title: Dental erosion in patients seeking treatment for gastrointestinal complaints: a case series.
abstract: BACKGROUND
  Eating disorders which embrace anorexia nervosa, bulimia nervosa, and eating disorders not otherwise specified can be life-threatening due to general medical complications; however, the diagnosis of eating disorder is often delayed due to a low suspicion index. Gastroenterologists are health care providers who may come into contact with patients with undiagnosed eating disorders; it has been previously demonstrated that patients with eating disorders frequently have a significant association with functional dyspepsia. Signs of dental erosion have been described in patients with eating disorders; hence, they may help to identify eating disorders in patients who present with functional dyspepsia and deny having an eating disorder.
  
  
  METHODS
  In this report we describe three cases (a 25-year-old white woman, a 24-year-old white woman, and a 40-year-old white man) with undiagnosed eating disorders, in which a more comprehensive approach, such as the recognition of dental erosion joined with a careful gastrointestinal investigation, was performed to reach a final diagnosis of an eating disorder.
  
  
  CONCLUSIONS
  The screening for dental erosion in patients seeking or receiving medical treatment for dyspeptic symptoms in a gastrointestinal out-patient clinic could be an aid for gastroenterologists to recognize the presence of an underlying eating disorder. A close collaboration with dentists, in addition to psychiatrists, could provide a more favorable treatment outcome.
authors.affiliation: Dental School, University of Ferrara, Via Savonarola 9, 44100, Ferrara, Italy. vincenzo.bruno@unife.it.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Bruno
authors.affiliation: Department of Medicine and Surgery, University of Salerno, Via S Allende, 84081, Baronissi, Italy. mamato@unisa.it.
authors.forename: Massimo
authors.initials: M
authors.lastname: Amato
authors.affiliation: Dental School, University of Ferrara, Via Savonarola 9, 44100, Ferrara, Italy. santo.catapano@unife.it.
authors.forename: Santo
authors.initials: S
authors.lastname: Catapano
authors.affiliation: Department of Medicine and Surgery, University of Salerno, Via S Allende, 84081, Baronissi, Italy. piovino@unisa.it.
authors.forename: Paola
authors.initials: P
authors.lastname: Iovino
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D052018:Bulimia Nervosa / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D016022:Case-Control Studies; D015928:Cognitive Behavioral Therapy; D003812:Dentist-Patient Relations; D004415:Dyspepsia / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012017:Referral and Consultation; D014077:Tooth Erosion / Q000209:etiology* / Q000523:psychology; D014839:Vomiting / Q000150:complications* / Q000523:psychology