Oral complications in anorexia nervosa.

Anorexia nervosa (AN), a psychosomatic disease mainly affecting young women, is characterized by conscious starvation, periods of excessive carbohydrate intake and often deliberate vomiting. Medical history, dental examination, and saliva tests of 39 patients aged 14 to 42 years, having suffered from AN for periods of 1 to 20 years, showed dental caries, due to excessive carbohydrate consumption, in all subjects, often in a rampant form. In patients with a history of intense vomiting (27 cases) severe lingual-occlusal erosion (perimylolysis) was nearly always present. Buccal erosion, mainly due to high consumption of acid fruits and drinks to relieve thirst caused by dehydration, was more frequent in vomiting than in non-vomiting patients. Subnormal values of saliva properties, owing to dehydration or xerostomia-inducing medication, were present in the majority of cases; the lowest values occurred in those vomiting. The association AN - vomiting - perimylolysis is discussed, as well as prophylactic and therapeutic measures. A medical, psychiatric, and dental survey of AN is presented.