Vroegdiagnostiek van Boulimia Nervosa door de tandarts.

Koppen, P.M. (2014) Vroegdiagnostiek van Boulimia Nervosa door de tandarts. thesis, Dentistry.

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Abstract

Introduction For several years there has been much attention to oral health as part of overall health. The importance of recognition of oral manifestations of physical and mental health as part of the dentist has an important position. Especially eating disorders like Anorexia Nervosa (AN), Bulimia nervosa (BN) and eating disorder not otherwise specified (NOS) are typical examples of the oral/systemic health interactions. An eating disorder is a disorder in the doing and thinking about food. Characteristic of eating disorders are a strong preoccupation with food and weight and a distorted body image. The Diagnostic and Statistical Manual of Mental Disorders V (DSM-V) of the American Psychiatric Association identifies three eating disorder called AN, BN, and the NAO (binge eating). Due to the fact that BN-patients, in terms of appearance generally are ‘normal’, in contrast to AN-patients, which are characterized by an emaciated appearance, the recognition and the consequent early diagnosis is very complex and will be pointed out in this investigation. Early diagnosis as part of the dentist makes it possible to influence. BN-patients often do not present to a doctor, so the dentist is the only medically trained person by whom the BN-patient is seen. Apart from the question of whether the dentist is able to detect characteristics of BN, the following questions are important: ‘What are the oral manifestations of Bulimia Nervosa' and 'What data needs early Bulimia Nervosa diagnose a dentist?'. The corresponding object is to draw up a protocol for early diagnosis of Bulimia Nervosa is possible . Materials & Method The research design of this study is a literature study, a systematic review of observational studies. The databases used are: Medline ( Pubmed ), Cochrane Library, Google Scholar, Scirus and Web of Science. The search terms used are: characteristics eating disorders, eating disorders, eating disorders prevalence, Bulimia Nervosa oral, Bulimia Nervosa, Anorexia Nervosa, Bulimia Nervosa oral manifestations, eating disorders and oral health, Erosion Bulimia Nervosa, salivary changes and dental erosion in Bulimia Nervosa, dental erosion in Bulimia Nervosa, Bulimia Nervosa change salivary composition, amylase changes Bulimia Nervosa, Bulimia Nervosa oral diagnosing, diagnosing Bulimia Nervosa and Bulimia Nervosa with parotid swelling sialadenosis. To limit the number of items, without a selection in type of research, it was decided to select only Fulltext articles in Medline (PubMed). Language filters used are: German, English and Dutch. The inclusion criteria are: Bulimia Nervosa and Oral manifestations and exclusion criteria are: alcohol and drug use. The qualitycheck has been done by using the method described in the Dutch Journal of Evidence- Based Practice. On the basis of a number of parameters are the articles analyzed and the results are summarized in several areas. Results Sialoadenose, change in serum electrolytes (hypokaliaemie, hypochloremia and metabolic alkalosis), erosion and changes in salivation are the only oral characteristics that can be reliable statements. The other oral features: caries, condition periodontium, Russell's sign, Bartter syndrome, the precise impact of medication on salivation and redness of the throat and palate, dry lips, cheilitis angularis, candidiasis, glossitis and ulcerations of the palate are too minimally described in the literature to make a correct statement. Discussion Sialoadenose, abnormal serum electrolyte levels, erosion and changes in salivation are characteristics of the relationship between BN and oral health. Caries , periodontal condition, Russell 's sign , serum amylase, Bartter syndrome, redness of the throat and palate, dry lips, cheilitis angularis, candidiasis, glossitis and ulcerations of the palate are possible characteristics of BN. The different results may be explained on the basis of the fact that these are case studies, of a size too small and thus not representative of reality show, or not comparable in connection with completely different inclusion and the results together exclusion criteria. The time during the course of BN characterizes the extent to which early diagnosis is possible for the dentist. It means that the time when the dentist suspected BN is going along with the number of present oral manifestations of BN. The sooner in the course of BN, the greater the chance that there are too few events present and the diagnosis BN missed. The number of BN-patients is greater than the number of dentists and the risk is theoretically available to all dentists, that they have to deal with a patient with BN. Early diagnosing BN by the dentist is regarded as necessary by educational institutions. This view is consistent with the need to make dentists major players in the evolution of BN. Conclusion The individual characteristics of BN, salivary gland swelling (sialoadenose), abnormal serum electrolyte levels (hypokaliaemie, hypochloremia and metabolic alkalosis), erosion, changes in salivation, caries, condition periodontium, Russell 's sign, serum amylase, Bartter syndrome, redness of the throat and palate, dry lips, cheilitis angularis, candidiasis, glossitis and ulcerations of the palate, all have to do with each other, it is a kind of chain reaction. The order in which the different characteristics begin to manifest and the increase in severity of the condition, BN, are logical, and therefore it is more important to be aware of what 's going on in patients with BN. Well informed to the questions: ‘What are the oral manifestations of Bulimia Nervosa?’ en 'What data needs a dentist for early Bulimia Nervosa diagnose?’ can be argued that sialoadenose , erosion and changes in salivation are valid characteristics of BN and should be within the framework of BN by the dentist. Another common feature of BN is a change in serum electrolyte levels. However, this is no longer the land of the dentist, so the dentist will have to refer to the doctor. Referring to the doctor and taking a blood test is part of the follow-up procedure and should therefore belong in the "Protocol deal with suspected Bulimia Nervosa for the dentist.".

Item Type:	Thesis (Thesis)
Supervisor name:	Jüch, Dr. P.J.W.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 11:07
Last Modified:	25 Jun 2020 11:07
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/2674

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