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Title Oral Manifestations in Patients With Anexoria and Bulimia
Clinical Question How do the oral manifestations of anorexia and bulimia differ?
Clinical Bottom Line Anorexia and bulimia have unique and defining oral health manifestations. These characteristics may allow the dental practitioner to distinguish between the two diseases to determine the management and prognosis of the patients’ dental treatment.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 18826377Lo/2008Patients with eating disorders (anorexia, bulimia, etc.)Critical Review
Key resultsMucosal atrophy is seen in both anorexia and bulimia due to patients lacking in vitamins and nutrients, and can lead to atrophic glossitis as well as diffuse oral burning sensations. Erythematous (mucosal lesions on the soft palate) is a characteristic seen in purging behavior found specifically in bulimic patients. Bulimic patients tend to exhibit poor oral hygiene leading to gingival inflammation and subsequently periodontitis. Anorexic patients are more critical of their appearance which can usually prevent periodontitis. Necrotizing sialometaplasia and dental erosions are also seen in association with bulimic instead of anorexic patients.
Evidence Search "anorexia"[All Fields] AND "bulimia"[All Fields] AND "oral manifestations"[All Fields]
Comments on
The Evidence
This article is a critical review that lacked specificity in the number of trials and number of patients, but gathered results found from multiple studies and resources that the authors have compiled together.
Applicability This article is applicable to dental practitioners who are diagnosing and treating patients undergoing eating disorders such as anorexia and bulimia. By treating these patients for their specific disorders, this can help in regards to the overall patient management and prognosis.
Specialty/Discipline (Public Health) (General Dentistry) (Periodontics) (Behavioral Science)
Keywords Eating disorders; anorexia; bulimia; oral manifestations
ID# 2190
Date of submission: 04/03/2012spacer
E-mail chauj@livemail.uthscsa.edu
Author Jennifer Chau
Co-author(s) e-mail
Faculty mentor/Co-author Georgiana S. Gross, MPH
Faculty mentor/Co-author e-mail grossg@uthscsa.edu
Basic Science Rationale
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None available
Comments and Evidence-Based Updates on the CAT
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by Mitchell Murphy, Joshua Champion (San Antonio, TX) on 12/01/2017
PubMed database was searched for related terms on 27 November ,2017 and which provided more recent results both of which support the conclusions of this CAT and expand outcome measures on extra-oral manifestations. The Systematic Review conducted by Ramanos et al. 2012 (PMID: 22750232) supports results presented originally in this CAT. Primary Research conducted by Bern et al. 2016 ( PMID: 27579693) focuses on gastrointestinal manifestations and confirms erosion and necrotizing sialometaplasia as common oral manifestations associated with bulimia nervosa.

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