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Eating Disorders in Dentistry

Natalie Bradley

StR Special Care Dentistry

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AIM

  • Define eating disorders with examples and their dental management

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Definition

  • Are Eating Disorders mental health problems?

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A group of related, but distinct disturbances in eating behaviour. Development is multi-factorial but triggers may include low self-esteem, trauma, abuse, obsession with food and dieting. Defined under DSM-5 conditions

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www.atoothgerm.co.uk

@natb990

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Definition

  • Are Eating Disorders mental health problems?

​

A group of related, but distinct disturbances in eating behaviour. Development is multi-factorial but triggers may include low self-esteem, trauma, abuse, obsession with food and dieting. Defined as a DSM-5 condition

​

www.atoothgerm.co.uk

@natb990

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Why?

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Bulimia Nervosa

1-3% incidence

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Anorexia Nervosa

  • Body weight intentionally maintained ≤ 85% of expected weight
  • Type 1 – restrictive
  • Type 2 – binge/purge
  • ?genetics

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1 in 300 incidence

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Binge Eating Disorder

  • Recurrent binge eating episodes (without purging)
  • Many patients overweight or dangerously obese

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2.5% incidence?

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Prader-Wili Syndrome

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1 in 15k incidence

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Prader-Wili Syndrome

  • Learning difficulties
  • Behavioural problems
  • Oesophageal reflux
  • High sugar frequency!
  • Salivary gland dysfunction
  • Caries
  • ?consent

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1 in 15k incidence

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Pica

  • Type 1 Eating non-nutritive substances
  • Type 2 Abnormal appetite for something which may be considered food
  • Toothwear
  • Russell’s sign

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20% incidence when…?

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Diabulimia

  • Purposely omitting insulin in diabetics
  • Type 1 or 2?

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4 in 15 women

1 in 10 men

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What would you do?

  • Dental management
  • Safeguarding
  • Signposting

www.atoothgerm.co.uk

@natb990

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Conclusions and Further Info

  • Dentists can be the first clinicians to spot an Eating Disorder
  • Eating disorders are mental health conditions which are defined in the DSM
  • People who suffer from eating disorders can be underweight, overweight or even at a normal weight
  • Dentists must be aware of dental implications of eating disorders and how to manage them

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Special Care in Dentistry Handbook of Oral Healthcare p152

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www.atoothgerm.co.uk

@natb990