Anorexia nervosa and purgative-type bulimia nervosa: a fundamental role of the dental surgeon in diagnosis and treatment

Introduction: In a world where appearance is considered above all by most people. It is in this unbridled search that some people end up acquiring eating disorders. Anorexia nervosa and purgative-type bulimia nervosa are diseases that are rarely taken into account in the first clinical assessment of the patient. Bulimia nervosa and Anorexia nervosa are eating disorder that causes serious physiological problems in the oral cavity, due to saliva calcification caused by frequent vomiting. Objective: it was to bring into discussion, through a literature review, the meticulous look that the dental surgeon must-have when performing the clinical examination and that he can be the first source in detecting signs of eating disorders and their clinical manifestations in the patient and so can forwards it to a multidisciplinary team for better diagnosis and treatment. Methods: This study followed an integrated literature review model and articles dating from 2001 to 2021 in English and Portuguese were selected. In virtual databases such as Scielo and PubMed. Results and Conclusion: The dental surgeon plays an important role in the team, controlling the development and progression of oral manifestations. Pass the oral hygiene guidelines, apply substances that can control the acids that are present in oral fluids; use salivary substitutes that can help reduce erosive wear. And always encourage this patient to come back for treatment. In extreme cases of damage to the dental structure, functional and anatomical, restorative or rehabilitative treatment is chosen. Recover form, function, esthetics and eliminate hypersensitivity and facilitate cleaning. The dental surgeon must be able to assess and diagnose the manifestations arising from eating disorders. Because it is the first professional to be able to detect and thus refer to a team of multi-professionals such as a psychologist, nutritionist, doctor and manage to perform the best possible treatment simultaneously and, through preventive and rehabilitative procedures, be able to return a better quality of life to the patient.

Latest Advancement in the Management of Xerostomia: A Review

Xerostomia, also known as dry mouth, is a subjective sensation arising due to the reduced salivary flow. The dry mouth interferes with normal oral functions such as swallowing, chewing and speech. An increase in the incidence of dental caries and oral infections that may impact the oral health is also seen. The aetiology of dry mouth may be due to systemic diseases, drugs or by radiation to the head and neck, the causes hence being multifactorial. The prevalence of dry mouth is commonly seen in nearly half of the elderly population and one fifth of the younger individuals. Salivary substitutes are used to manage xerostomia. However, for long- standing xerostomia, a lot of potential systemic therapies exist. Oral health care providers are now making significant contributions to the diagnosis and are aware of the latest trends in the management of xerostomia. This review aimed to illustrate the current trends in the management of xerostomia.

Artificial Saliva: Challenges and Future Perspectives for the Treatment of Xerostomia

The chronic sensation of a dry mouth is a disease condition called xerostomia and affects a large part of the population. Xerostomia is associated with decreased secretion, or more often, qualitative changes in saliva proteins and immunoglobulin concentrations that develop as a result of salivary gland dysfunction. Several reasons causing dry mouth were described, and usually, they include taking medications, diseases or radiotherapy. In some situations, when it is difficult to use salivary stimulants or salivary gland damage is irreversible, the only option might seem to be saliva substitutes. The paper presents the most important aspects considering saliva preparations. The rheological and lubricating properties and the reconstruction of the complex saliva structure has been the main purpose of research. The biological properties of saliva preparations were also widely discussed. As part of the work, the antimicrobial effect of three commercial saliva preparations was tested. Finally, inadequate antimicrobial properties against the strains isolated from the oral cavity were demonstrated. The development of salivary substitutes, in particular, the improvement of antimicrobial properties, can be achieved using nanotechnology, including drug delivery systems containing nanocarriers.

The use of drugs for the treatment of xerostomia – brief review

Inadequate production of saliva causes an oral imbalance that has a great impact on the individual's quality of life. Diseases of various types are responsible for impaired production of saliva and dry mouth, as happens in xerostomia. It is usually associated with hypofunction of the salivary glands, which shows signs of dryness on oral mucosa, and other morphological features in the oral cavity. Saliva is composed of water and 1% of electrolytes and immunoglobulins, enzymes and other proteins. Its fluid component, which contains ions, is mainly produced by parasympathetic stimulation, while the protein component, produced in the acinar secretory vesicles, is released by sympathetic stimulation. The use of certain drugs is a major cause of xerostomia. Among these we found analgesics, anticonvulsants, antihistamines, antihypertensives, diuretics and antidepressants. The treatment is mainly done by saliva substitutes such as sodium chloride, potassium chloride, monopotassium phosphate and dipotassium phosphate. However, in some cases, stimulants, such as citric acid and sodium citrate, or even topical salivary substitutes can be effective. Furthermore, the use of specific oral care products is well accepted by the patients. The treatment is selected according to the ability of the glands to produce saliva. It is still not fully known what mechanism of action drugs that cause hyposalivation, dry mouth or changes in saliva composition use. Yet, it is important to know the side effects of prescribed drugs.