Steve Kisely, MD, PhD, School of Medicine, University of Queensland, Woolloongabba; Hooman Baghaie, BOH, School of Dentistry, University of Queensland, Herston, Queensland; Ratilal Lalloo, MChD, PhD, Australian Centre for Population Oral Health, School of Dentistry, University of Adelaide, South Australia; Newell W. Johnson, MDSc, PhD, Population and Social Health Research Programme, Griffith Health Institute, Gold Coast, Queensland, Australia
Steve Kisely, MD, PhD, School of Medicine, University of Queensland, Woolloongabba; Hooman Baghaie, BOH, School of Dentistry, University of Queensland, Herston, Queensland; Ratilal Lalloo, MChD, PhD, Australian Centre for Population Oral Health, School of Dentistry, University of Adelaide, South Australia; Newell W. Johnson, MDSc, PhD, Population and Social Health Research Programme, Griffith Health Institute, Gold Coast, Queensland, Australia.
Br J Psychiatry. 2015 Oct;207(4):299-305. doi: 10.1192/bjp.bp.114.156323.
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.
To determine the association between eating disorder and poor oral health, including any difference between patients with and without self-induced vomiting.
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).
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).
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.
在存在自我诱导性呕吐的情况下，口腔病理学和饮食失调之间存在着明确的联系。尽管存在精神药物引起的口干、营养缺乏或酸性饮食等风险因素，但在没有自我诱导性呕吐的情况下，这种关系的相关信息较少。
确定饮食失调与口腔健康不良之间的关联，包括有无自我诱导性呕吐的患者之间的差异。
对 Medline、PsycINFO、EMBASE 和文章参考文献进行了系统搜索。结果是牙齿侵蚀、唾液腺功能以及龋齿、缺失和填充的牙齿或表面数（DMFT/S）。
有 10 项研究有足够的数据进行随机效应荟萃分析（精神科患者 n = 556，对照组 n = 556）。与对照组相比，饮食失调患者发生牙齿侵蚀的几率高出五倍（95%CI 3.31-7.58）；有自我诱导性呕吐的患者几率最高（比值比（OR）= 7.32）。患者的 DMFS 评分也显著更高（平均差异 3.07，95%CI 0.66-5.48），唾液流量减少（OR = 2.24，95%CI 1.44-3.51）。
这些发现强调了牙科和医疗从业者之间合作的重要性。鉴于患者不愿接受精神治疗，牙医可能是第一个怀疑饮食失调的临床医生，而精神健康临床医生应该意识到不适当饮食、精神药物和自我诱导性呕吐的口腔后果。
