Malocclusion and its relationship with oral health-related quality of life in patients with eating disorders

Abstract

Objective: To evaluate the prevalence and severity of malocclusion and its impact on oral health-related quality of life (OHRQoL) and self-reported satisfaction of patients with anorexia and bulimia nervosa. Methods: The sample consisted of sixty women who attended a specialized mental health clinic of a Brazilian medical school. Participants were distributed into two groups: patients with anorexia and bulimia nervosa (ABN; n=30) and control patients without eating disorders (CN; n=30). The dental occlusion was evaluated by the Dental Aesthetic Index; the OHRQoL was assessed using the OHIP-14 questionnaire; and the self-reported satisfaction with the appearance of teeth, speech ability and chewing was obtained by interviews. Results: Severe and very severe malocclusion were observed in 26.67% and 46.67% of patients in the ABN group, respectively, while the CN group showed 80.00% of patients without abnormality/mild malocclusion. ABN group showed a higher proportion of patients (p < 0.05) with tooth loss, spacing in the region of incisors, maxillary misalignment, and mandibular misalignment in relation to CN group. ABN group presented lower (p< 0.05) OHRQoL and self-reported satisfaction with the appearance of teeth, speech ability and chewing, compared to the CN group. There was a significant positive correlation (p< 0.05) between the Dental Aesthetic Index and OHIP-14 scores in the ABN group. Conclusions: The prevalence of severe malocclusion in ABN group was high, with a negative impact on OHRQoL and self-reported satisfaction with the chewing ability, speech ability and appearance of teeth.

El Rol de los Trastornos de Conducta Alimentaria sobre la Periodontitis: Breve Revisión Sistemática de Estudios Observacionales

“…En la actualidad la bulimia y anorexia se consideran grandes problemáticas de salud mundial producto de sus grandes repercusiones sobre la tasa de mortalidad y morbilidad, siendo reportadas algunas manifestaciones orales desde etapas tempranas durante el transcurso de ambas patologías, donde muchas veces la identificación y/o diagnóstico son fundamentales para la generación de una pronta derivación y recuperación medica vinculada a las manifestaciones orales relacionadas con la erosión dental producto de la deshidratación generada por el vómito o el agrandamiento de las glándulas parótidas asociadas a la estimulación colinérgica, mientras que la anorexia comúnmente reporta una higiene bucal deficiente junto a patrones de conducta alimentaria inadecuados como el consumo excesivo de bebidas azucaradas y alimentos ricos en carbohidratos que predisponen cuadros orales dolorosos que pueden conllevar la perdida de piezas dentarias (Lo Russo et al, 2008;Krukowska-Zaorska et al, 2021;Lin et al, 2021;Chiba et al, 2022). No obstante, la mayor tendencia de caries en pacientes con TCA es un comportamiento aún contradictorio debido a que algunos pacientes pueden exhibir un alto nivel de higiene bucal como forma compensatoria al vomito compulsivo, mientras que otros reportan un comportamiento independiente al diagnóstico clínico y conducta vomitiva producto de la etiología multifactorial (Kisely et al, 2015;Krukowska-Zaorska et al, 2021).…”

Malocclusion impairs cognitive behavior via AgRP signaling in adolescent mice

“…A prior survey disclosed a negative correlation between malocclusion severity (assessed by the Index of Orthodontic Treatment Need-Dental Health Component) and mastication (assessed by food intake ability) ( Choi et al, 2016 ). The association between eating disorders and occlusal disharmony has been shown ( Chiba et al, 2022 ), and individuals with anorexia display perturbation of cognitive function ( Kaye, 2008 ) and elevated plasma AgRP levels ( Moriya et al, 2006 ). Patients with anorexia do not eat even when AgRP is activated ( Escelsior et al, 2022 ).…”

“…Recently, an association between eating disorders and occlusal disharmony was revealed ( Chiba et al, 2022 ). Anorexia nervosa is a serious eating disorder in adolescent women and causes cognitive decline, such as body image distortion ( Dalhoff et al, 2019 ).…”