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Bulimia-TheImplica/onsofRelevancefortheDen/st.

Whatisbulimia?-Bulimiaisaphysiologicaldisorderstemmingfromdistortedperceptionsofshapeandweight.Itisassociatedwithapersistentpreoccupationofeating(bingeeating)andcompensatorybehaviororreducingcaloricintake(purging)(Frydrych,Daviesetal.2005).

Etiology-Therearemanyproposedpredisposingandetiologicalfactorsbothpsychologicalandbiological.Theattributesthattendtopredisposeanindividualtodevelopandretainaneatingdisorderare:thestriveforperfection,admirationofbeingthin,distortedviewsofweightgain,cultural/socialpressures,familypressuresandindividualfactors(Burke,Belletal.1996)

Whoisatrisk?- Teenagegirlstomid30s(Pyle,Mitchelletal.1983)- EliteAthetes(Frydrych,Daviesetal.2005)- Performingartsstudents(Frydrych,Daviesetal.2005)- 35%ofAmericancollegestudents(Pyle,Mitchelletal.1983)

DentalImplicationsClassically,themostcommonanddramaticcommonlyobservedmanifestationisaciderosionduetovomiting.Dentistsarerecongizedasoneoftheirsthealthpractictionerstodignoseeatingdisorders(Frydrych,Daviesetal.2005),andthereforeshouldbeawareofalltheoralsignstobegintreatmentsinceerosiontakes2yearstobecomeapparent(Brownridge1994).

Dental Management- Emergency care to treat pain (desnesitization, temporary / definitiverestorations), patient education, antacid mouth rinse, fluoride mouth rinse, and a magnesiumhydroxide lined bite splint (Burke, Bell et al. 1996).

Bulimia

EnamelErosionPalatal /occlusal

vomiting

sensitivity

bingeeating - Acid /

sugar food

Enamelerosionbuccal /occlusal

increasedcaries

Reducedsaliva rate /

bicarbonate

DMFT

anti-depressants

lackof nutrition

reduced peakbone mass

periodontaldisease.(manifests inlater life)

impaired tissuerepair

ulcers,glossitis and

tissue lesions

loss of gag reflex

candida infection

angular chelitis

osteopenia/osteoporosis

Sialadenosis

initiationof gagging

UNDERDEBATE

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Bibliography

Brownridge, E. (1994). "Eating disorders and oral health. How the dentist can help." OntDent 71(6): 15-18.!

Burke, F. J., T. J. Bell, et al. (1996). "Bulimia: implications for the practising dentist." BrDent J 180(11): 421-426.!

Frydrych, A. M., G. R. Davies, et al. (2005). "Eating disorders and oral health: a review ofthe literature." Aust Dent J 50(1): 6-15; quiz 56.!

Pyle, R. L., J. E. Mitchell, et al. (1983). "The incidence of bulimia in freshman collegestudents." International Journal of Eating Disorders 2(3): 75-85.!