Purpose: Eating disorders are a major public health problem. This study was
undertaken to investigate the role of dental surgery in the etiology and c
linical course of these serious and occasionally life-threatening disorders
.
Methods: Three questions concerning dental therapy were included in a pretr
eatment assessment of 97 consecutive patients entering an eating disorder t
herapy program during a 22-month period. These questions were designed to d
etermine the influence of dental surgery, including frequency and severity,
on eating disorders.
Results: All 97 patients, of which 96 were female, complied with the questi
onnaire. Seventy-five of 97 were 25 years or younger, and 53 of 97 were dia
gnosed as having anorexia nervosa. Sixteen patients (16.5%) reported having
had orthodontic therapy, and 21 (21.6%) had undergone third molar surgery.
Nine patients (9.3%) (1 orthodontic, 8 third molar surgery) indicated that
dental procedures had caused exacerbation or relapse of their eating disor
ders; 8 of 21 (38%) who had undergone third molar surgery were positive res
pondents. None of the patients linked dental care to the initial onset of t
heir eating disorders.
Conclusions: These data reveal that dental procedures, specifically third m
olar surgery, can significantly alter the course of eating disorders, causi
ng exacerbation or relapse. No patient indicated that dental therapy was th
e primary cause of these multifactorial psychonutritional disorders. A hist
ory of eating disorder should alert the practitioner to the risks of perfor
ming third molar surgery without a medical or psychotherapy consultation un
less there is documentation of remission. Delay of surgical intervention is
recommended if third molars are asymptomatic. If surgery is necessary, the
surgeon and other members of the psychotherapy team should establish clear
guidelines regarding behavior and postoperative nutrition and should monit
or the patient's nutritional status. (C) 2001 American Association of Oral
and Maxillofacial Surgeons.