The mouth, a site of control and pain: a patient-centered qualitative study on oral health experiences in anorexia nervosa
Bibliographic record
Abstract
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. 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. 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. 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. Anorexia nervosa (AN) is a serious illness that affects both the body and the mind. While many people know about the physical and psychological effects of AN, its impact on oral health is much less discussed. Yet oral health problems are common. People with AN often experience tooth pain, enamel erosion, dry mouth, or gum disease. These difficulties can make everyday life more challenging. They can interfere with eating and speaking, lower self-confidence, and reduce overall wellbeing. In the DENT’ANOREXIE study, we wanted to understand how people with AN themselves view their mouth and their oral health. We spoke with 12 women hospitalized in Toulouse who kindly agreed to share their experiences. From these interviews, three main findings emerged. First, participants described their mouth as having both a functional role (for eating and speaking) and a symbolic meaning, often linked to feelings of control or denial. Second, they developed personal oral care routines, strongly influenced by their eating disorder behaviors. Third, they reported important barriers to accessing dental care, such as fear of being judged, feelings of shame, and the cost of treatment. These testimonies show that people with AN need dental care that is more understanding, compassionate, and adapted to their needs. Better collaboration between dentists, doctors, and psychologists, together with improved training on eating disorders, could help improve prevention, early detection, and long-term support for oral health.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".