This week the Irish newspapers were buzzing with headlines about the possible link between orthodontic braces and anorexia nervosa. “Braces on teeth may be a cause of anorexia” said the Irish Independent.
But before we start petitioning orthodontists, let’s have a look at the journal article.
The full paper can be seen here (thanks to @kirstychallen for finding it).
What did the paper look at?
This article reviewed the demographics of all inpatients at the Children’s University Hospital, Dublin, admitted with anorexia nervosa between 2005 and 2011. Data from medical and dietetic files were analysed.
Who were the patients?
Well, there were only 20 patients admitted during that time, so it’s small numbers.
All of them came through ED, although the average time since onset of anorexia nervosa was 6 months.
30% of the patients were male. The average age was 13.5 years.
What were the interesting findings in this group?
65% had been over-exercising and 25% has been known to be vomiting.
35% had had recent orthodontic treatment.
Girls presented earlier than boys (4.5 months v 8 months), but had a lower BMI by the time of presentation.
So, do braces cause anorexia nervosa?
Unlikely – I wouldn’t get too excited. The authors refer to some UK stats which suggest that 15% of 15 year old have current braces, whereas these result show 35%. It’s worth looking into further.
The paper suggests possible mechanisms for a link i.e. getting braces fitted causes pain, children are given specific dietary advice at that time and this may trigger eating problems. But it’s just discussion and there is no suggestion that this paper proves any link.
For me, the most interesting finding in this paper is the fact that all admissions came through ED. Nobody attended CAMHS. We need to consider better education and consequently better use of resources.
Bottom line: don’t cancel that orthodontist appointment
O’Reilly M, Carr C, Boylan C, Anglim M, Houlihan B, 2014, Anorexia Nervosa (AN) in Inpatients at a Children’s Hospital (2005-2011), Irish Medical Journal, 107(1).