An eating disorder is a psychological disorder characterized by abnormal or disturbed eating habits. For many afflicted with this set of diseases it is a difficult road both mentally and physically. The persons general health suffers from either insufficient or excessive food intake. While many focus on the general health effects, there are countless oral health effects as well.

Most Common Eating Disorders

Anorexia (medical name is anorexia nervosa) is characterized by a person's refusal to maintain what is considered a healthy body weight and a poor self image of one's self. Anorexia comes with severe medical consequences including bone loss, skin changes, and sexual changes. It can even lead to death in sever cases from malnutrition. Many women suffer from self image issues due to the increase in media exposure of the "perfect" female form. In patients with eating disorders this image is magnified by those afflicted. Recent research genetics may play a role but how big is unknown at this time.

Bulimia (medical name is bulimia nervosa) is characterized by constantly binge eating and then purging the food from the body. The purging is done in various ways including forced vomiting, use of laxatives/diuretics, and/or excessive exercise.

Compulsive Over-Eating is characterized by consuming large quantities of food when not hungry. These patients are generally unconcerned about their nutritional intake.

Possible Dental Issues

Tooth Enamel Erosion occurs mainly in anorexic patients due to the constant vomiting to expel foods. The stomach acids will come up with the food into the mouth eroding the enamel from the teeth. A common sign is erosion on the inside of the teeth towards the tongue.

Tooth Decay is quite common to see as most of these patients are eating very poorly which leads to an increase in tooth decay incidence. It is also important to note for many binge eaters they do it late at night and go back to sleep without brushing which will increase the chances of the development of tooth decay.

Damage To Oral Tissues includes the tonsils, tongue, and the uvula at the back of the mouth. These tissues will also be affected by the repeated regurgitation of stomach acids into the mouth. These areas will be marked by red, swollen tissues. You may also see scratching in the back of the mouth from patients inducing vomiting by using their fingers. Other areas of concern include salivary gland enlargement, dry mouth (xerostomia), and reddened, dry, cracked lips.

Increased Tooth Sensitivity in extreme cases the nerve of the tooth can be exposed and cause infection, change in color, or even death of the tooth.

How Are These Issues Treated?

First, and foremost an eating disorder must be brought out in the open by the patient. Communication between dentist and patient is critical for success. Standard dental treatment will include restoring any tooth decay present using dental restorations (dental bonding and dental crowns), root canal therapy may be needed, as well as removal of any unrepairable teeth. Dental implants can also be an option to replace any missing teeth.

There are some simple steps to help those who do purge. These include:

Brushing at least two times per day with a fluoride toothpaste. Brushing after purging is a good idea as well as it will help lessen the effects of the stomach acids on the teeth and oral tissues.

Floss Daily

After purging rinse with a sodium bicarbonate and water mix (1 teaspoon of sodium bicarbonate in a half glass of water). 

Have regular dental checkups.

Rinse with a fluoride rinse to help protect your teeth's enamel.

Will these strategies keep the effects of purging away? Probably not, but they can help minimize the damage.

Conclusion

Eating disorders are difficult to diagnose and treat properly. It takes a team approach utilizing medical and dental teams. It affects a persons overall health, their psychological health, and their dental health. Trust between patient and healthcare provider is of utmost importance.

Many underestimate the power of a beautiful smile on one's self image. A positive self image is critical if one is to overcome an eating disorder and get back on track to leading a long healthy life.

About the Author

Dr. Marielaina Perrone is a cosmetic dentist. Her advanced professional training and extensive dentistry experience translate into greater confidence and convenience for your entire family. Learn more at Henderson Cosmetic Dentist.