The mouth, a site of control and pain: a patient-centered qualitative study on oral health experiences in anorexia nervosa.

Abstract

Introduction: Anorexia nervosa (AN) is a severe eating disorder with profound psychosocial and physical impacts, including oral health consequences. Despite the documented oral health issues in AN, limited research explores patients' perceptions of their oral health, care and needs.

Methods: The DENT'ANOREXIE study employed a qualitative design, conducting semi-structured interviews with 12 female participants (ages 18-57) diagnosed with AN, at a single French hospital. Data were analyzed thematically using Braun and Clarke's six-step framework.

Results: Three key themes emerged: (1) symbolic and functional perceptions of the mouth, influenced by control and denial; (2) personalized oral hygiene practices shaped by AN behaviors ; and (3) challenges in accessing dental care, including feelings of judgment and financial barriers. Participants highlighted the need for integrated, empathetic, and person-centered dental care to address their complex oral health needs.

Discussion: This study underscores the importance of systemic and interdisciplinary approaches to oral health care for individuals with AN. Further research is needed into strategies to enhance early identification and management of oral health problems of people with AN. These may include enhancing the training of healthcare providers in eating disorders and the fostering of collaborative frameworks.