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Tooth Erosion and Eating Disorders: A Systematic Review and Meta-Analysis

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  • Ana Paula Hermont
  • Patrícia A D Oliveira
  • Carolina C Martins
  • Saul M Paiva
  • Isabela A Pordeus
  • Sheyla M Auad

Abstract

Background: Eating disorders are associated with the highest rates of morbidity and mortality of any mental disorders among adolescents. The failure to recognize their early signs can compromise a patient's recovery and long-term prognosis. Tooth erosion has been reported as an oral manifestation that might help in the early detection of eating disorders. Objectives: The aim of this systematic review and meta-analysis was to search for scientific evidence regarding the following clinical question: Do eating disorders increase the risk of tooth erosion? Methods: An electronic search addressing eating disorders and tooth erosion was conducted in eight databases. Two independent reviewers selected studies, abstracted information and assessed its quality. Data were abstracted for meta-analysis comparing tooth erosion in control patients (without eating disorders) vs. patients with eating disorders; and patients with eating disorder risk behavior vs. patients without such risk behavior. Combined odds ratios (ORs) and a 95% confidence interval (CI) were obtained. Results: Twenty-three papers were included in the qualitative synthesis and assessed by a modified version of the Newcastle-Ottawa Scale. Fourteen papers were included in the meta-analysis. Patients with eating disorders had more risk of tooth erosion (OR = 12.4, 95%CI = 4.1–37.5). Patients with eating disorders who self-induced vomiting had more risk of tooth erosion than those patients who did not self-induce vomiting (OR = 19.6, 95%CI = 5.6–68.8). Patients with risk behavior of eating disorder had more risk of tooth erosion than patients without such risk behavior (Summary OR = 11.6, 95%CI = 3.2–41.7). Conclusion: The scientific evidence suggests a causal relationship between tooth erosion and eating disorders and purging practices. Nevertheless, there is a lack of scientific evidence to fulfill the basic criteria of causation between the risk behavior for eating disorders and tooth erosion.

Suggested Citation

  • Ana Paula Hermont & Patrícia A D Oliveira & Carolina C Martins & Saul M Paiva & Isabela A Pordeus & Sheyla M Auad, 2014. "Tooth Erosion and Eating Disorders: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-10, November.
    • Handle: RePEc:plo:pone00:0111123
    DOI: 10.1371/journal.pone.0111123
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    Cited by:

    1. Maryam Elyasi & Lucas Guimarães Abreu & Parvaneh Badri & Humam Saltaji & Carlos Flores-Mir & Maryam Amin, 2015. "Impact of Sense of Coherence on Oral Health Behaviors: A Systematic Review," PLOS ONE, Public Library of Science, vol. 10(8), pages 1-16, August.
    2. Vélez-Coto, María & Rute-Pérez, Sandra & Pérez-García, Miguel & Caracuel, Alfonso, 2021. "Unemployment and general cognitive ability: A review and meta-analysis," Journal of Economic Psychology, Elsevier, vol. 87(C).

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