Non-Cochrane · aetiology · PMC13703190
Oral Manifestations in Children and Adolescents with Eating Disorders or Eating-Disorder Risk: A Systematic Review and Stratified Meta-Analysis
2026 · PubMed
Findings
12 findings
| Population | ||||
|---|---|---|---|---|
| Children and adolescents aged 9-18 years with clinically diagnosed anorexia nervosa (DSM-IV/DSM-5) | Clinically diagnosed anorexia nervosa | Healthy controls without eating disorder | Erosive tooth wear (odds) Subgroup 1: clinically diagnosed anorexia nervosa | OR 7.72 [2.24, 26.64] Very low Downgraded: imprecision 1 study · 220 participants |
| Children and adolescents aged 9-18 years with clinically diagnosed anorexia nervosa (DSM-IV/DSM-5) | Clinically diagnosed anorexia nervosa | Healthy controls without eating disorder | Dental caries experience (DMFT index) Subgroup 1: clinically diagnosed anorexia nervosa | MD 1.9 [0.99, 2.81] Very low Downgraded: imprecision 1 study · 220 participants |
| Children and adolescents aged 9-18 years with clinically diagnosed anorexia nervosa (DSM-IV/DSM-5) | Clinically diagnosed anorexia nervosa | Healthy controls without eating disorder | Unstimulated whole salivary flow rate (mL/min) Diagnosed anorexia nervosa cohorts | MD -0.2 [-0.24, -0.15] Very low Downgraded: imprecision, indirectness 2 studies · 156 participants |
| Children and adolescents aged 9-18 years screening-positive for eating-disorder risk (EAT-26 or BITE) | Screening-identified eating-disorder risk | Healthy controls with low risk scores | Dental caries experience (DMFT index) Subgroup 2: screening-positive/at-risk cohorts | MD 0.88 [-0.95, 2.71] Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness 2 studies · 172 participants |
| Children and adolescents aged 9-18 years screening-positive for eating-disorder risk (EAT-26 or BITE) | Screening-identified eating-disorder risk | Healthy controls with low risk scores | Poor subjective oral health Subgroup 2: screening-positive/at-risk cohorts | OR 0.89 [0.71, 1.12] Very low Downgraded: risk of bias, imprecision, indirectness 1 study · 46146 participants |
| Children and adolescents aged 9-18 years screening-positive for eating-disorder risk (EAT-26 or BITE) | Screening-identified eating-disorder risk | Healthy controls with low risk scores | Erosive tooth wear (odds) Subgroup 2: screening-positive/at-risk cohorts | OR 3.5 [1.49, 8.23] Very low Downgraded: risk of bias, imprecision, indirectness 3 studies · 810 participants |
| Children and adolescents aged 9-18 years with eating disorders or eating-disorder risk (unstratified) | Eating disorder (clinically diagnosed) or screening-identified eating-disorder risk | Healthy controls | Erosive tooth wear (odds) Overall (unstratified) | OR 4.16 [1.97, 8.77] GRADE not reported 4 studies · 1030 participants |
| Children and adolescents aged 9-18 years with eating disorders or eating-disorder risk (unstratified) | Eating disorder (clinically diagnosed) or screening-identified eating-disorder risk | Healthy controls | Dental caries experience (DMFT index) Overall (unstratified) | MD 1.26 [0.07, 2.45] GRADE not reported 3 studies · 392 participants |
| Children and adolescents aged 9-18 years with eating disorders or eating-disorder risk (unstratified) | Eating disorder (clinically diagnosed) or screening-identified eating-disorder risk | Healthy controls | Erosive tooth wear (odds) Sensitivity: leave-one-out omitting Hermont 2013 | OR 3.26 [1.53, 6.94] GRADE not reported 3 studies · 930 participants |
| Children and adolescents aged 9-18 years with eating disorders or eating-disorder risk (unstratified) | Eating disorder (clinically diagnosed) or screening-identified eating-disorder risk | Healthy controls | Dental caries experience (DMFT index) Sensitivity: leave-one-out omitting Paszynska 2022 | MD 0.88 [-0.95, 2.71] GRADE not reported 2 studies · 172 participants |
| Children and adolescents aged 9-18 years with eating disorders or eating-disorder risk (unstratified) | Eating disorder (clinically diagnosed) or screening-identified eating-disorder risk | Healthy controls | Erosive tooth wear (odds) Sensitivity: leave-one-out omitting Ximenes 2010 | OR 6.45 [2.98, 13.96] GRADE not reported 3 studies · 380 participants |
| Children and adolescents under 18 years with clinically confirmed bulimia nervosa | Clinically confirmed bulimia nervosa | Healthy controls | Oral manifestations (all outcomes) | no estimate extracted No studies found 0 studies · 0 participants |
Included primary studies 23
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Paszynska 2015 Salivary enzyme activity in anorexic persons—a controlled clinical trial DOI:10.1007/s00784-015-1442-3 | 2015 | 1 other review | Unstimulated whole salivary flow rate (mL/min) | not extracted yet |
| Paszynska 2015 Salivary enzyme activity in anorexic persons—a controlled clinical trial. PMID:25753979 | 2015 | 1 other review | Unstimulated whole salivary flow rate (mL/min) | not extracted yet |
| Paszynska 2017 Enzyme activities in parotid saliva of patients with the restrictive type of anorexia nervosa DOI:10.1016/j.archoralbio.2016.12.012 | 2017 | 1 other review | not stated | not extracted yet |
| Paszynska 2017 Enzyme activities in parotid saliva of patients with the restrictive type of anorexia nervosa. PMID:28068524 | 2017 | 1 other review | not stated | not extracted yet |
| Paszynska 2018 Study of salivary and serum vaspin and total antioxidants in anorexia nervosa DOI:10.1007/s00784-018-2370-9 | 2018 | 1 other review | Unstimulated whole salivary flow rate (mL/min) | not extracted yet |
| Paszynska 2022 Risk of Dental Caries and Erosive Tooth Wear in 117 Children and Adolescents' Anorexia Nervosa Population-A Case-Control Study. PMID:35619622 | 2022 | 1 other review | Erosive tooth wear (odds); Dental caries experience (DMFT index) | not extracted yet |
| Brandt 2017 Relationship between Risk Behavior for Eating Disorders and Dental Caries and Dental Erosion DOI:10.1155/2017/1656417 | 2017 | this review only | Erosive tooth wear (odds); Dental caries experience (DMFT index) | not extracted yet |
| Brandt 2017 Relationship between Risk Behavior for Eating Disorders and Dental Caries and Dental Erosion. PMID:29423431 | 2017 | this review only | Erosive tooth wear (odds); Dental caries experience (DMFT index) | not extracted yet |
| Gokkaya 2022 Assessment of the eating disorders and relationship with dental caries, age, gender, and body mass index in a sample of Turkish… PMID:35593615 | 2022 | this review only | Dental caries experience (DMFT index) | not extracted yet |
| Gokkaya and Kargul 2022 Assessment of the Eating Disorders and Relationship with Dental Caries, Age, Gender, and Body Mass Index in a Sample of Turkish… DOI:10.4103/njcp.njcp_1998_21 | 2022 | this review only | Dental caries experience (DMFT index) | not extracted yet |
| Hermont 2013 Eating disorder risk behavior and dental implications among adolescents DOI:10.1002/eat.22132 | 2013 | this review only | Erosive tooth wear (odds) | not extracted yet |
| Hermont 2013 Eating disorder risk behavior and dental implications among adolescents. PMID:23625589 | 2013 | this review only | Erosive tooth wear (odds) | not extracted yet |
| Hermont 2021 Acidic food choice among adolescents with bulimic symptomatology: a major risk factor for erosive tooth wear? DOI:10.1007/s40519-020-01008-0 | 2020 | this review only | not stated | not extracted yet |
| Hermont 2021 Acidic food choice among adolescents with bulimic symptomatology: a major risk factor for erosive tooth wear? PMID:32929621 | 2021 | this review only | not stated | not extracted yet |
| Jung 2022 Relationship between Risk Factors Related to Eating Disorders and Subjective Health and Oral Health. PMID:35740722 | 2022 | this review only | not stated | not extracted yet |
| Jung and Jun 2022 Relationship between Risk Factors Related to Eating Disorders and Subjective Health and Oral Health DOI:10.3390/children9060786 | 2022 | this review only | Poor subjective oral health | not extracted yet |
| Lesar 2022 Oral Changes in Pediatric Patients with Eating Disorders DOI:10.20471/acc.2022.61.02.03 | 2022 | this review only | not stated | not extracted yet |
| Lesar 2022 ORAL CHANGES IN PEDIATRIC PATIENTS WITH EATING DISORDERS. PMID:36818917 | 2022 | this review only | not stated | not extracted yet |
| Montecchi 2003 Oral manifestations in a group of young patients with anorexia nervosa DOI:10.1007/bf03325007 | 2003 | this review only | not stated | not extracted yet |
| Montecchi 2003 Oral manifestations in a group of young patients with anorexia nervosa. PMID:12880195 | 2003 | this review only | not stated | not extracted yet |
| Paszynska 2018 Study of salivary and serum vaspin and total antioxidants in anorexia nervosa. PMID:29445881 | 2018 | this review only | Unstimulated whole salivary flow rate (mL/min) | not extracted yet |
| Ximenes 2010 Eating disorders in adolescents and their repercussions in oral health DOI:10.1002/eat.20660 | 2009 | this review only | Erosive tooth wear (odds) | not extracted yet |
| Ximenes 2010 Eating disorders in adolescents and their repercussions in oral health. PMID:19260040 | 2010 | this review only | Erosive tooth wear (odds) | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children and adolescents aged 9 to 18 years | Adolescents aged 9 to 18 years (n=12 studies); diagnosed anorexia nervosa (restricting subtype in most), screening-positive school cohorts, one nationwide survey (n=46,146) |
| Intervention | Exposure: clinically diagnosed eating disorder (DSM-IV, DSM-5, ICD-10) or screening-positive/at-risk cohorts (EAT-26 >= 20, BITE, survey criteria) | Diagnosed anorexia nervosa (4 comparative studies pooled or reported); screening-positive/at-risk (BITE, EAT-26); unhealthy weight control behaviors (survey) |
| Comparison | Healthy young controls without eating disorder diagnosis or elevated screening risk | Healthy controls (9 comparative studies); no controls in 3 case series |
| Outcomes | Primary: erosive tooth wear, salivary flow rate (unstimulated and stimulated). Secondary: caries (DMFT/dmft), soft-tissue alterations, subjective oral health | Erosive tooth wear (4 studies, N=1030); DMFT (3 studies, N=392); unstimulated whole salivary flow (2 studies, N=156); subjective oral health (1 survey, qualitative) |
| Study designs | Controlled cross-sectional, case-control, cohort and single-arm descriptive case series | Case-control, cross-sectional, case series; 9 comparative and 3 single-arm (n=12) |
| Timing | Not specified | Not specified |