From the National Eating Disorders Association comes a little-known fact: Up to 89 percent of patients with bulimia nervosa show signs of tooth erosion.
Specifically, patients can suffer erosive lesions throughout their mouth, and teeth can become brittle and translucent, sometimes dramatically shrinking in size.
Don’t believe it?
Check out the alarming photographs taken by dentist Craig A. Mabrito on the PDF “Eating Concerns and Oral Health,” available from NEDA’s website at www.nationaleatingdisorders.org
“Dietary habits can and do play a role in oral health,” emphasizes the NEDA information sheet. Dental problems arise from constant regurgitation, a high intake of diet sodas and other acidic foods, and generally restrictive dietary habits.
“The harmful habits and nutritional deficiencies that often accompany disordered eating can have severe consequences on one’s dental health,” the NEDA adds.
In fact, it’s not uncommon for dentists and hygienists to spot an eating disorder. And often, individuals first seek help for their eating disorders after recognizing the pain and discomfort of dental complications.
Of the three major psychological eating disorders -- anorexia nervosa, bulimia nervosa and binge eating disorder -- bulimia is the one that most often causes dental problems.
The Cleveland Clinic defines bulimia nervosa as episodes of binge eating followed by inappropriate methods of weight control, including vomiting, fasting, using enemas, using laxatives and diuretics to excess, and compulsive exercising.
Amid the many physical and emotional outcomes of bulimia nervosa, dental problems cannot be underestimated. In fact, certain symptoms can appear in as little as six months after the start of the eating disorder.
Health care professionals look for:
- Erosion of tooth enamel caused by the repeated exposure to the stomach’s acidic contents through purging
- Dental cavities
- Unprovoked pain within a particular tooth
- Changes in the color, shape and length of teeth
- Tooth sensitivity to hot or cold food
Also, dentists and doctors often can detect swelling and soreness in the salivary gland (from repeated vomiting) and dehydration or dry mouth, among many other medical symptoms.
As for signs of tooth decay, the NEDA says decay can be aggravated by repeated acts of tooth brushing and rinsing after vomiting.
In an effort to help dentists and hygienists broach the subject of a possible eating disorder when they see signs of it in their patients, the NEDA has an information sheet called “Dental Complications of Eating Disorders” that suggests a way to talk about it.
Dentists might ask, “Can you tell me about any behaviors you may be currently engaged in that could be having this effect on your mouth?”
If their fears are confirmed, another action might be to suggest resources such as the NEDA and to say that, in the meantime, the patient might be helped by a mouth guard and by not brushing immediately after vomiting.
“Bulimia Nervosa (Also Called ‘Purging’). Cleveland Clinic Health Information. Web. 26 March 2012. http://my.clevelandclinic.org/disorders/bulimia/hic_bulimia_nervosa.aspx
“Eating Concerns and Oral Health.” PDF download (OrahHlth.pdf) from the National Eating Disorders Association. Web. 26 March 2012. http://www.nationaleatingdisorders.org/information-resources/general-information.php#doctors_and_dentists
“Dental Complications of Eating Disorders.” PDF download (Dental Complications of EDs(1).pdf) from the National Eating Disorders Association. Web. 26 March 2012.
Reviewed March 26, 2012
by Michele Blacksberg RN
Edited by Jody Smith