DENTAL EROSION, ORAL HYGIENE, AND NUTRITION IN EATING DISORDERS

Objective: To determine the influence of oral hygiene practices and ad ditional fluoride on erosive tooth wear in eating disorders. The propo rtional dietary intake of carbohydrates, fats, and proteins was also i nvestigated. Method: Tooth wear was measured with the use of the tooth wear index (TWI). All subjects completed a questionnaire on past dent al history as well as a 1-week diet sheet A total of 33 subjects parti cipated in the study, 20 of whom were follow-ups, allowing the progres s of dental erosion to be made. All subjects were referred from the De partment of Clinical Psychology. Results: Oral hygiene practices betwe en subjects with and without severe erosion were not significantly dif ferent. Only 8 bulimics spent more time brushing after vomiting than a t other times. The pH of vomitus from 6 subjects ranged between 2.9 an d 5.0, with a mean of 3.8, well below the critical pH for enamel demin eralization to occur. Of the 20 follow-up subjects, 12 (60%) exhibited worsening tooth wear The mean values for daily carbohydrate, protein, and fat intake were not significantly different at baseline and at re call, and the proportional dietary intake was similar to recommended e nergy provision at 47%, 40%, and 13%, respectively, Discussion: The co ntribution by toothbrush abrasion to the overall wear in the eroded de ntition of bulimics is not significant. Therefore, immediate post-vomi ting oral hygiene practices can be recommended. The proportional nutri tional intake values of carbohydrates, fats, and proteins in this grou p of bulimics are acceptable. (C) 1997 by John Wiley & Sons, Inc.