Association Between Nutritional Status and Dental Caries in Brazilian Teenagers with and without Risk for Eating Disorders

Amanda Silva Aragão, Liege Helena Freitas Fernandes, Lorenna Mendes Temóteo Brandt, Sheyla Márcia Auad, Alessandro Leite Cavalcanti


Objective: To evaluate the relationship between nutritional status and dental caries in Brazilian female adolescents with and without behavioral risk for eating disorders. Material and Methods: Cross-sectional study involving 60 girls, 15 to18 years old, randomly selected from public and private schools. Risk behavior for eating disorder was assessed by the Bulimic Investigatory Test of Edinburgh, anthropometric measurements were taken to calculate the body mass index, dental examinations were performed to verify the caries experience and a questionnaire to collect sociodemographic data was applied.  Data were analyzed descriptively and analytically using the Statistical Package for the Social Sciences 18.0 software. The level of statistical significance was set at 5%, with a 95% confidence interval. Results: Most of the girls studied in public school (75,0%), had no partner (95,0%) and had a monthly family income above the minimum wage (63,3%). The prevalence of dental caries was high (86.7%). The most used practice for weight loss was the act of purge (18.3%). There was no statistically significant association between dental caries and Body Mass Index (p=0,655), however, it was observed that adolescents with high Body Mass Index had a higher risk for Eating Disorders (p<0,05). Conclusion: The nutritional status was not associated with dental caries, however the monitoring of girls with high Body Mass Indexis important due to the increased risk of eating disorders.


Body Mass Index; Feeding Behavior; Dental Caries; Adolescent Behavior.

Full Text:



Johansson A-K, Norring C, Unell L, Johansson A. Eating disorders and oral health: a matched case-control study. Eur J Oral Sci 2012; 120(1):61-8.

Lima DSM, Coutinho VM, Holanda LCA, Grinfeld S, Colares V. [The oral health and eating disorders among adolescentes]. Rev Bras Odontol 2012; 69(2):190-3.

Hermont AP, Paiva SM, Abreu MHNG, Auad SM. Eating disorder behavior and dental implications among adolescents. Int J Eat Disord 2013; 46(7):677-83.

American Psychiatric Association: Diagnostic and statistical manual of mental disorders. 5. th. ed. Washington D C: American Psychiatric Association, 2013.

Caro LGC, Pérez LML, Feu S, Preciado VG. Satisfaction with weight and characteristics of eating disorders in high school. An Pediatr 2015; 82(5):338-46.

Bittencourt LJ, Nunes MO, Oliveira JJF, Caron J. Risk of eating disorders in school children from Salvador, Bahia according to race. Rev Nutr 2013; 26(5):497-508.

Mas-Manchón L, Rodríguez-Bravo A, Montoya-Vilar N, Morales-Morante F, Lopes E, Añaños E et al. Valores percebidos em la publicidad de alimentos por jóvenes com y sin trastornos de la conducta alimentaria. Salud Colectiva 2015; 11(3):423-44.

Burkert NT, Muckenhuber J, Groβschädl F, Rásky É, Freidl W. Nutrition and health – the association between eating behavior and various health parameters: a matched sample study. PLoS One 2014; 9(2):e88278.

Vale AMO, Kerr LRS, Bosi MLM. [Risk behaviors for eating disorders among female adolescents from different social strata in the Brazilian Northeastern]. Ciênc Saud Colet 2011; 16(1):121-32.

Lifante-Oliva C, López-Jornet P, Camacho-Alonso F, Esteve-Salinas J. Study of oral changes in patients with eating disorders. Int J Dent Hyg 2008; 6(2):119-22.

Jones M, Lynch KT, Kass AE, Burrows A, Williams J, Wilfley DE et al. Healthy weight regulation and eating disorder prevention in high school students: a universal targeted web-based intervention. J Med Internet Res 2014; 16(2):e57.

Medeiros Junior R, Catunda IS, Silva IHM, Silva NFAS, Silva CHV, Beatrice LCS. [Oral and maxillofacial manifestations secondary to bulimia nervosa: a systematic review]. Pesq Bras Odontoped Clin Integr 2012; 12(2):279-84.

Faine MP. Recognition and management of eating disorders in the dental office. Dent Clin N Am 2003; 47(2):395-410.

IBGE. Instituto Brasileiro de Geografia e Estatística. Cidades – Campina Grande, 2015. Available at: Access on 16 May 2016.

Brandt LMT. Distúrbios alimentares e sua associação com erosão e cárie dentária em adolescentes. 2015. 101 f. Dissertação (Mestrado em Odontologia). Universidade Estadual da Paraíba, Campina Grande. 2015.

World Health Organization. Oral health surveys. Basic methods. 5. th. ed. Geneva: WHO; 2013.

Henderson M, Freeman P. A self-rating scale for bulimia. The ‘BITE’. Br J Psychiatry 1987; 150:18-24.

Ximenes R, Colares V, Bertulino, Couto G, Sougey E. [Brazilian version of the “BITE” for use in adolescentes]. Arq Bras Psicol 2011; 63(1):52-63

Cardoso AMR, Gomes LN, Silva CRD, Soares RSC, Abreu MHNG, Padilha WWN et al. Dental caries and periodontal disease in Brazilian children and adolescents with cerebral palsy. Int J Environ Res Public Health 2015; 12(1):335-53.

World Health Organization. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. WHO Technical Report Series 854. Geneva: World Health Organization; 1995.

Popoff DAV, Santo-rosa TTA, Paula ACF, Biondi CMF, Domingos MA, Oliveira SA. Bulimia: manifestações bucais e atenção odontológica. Rev Gaúcha Odontol 2009; 58(3):381-5.

Conviser JH, Fisher SD, Mitchell KB. Oral care behavior after purging in a sample of women with bulimia nervosa. J Am Dent Assoc 2014; 154(4):352-4.

American Dietetic Association. Position of American Dietetic Association: nutrition intervention in the treatment of anorexia nervosa, bulimia nervosa, and other eating disorders. J Am Diet Assoc 2006; 106(12):2073-82.

Starr TB, Kreipe RE. Anorexia nervosa and bulimia nervosa: brains, bones and breeding. Curr Psychiatry Rep 2014:16(5):441.

Alvarenga MS, Lourenço BH, Philippi ST, Scagliusi FB. Disordered eating among Brazilian female college students. Cad Saúde Pública 2013; 29(5):879-88.

Smink F, Hoeken D, Hoek H. Epidemiology of eating disorders: incidence, prevalence and mortality rates. Curr Psychiatry Rep 2012; 14(4):406-14.

Manios Y, Dimitriou M, Moschonis G, Kocaoglu B, Sur H, Keskin Y et al. Cardiovascular disease risk factors among children of different socioeconomic status in Istanbul. Turkey: directions for public health and nutrition policy. Lipids Health Dis 2004; 4(3):11.

Santin GC, Martins CC, Pordeus IA, Calixto FF, Ferreira FM. Food insecurity in oral health: A systematic review. Pesq Bras Odontoped Clin Integr 2014; 14(4):335-46.

Cinar AB, Murtomaa H. Interrelation between obesity, oral health and life-style factors among Turkish school children. Clin Oral Invest 2011; 15(2):177-84.

Emerich TB, Pacheco KTS, Carvalho RB, Muniz EN, Sarcinelli GP, Sarti TD. Access to dental services and related factors in adolescents from Vitória, Espírito Santo, Brazil, 2011. Pesq Bras Odontoped Clin Integr 2015; 15(1):253-62.

Baldani MH, Pupo YM, Lawder JAC, Silva FFM, Antunes JLF. [Individual determinants of recent use of dental services by low-income adolescents and young adults]. Pesq Bras Odontoped Clin Integr 2011; 11(1):91-8.

Kavitha PR, Vivek P, Hegde AM. Eating disorders and their implications on oral health – role of dentists. J Clin Pediatr Dent 2011; 36(2):155-60.

Costa EL, Ferreira PVC, Oliveira BEC, Portugal RP, Rodrigues VP, et al. Socioeconomic, nutritional, and behavioral factors associated with severe childhood caries in children aged 18 – 36 months. Pesq Bras Odontoped Clin Integr 2014; 14(2):79-87.

Lima CAS, Peruchi CTR, Poli-Frederico RC, Tomasetti CSC, Fracasso MLC, Maciel SM. Explore the association between dental caries, obesity and sensory characteristics in students living in Southern Brazil. Pesq Bras Odontoped Clin Integr 2014; 14(4):283-92.

Alswat K, Mohamed WS, Wahab MA, Aboelil AA. The association between body mass index and dental caries: cross-sectional study. J Clin Med Res 2016; 8(2):147-52.

Woo J. Survey of overweight, body shape perception and eating attitude of Korean female university students. J Exerc Nutrition Biochem 2014; 18(3):287-92.

Lavender JM, Shaw JA, Crosby RD, Feig EH, Mitchell JE, Crow SJ. Associations between weight suppression and dimensions of eating disorder psychopathology in a multisite sample. J Psychiatr Res 2015; 69:87-93.