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Type: Journal article
Title: Association between poor oral health and eating disorders: systematic review and meta-analysis
Author: Kisely, S.
Baghaie, H.
Lalloo, R.
Johnson, N.
Citation: British Journal of Psychiatry, 2015; 207(4):299-305
Publisher: The Royal College of Psychiatrists
Issue Date: 2015
ISSN: 0007-1250
Statement of
Steve Kisely, Hooman Baghaie, Ratilal Lalloo, Newell W. Johnson
Abstract: Background: There is a well-established link between oral pathology and eating disorders in the presence of self-induced vomiting. There is less information concerning this relationship in the absence of self-induced vomiting, in spite of risk factors such as psychotropic-induced dry mouth, nutritional deficiency or acidic diet. Aims: To determine the association between eating disorder and poor oral health, including any difference between patients with and without self-induced vomiting. Method: A systematic search was made of Medline, PsycINFO, EMBASE and article bibliographies. Outcomes were dental erosion, salivary gland function and the mean number of decayed, missing and filled teeth or surfaces (DMFT/S). Results: Ten studies had sufficient data for a random effects meta-analysis (psychiatric patients n = 556, controls n = 556). Patients with an eating disorder had five times the odds of dental erosion compared with controls (95% CI 3.31-7.58); odds were highest in those with self-induced vomiting (odds ratio (OR) = 7.32). Patients also had significantly higher DMFS scores (mean difference 3.07, 95% CI 0.66-5.48) and reduced salivary flow (OR = 2.24, 95% CI 1.44-3.51). Conclusions: These findings highlight the importance of collaboration between dental and medical practitioners. Dentists may be the first clinicians to suspect an eating disorder given patients' reluctance to present for psychiatric treatment, whereas mental health clinicians should be aware of the oral consequences of inappropriate diet, psychotropic medication and self-induced vomiting.
Keywords: Salivary Glands
Tooth Diseases
Tooth Erosion
Risk Factors
Publication Bias
Oral Health
Feeding and Eating Disorders
Rights: © The Royal College of Psychiatrists 2015
DOI: 10.1192/bjp.bp.114.156323
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Appears in Collections:Aurora harvest 3
Dentistry publications

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