Possible anorexia link with braces ‘needs to be researched’

Research looks at all patients admitted to Temple Street with anorexia from 2005 to 2011

The authors of a study published in the latest edition of the Irish Medical Journal  say when braces are fitted and frequently adjusted, the teeth loosen and move, causing pain. “Oral pain must be considered in cases of unintentional weight loss which could later precipitate disordered eating,” they say. Photograph: Peter Dazeley/Getty images

The authors of a study published in the latest edition of the Irish Medical Journal say when braces are fitted and frequently adjusted, the teeth loosen and move, causing pain. “Oral pain must be considered in cases of unintentional weight loss which could later precipitate disordered eating,” they say. Photograph: Peter Dazeley/Getty images

Wed, Feb 12, 2014, 06:52

A study of anorexia nervosa among children admitted to Temple Street Children’s Hospital in Dublin has found a number of them had commenced orthodontic treatment before developing the condition.

The authors of the study, published in the latest edition of the Irish Medical Journal (IMJ), say when braces are fitted and frequently adjusted, the teeth loosen and move, causing pain. “Oral pain must be considered in cases of unintentional weight loss which could later precipitate disordered eating,” they say.

They point out that future research should explore the relationship of orthodontics to weight loss.

The research looked at all patients admitted to Temple Street with anorexia over a seven-year period between 2005 and 2011. Some 20 patients were admitted over this period and their average age was 13.5 years. Comparing this with 2002 census estimates suggested anorexia was now presenting at an earlier age - six months earlier.

Six of the 20 admitted were boys. “The relatively high male showing corroborates recent research indicating increased male prevalence,” the report said.

All patients presented through A&E with the majority (60 per cent) self-referrals, while the remainder were referred by a GP.

On admission, girls were more underweight than boys, despite girls presenting to hospital sooner than boys after the onset of symptoms.

Aside from low weight, over-exercising and food restricting were the most common presenting features. Of the 20 patients involved in the study, five had been vomiting, and another 13 reported to be over-exercising, while all were “food restricting”.

The report also draws a possible link between having braces fitted and developing anorexia. It notes that children are often instructed to avoid eating certain foods when receiving orthodontic treatment, and that eating can be painful as the teeth loosen.

“Sometimes dental professionals may discourage certain foods if they interfere with treatment, which the ‘perfectionist’ child may over-interpret,” the report said.

The “dramatic increase” in children presenting with anorexia at Children’s University Hospital, Temple Street in the past decade may be mirrored nationally, it added. The report says provisions will need to be made in the planning of the new paediatric hospital for dedicated beds and dietetic posts.