The aim was to record changes over time in the oral status of subjects with
diagnosed eating disorders. The outpatient psychiatrist had referred to th
e hospital dental clinic 35 women (19-47 yr, median 27 yr) with eating diso
rders, diagnosed according to DSM III-R criteria. At the baseline examinati
on, dental, medical and dietary histories were taken, and intra-oral clinic
al and radiographic examinations were supplemented by intra-oral photograph
s, study casts and salivary analysis. The subjects were re-examined 1 yr la
ter. Together, the investigators assessed progression of tooth wear blindly
by comparing coded study casts from the baseline and 12-month examinations
. Progression of erosive tooth wear was recorded in almost half of the subj
ects. Several subjects had low unstimulated salivary flow rates (<0.1 ml/mi
n) and very high counts of mutans streptococci and lactobacilli, both at ba
seline and 1 yr later. The flow rates for paraffin-stimulated saliva at bas
eline were significantly lower for subjects with progression of erosive too
th wear than for those without. Because of the increased susceptibility to
both caries and erosion, patients with eating disorders should be encourage
d to have regular dental check-ups. Test of salivary flow may serve as an i
ndicator of patients' risk of progression of erosive tooth wear.