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Eating Disorders and Orthodontics Amardeep Singh Dhadwal Ben Marnell Dental Update 2024 15:3, 707-709.
Authors
Amardeep SinghDhadwal
Final Year BDS Undergraduate Student, The Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University, London, E1 2AT, UK
In modern-day practice, there is an expanding population of patients with suspected or confirmed eating disorders. Increased awareness of the presenting features and manifestations of eating disorders is required for recognition of this situation and appropriate management. This article provides an overview of features of common eating disorders that may present in practice. It will draw attention to potential difficulties when orthodontic treatment is required and will make recommendations on how to judiciously manage potential problems.
CPD/Clinical Relevance: This article outlines issues of importance for the orthodontic team when encountering patients with known or suspected eating disorders and provides guidance in the appropriate management.
Article
Eating disorders involve abnormal eating behaviours that are not part of another health condition, and not developmentally appropriate or culturally sanctioned.1 It is estimated that there are 1.25 million people in the UK with an eating disorder.2 The aetiology is thought to be multifactorial and attributed to a combination of genetic, psychosocial, biological and developmental determinants.3 Multiple similarities in the manifestations and risk factors among eating disorders, however, evoke difficulties in separating them based on their individual underlying features.4 Eating disorders adversely affect quality of life, and with a high morbidity, they have the highest mortality of all mental health disorders.5 Affected patients are at a greater risk of premature death and suicide.6
The detection of eating disorders increases with the onset of adolescence: a period in which many patients will embark upon orthodontic treatment. Orthodontists are in a unique position among medical professionals, because treatment occurs over a prolonged period and with regular appointments. Orthodontists usually see these patients every 6–8 weeks, and may be the only healthcare professional to encounter these often seemingly fit patients.7 It is important for orthodontists to be able to recognize eating disorders in their patients and refer them appropriately. It should not be assumed that patients only experience an eating disorder during adolescence. Their manifestations and signs of body image concerns, appearance ideals and dietary restraint could be encountered at any age and can continue throughout life. This was emphasized by a study of 5-year-old girls in which over one-third of them demonstrated weight-focused dietary restraint tendencies in relation to body image.8
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