Orthodontic abnormalities in patients with eating disorders.

Many anorexic and bulimic patients induce vomiting by inserting their fingers in the oral cavity. We hypothesized that finger pressure could lead to tooth movement, eventually resulting in the development of orthodontic abnormalities, particularly open-bite. Twenty-four females with eating disorders and 24 matched controls underwent orthodontic examination and completed a dental questionnaire. Orthodontic abnormalities were more commonly found in the eating disorder group and open-bite was the most common abnormality seen. The presence of open-bite or other orthodontic abnormality was not associated with patient reports of self-induced vomiting, which would suggest that digital pressure was not the causative factor. The dental appearances indicated that the skeletal base pattern was abnormal in many cases. The findings could, in part, be accounted for by the fact that patients with eating disorders were less likely than controls to have completed courses of orthodontic treatment. Alternatively, the orthodontic abnormality may have contributed to the development of an eating disorder. Further study of this area is proposed.