Changes in oral cavity during period of intensive vomiting in patient with somatoform autonomic dysfunction - description of the case.

INTRODUCTION The most important endogenous causes of erosion are eating disorders, gastro-oesophageal reflux (GERD), alcoholism and syndromes involving lowered saliva secretion. AIM The aim of this work is to study a patient with symptoms of somatoform autonomic dysfunction, in which significant erosive loss occurred through chemical influence of gastric acid on oral cavity. METHODS Seventeen years old girl was sent to Department of Child and Adolescent Psychiatry due to persistent nausea and vomiting, which occurred over a period of about 10 months. Because of this she was repeatedly admitted to a paediatric hospital. Nausea and vomiting led to fear of going out of the house and of being in public places. In addition dental clinical examination was performed. RESULTS Somatoform Disorders, during which there has been intense vomiting, can be seen as an unusual example of purging-type eating disorders. Erosion of enamel was the most common. In examination of oral mucosa, keratinisation, tongue covered with removable coating and exfoliative cheilitis associated with drying and cracking of lips, were detected. CONCLUSIONS Observed erosion of teeth and changes in macroscopic construction of oral mucosa seem to be symptoms caused mainly by induced intense and prolonged vomiting. Those changes may be a serious problem not only for the patient's health but also their aesthetics. The described case of patient with intense and long-term vomiting indicates the need of multidisciplinary medical care, including systematic dental assessment.