Oral Health and Bone Density in Adolescents and Young Women with Anorexia Nervosa

Purpose: To evaluate the dental and periodontal health of adolescents and young women with restrictive anorexia nervosa (AN), and relationship between bone mineral density (BMD) assessed by dual energy Xray absorptiometri, (DXA) and dental radiographs. Study Design: Twenty-three voting women, median age 17.6 years (range 14.4-27.2), were studied within three months of entering a clinical trial. DXA BMD measurements were obtained and subjects underwent a comprehensive dental examination, including panoramic and bitewing dental radiographs. Three observers assessed mandibular cortical width (MCW) in the mental foramen region on panoramic radiographs. Results: Dental findings included very good to excellent oral hygiene. Gingival recession was evident in 10 participants (43%). Dental erosion was not seen and the mean decayed missing or filled teeth (DMFT) was 8.6. There was a weak positive correlation between BMD by DXA and MCW on radiographs. Conclusions: We report dental manifestations associated with restrictive AN, and the association between bone assessments by DXA and dental radiographs in this patient group. Despite subnormal DXA measurements in most patients, essentially all adolescents had a normal dental examination. Dental providers should be cognizant of the fact that man), patients with eating disorders may not display the "classic" findings reported in the literature.