Paszynska Elzbieta, Hernik Amadeusz, Slopien Agnieszka, Roszak Magdalena, Jowik Katarzyna, Dmitrzak-Weglarz Monika, Tyszkiewicz-Nwafor Marta
Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznań, Poland.
Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznań, Poland.
Front Psychiatry. 2022 May 10;13:874263. doi: 10.3389/fpsyt.2022.874263. eCollection 2022.
Restrictive type of (AN) is still one of the most severe eating disorders worldwide with an uncertain prognosis. Patients affected by AN should be encouraged to undertake psychiatric care and psychotherapy, but whether they should necessarily be included in careful dental care or not may still be questionable. Even though there is a constantly increasing number of AN studies, there are just a few data about the youngest group of AN children and adolescents aged < 18.
This case-control study aimed to compare the dental health and gingival inflammation level in female adolescent inpatients affected by severe AN restrictive subtype vs. controls. Based on clinically confirmed 117 AN cases (hospitalized in years 2016-2020 in public Psychiatric Unit, BMI < 15 kg/m, mean age 14.9 ± 1.8), the dental status has been examined regarding the occurrence of caries lesions using (DMFT), erosive wear as (BEWE), gingival condition as (BOP) and plaque deposition as (PCR). The results were compared with age-matched 103 female dental patients (BMI 19.8 ± 2.3 kg/m, age 15.0 ± 1.8, = 0.746) treated in a public University dental clinic.
AN patients were found to present a higher incidence of oral-related complications according to dental status (DMFT 3.8 ± 4.5 vs. 1.9 ± 2.1, = 0.005), erosive tooth wear (BEWE 18.9 vs. 2.9%, < 0.001), less efficient in controlling plaque (PCR 43.8 vs. 13.7%, < 0.001) and gingival inflammation (BOP 20.0 vs. 3.9%, < 0.001) compared with female adolescents. In the AN group, a significant correlation between BOP, BEWE, and duration of AN disease ( < 0.05), similarly to the number of decayed teeth D, filled teeth F and PCR were detected ( < 0.05).
Although the obtained results did not reveal any severe oral status, our findings indicated impaired dental and gingival conditions in young anorexics. Considering AN's potential role in oral health, it is essential to monitor dental treatment needs and oral hygiene levels in their present status to prevent forward complications in the future.
神经性厌食症（AN）的限制型仍然是全球最严重的饮食失调症之一，预后不明。应鼓励患有神经性厌食症的患者接受精神科护理和心理治疗，但他们是否必须接受细致的牙科护理仍值得怀疑。尽管关于神经性厌食症的研究数量不断增加，但关于年龄最小的18岁以下神经性厌食症儿童和青少年群体的数据却很少。
本病例对照研究旨在比较患有严重AN限制亚型的女性青少年住院患者与对照组的牙齿健康和牙龈炎症水平。基于临床确诊的117例AN病例（2016 - 2020年在公共精神科住院，BMI < 15 kg/m²，平均年龄14.9 ± 1.8岁），使用龋失补牙数（DMFT）检查龋齿病变的发生情况，使用牙齿侵蚀性磨损指数（BEWE）检查侵蚀性磨损情况，使用牙龈出血指数（BOP）检查牙龈状况，使用菌斑沉积率（PCR）检查菌斑沉积情况。将结果与在公立大学牙科诊所接受治疗且年龄匹配的103名女性牙科患者（BMI 19.8 ± 2.3 kg/m²，年龄15.0 ± 1.8岁，P = 0.746）进行比较。
根据牙齿状况，发现AN患者口腔相关并发症的发生率更高（DMFT 3.8 ± 4.5 vs. 1.9 ± 2.1，P = 0.005），牙齿侵蚀性磨损（BEWE 18.9% vs. 2.9%，P < 0.001），控制菌斑的效率较低（PCR 43.8% vs. 13.7%，P < 0.001），牙龈炎症（BOP : 20.0% vs. 3.9%，P < 0.001）。在AN组中，检测到BOP、BEWE与AN病程之间存在显著相关性（P < 0.05），类似地，龋齿数D、补牙数F和PCR之间也存在显著相关性（P < 0.05）。
虽然获得的结果未显示任何严重的口腔状况，但我们的研究结果表明年轻厌食症患者的牙齿和牙龈状况受损。考虑到神经性厌食症在口腔健康中的潜在作用，监测他们目前的牙科治疗需求和口腔卫生水平对于预防未来的进一步并发症至关重要。
