institute, Inc., pp. 1-1290.

18.

Stege, P. ; Visco-Dangler, L. ; and Rye, L. (1982): Anorexia Nervosa: Review Including Oral and Dental Manifestations, J Am Dent Assoc 104:648-652.

19.

Toone, B.K. and Lader, M.H. (1979): Salivary Secretion in the Affective Disorders and Schizophrenia, Acta Psychiatr Scand 59:529-535.

20.

World Health Organisation (1977): Oral Health Surveys, 2nd ed., Geneva: World Health Organisation, pp. 1-68.