Dental erosion, salivary differences in bulimics treated with serotonin inhibitor

Objectives: to evaluate the prevalence of dental erosion in subjects with bulimia nervosa and to investigate the levels of selected components in their saliva when compared with a group of patients on similar medication and a control group of normal subjects. Methods: 106 subjects who met the DSM-III-R criteria for bulimia of the American Psychiatric Association formed Group B. All were taking of the antidepressant serotonin inhibitor Fluoxetine (X), 40 mg/day. 25 non-bulimic depressives, receiving (X) 20 mg/day, formed Group D and 50 healthy subjects matched for sex, age and medical history, formed Group C. Dental erosion was determined according to the Smith and Knight Tooth Wear Index. The levels of pH, bicarbonates, inorganic phosphates and urea in resting and stimulated whole saliva were determined by spectrophotometric (340 nm UV) and colorimetric methods, salivary flow rates were measured. Kruskall Wallis and one-way ANOVA and Rank and Dunn pairwise multiple comparisons were used for the statistical analyses (pH<0.05). Results: The greatest prevalence of dental erosion was found in Group B (23.31%). Salivary flow rates, pH and bicarbonate levels in mixed saliva were significantly higher in the control group C (0.61ml/min; 6.75; 5.06mmol/l) then in Group B (0.28ml/min; 6.45; 4.4mmol/l). There were no differences in the levels of phosphates and urea between groups C (15.2 mg/dl) and B (16.9 mg/dl). In the depressive, non-bulimic group (D) salivary flow (0.37ml/min), pH (6.58), bicarbonate (4.8mmol/l) and phosphate (17.3 mg/dl) levels were lower then in group C, but the difference were not significant. Urea level (48.3 mg/dl) was significant higher in comparison to groups B (38.7 mg/dl) and C (37.1 mg/dl). Conclusions: These findings suggest that the levels of some salivary components could contribute to the degree of erosion seen in bulimic patients. Supported by State Committee for Scientific Research grant 2 PO5EO9826