Ovidio Bermudez, MD, FAAP, FSAHM, FAED, F.iaedp, CEDS LinkChief Clinical Education OfficerOvidio Bermudez, M.D. is the Senior Medical Director of Child & Adolescent Services, Chief Clinical Education Officer and ...READ MORE
Review by Ovidio Bermudez
Souza, S. P., Antequerdds, R., Aratangy, E. W., Siqueira, S. R. D. T., Cordas, T. A., & Siqueira, J. T. T. (2018). Pain and temporomandibular disorders in patients with eating disorders. Brazilian Oral Research, 32, e51.
Eating disorders cause a plethora of medical complications that involve multiple organ systems. Due to the frequent egosyntonic nature of eating disorders, patients may not seek help directly for the eating pathology but for medical issues that concern them. This includes dental and oral complaints. Therefore, oral health related symptoms may be a reason for which patients seek help and thus an opportunity for early recognition and timely intervention. Pain in general may be one of those reasons for patient’s seeking medical assistance and oral pain is no exception. Oral pain can negatively influence patient’s willingness or ability to eat and their mood. Research in this area has been modest but growing and overall is an important contribution to the eating disorder literature.
This cross-sectional study of adults diagnosed with eating disorders and being followed by an outpatient eating disorders clinic in a large metropolitan area reached two important conclusions. One, patients in all subgroups of ED diagnosis (AN-R, AN-BP, and BN) reported more orofacial pain and TMJ dysfunction than the control although there were no differences across the sub-groups. Second, patients with masticatory orofacial pain were more likely to report pain elsewhere in the body and in other studies this has correlated with higher rates of depression. Patients in this study experienced more depression than controls. This is important because the interference with food intake due to the experience of pain or the negative effect on mood is likely to exacerbate the nutritional state of these individuals. Efforts to include dental health assessments and follow up of identified oral health issues may be important contributions to the treatment of eating disorders. It is also important to educate dental health professionals on eating disorders and the oral complications including oral and facial pain.