The aim was to explore possible correlations between the oral status of pat
ients undergoing treatment at a special outpatient psychiatric clinic for e
ating disorders and such variables as psychiatric diagnosis and duration of
illness, oral hygiene habits, salivary function, and dietary habits. Healt
hy volunteers of a similar age were recruited for comparison. The material
comprised 100 consecutive referrals, of whom 79 were women and 2 were men (
age range 17 to 47, median 25 yr) participated. The eating disorders were d
iagnosed according to the American Psychiatric Association's DSM III-R crit
eria. The clinical and radiographic examinations were supplemented by stand
ardized intraoral photographs, study models and salivary analysis. The deca
yed, missing, filled surfaces (DMFS) index was 15.3+/-10.9, a significantly
higher caries frequency than for the reference group. More than half the s
ubjects had erosive tooth wear involving the dentine, and about one-third h
ad very low unstimulated salivary flow rates and very high counts of mutans
streptococci and lactobacilli. Erosive tooth wear was significantly correl
ated to the number of years of binge-eating. Compared to age-matched indivi
duals, subjects with diagnosed eating disorders are more susceptible to bot
h dental caries and erosion. They should be encouraged to adopt appropriate
ly tailored preventive programmes and to have regular dental check-ups.