Dental implications of eating disorders

Eating disorders are illnesses characterized by significant disturbances in a person’s eating behavior, accompanied by intense focus or distress related to food consumption, body shape or weight. Eating disorders can have a large negative impact on an individual’s quality of life. Self-image, relationship with families and friends as well as performance in school or at the job can be damaged.

The National Eating Disorders Association (NEDA) estimates that there are almost 10 million of women and 1 million of men affected by anorexia and bulimia in the United States. Another 25 million suffer from binge-eating disorders.

Types of eating disorders

Anorexia. People who have anorexia limit the amount of food they eat and can become extremely thin. Even though these individuals may be extremely underweight, they see themselves as “fat”.

Bulimia. People with bulimia eat compulsively (binge). After they overeat, these individuals try “to undo” the fact that they ate too much by forcing themselves “to throw up”. They can also exercise a lot or use laxatives in order to lose weight.

Binge eating or compulsive overeating. People with binge-eating disorders will regularly eat large amount of food within a couple of hours or less, but they do not regularly try to get rid of the food immediately by throwing up or by misusing laxatives.

Dental complications

Eating disorders can affect a person’s oral health.

Without proper nutrition, gums and other soft tissue inside your mouth may bleed easily. They can become red and swollen, which is usually a sign of gingivitis.

The salivary glands may swell and individuals may experience dry mouth, due to dehydration. Lips may become dry and cracked.

Throwing up frequently can affect teeth too. That is because when strong stomach acid repeatedly flows over teeth, the tooth’s enamel can be lost. As a result teeth change in color, shape and length. The edges of teeth will become thin and break off easily. Eating cold or hot food may become uncomfortable. Tooth decay can also be aggravated by extensive tooth brushing or rinsing following vomiting.

Purging can lead to scratches and cuts inside the mouth, especially on the upper surface.

By doing an oral examination, dentists will be able to discover if a person suffers from an illness such as eating disorder. They may recommend therapists and also teach their patients to minimize the effects of purging (a clear indicator of bulimia). For example patients should immediately rinse their mouth with soda water or use a sugar-free mouth rinse to neutralize the stomach acid in their mouth. Patients should swish water around their mouth if there is nothing else available and brush with a fluoride toothpaste and a soft brush.

Rigorous hygiene and home care are recommended to prevent further damage to the tooth structure. The measure should include the following:

• Regular professional dental care;
• In-office fluoride application to prevent further erosion of the tooth;
• Use of artificial saliva for patients with severe xerostomia;
• Rising with water immediate after vomiting. Tooth brushing must be avoided right after vomiting.

Conclusion

Eating disorders are real problems and negatively affect every system in the human body. Sometimes eating disorders are discovered too late, when irreversible damage has been done to the teeth and body. Dental treatment is recommended when the patient is stabilized psychologically. This is because an acceptable prognosis for more complex dental treatment depends on cessation of the binge-purge habit.

Dentists play an important role in finding people who suffer from an eating disorder. Effective treatment requires a multi-disciplinary team of health professionals to provide medical/ dental, psychological and nutritional support. People with eating disorders will try to hide because they are ashamed. So the family support is very important.

If you need additional information, Dr. Arhiri is here to help. 610.647.7611  is our phone number.

References:

https://www.nationaleatingdisorders.org/dental-complications-eating-disorders

http://www.ada.org/en/member-center/oral-health-topics/anorexia-nervosa

http://www.mouthhealthy.org/en/az-topics/e/eating-disorders

http://jdh.adha.org/content/88/3/156.full

https://www.deltadentalins.com/oral_health/eating_disorders.html

http://www.knowyourteeth.com/infobites/abc/article/?abc=E&iid=346&aid=1236