Oral rehabilitation in a patient with eating disorders and severe dental erosion - a case report
Göthe P*, Thortensson B, Bergendal B
The aim was to present an extensive oral rehabilitation with conventional and adhesive fixed restorations in a patient with anorexia nervosa and severe dental erosion. Because of self-starving, self-induced vomiting, and periods of excessive exercise, the patient collapsed at 21 yrs of age. Her weight was then 25 kilos, and she was severely medically compromised.
At 29 years, after medical recovery, the patient had a first oral rehabilitation of incisors and canines in the upper jaw with ceramic crowns after gentle preparation, and incisal composite restorations in the lower incisors.
At 41 years, dental erosion was aggravated, and extensive oral rehabilitation with full coverage in all teeth except the second molars started. Gold crowns were made on all first molars and adhesively cemented ceramic crowns (Empress) on incisors, canines and premolars
The eating disorders were now under better control, and the patient improved her dietary habits successfully. The treatment could be performed in local anaesthesia, and with good co-operation from the patient. The teeth were prepared in segments, starting posteriorly. The vertical dimension was increased by
The reconstructions of the damaged teeth offer maximum future protection of the dentition. A carefully designed hygiene programme was worked out, and the patient managed to perform hygiene measures very well. Due to suspected nightly grinding, she was provided with a soft occlusal splint in the maxilla in order to protect the porcelain.
Oral rehabilitation of the frontal teeth at 29 yrs when her disease was not under full control did not prevent further dental erosion in the lateral segments. At 41 yrs she had full coverage restorations on all teeth except the second molars. Regular supervision of the oral situation is mandatory.