Although those who have eating disorders like bulimia and anorexia can often hide their disease from family and friends, they can’t hide the oral effects which can be detected by a dentist. In fact, 89% of people with bulimia have signs that show up in the mouth (National Eating Disorder Association, 2002).89% of people with bulimia have signs that show up in the mouth (National Eating Disorder Association, 2002)
Dental health refers to all aspects of the health and functioning of your mouth, especially the gums and teeth. Aside from enabling you to speak, eat, and laugh, research shows that your teeth can speak volumes about your overall health. So while parents and guardians may be unaware that an eating disorder is occurring, they will usually take their children to the dentist at regular intervals, and this can be the catalyst for patients to get the help they need.
For this reason, dentists are often becoming the first line of defense when it comes to identifying possible eating disorders in their patients. The Center of Pediatric Dentistry instructs dental professionals to approach their patients in an effective and non-judgmental manner when talking to them about concerns regarding possible eating disorder behavior. It is also recommended that oral health professionals are aware of resources in the community if the patient discloses an eating disorder and a referral is necessary.
How Do Eating Disorders Damage Your Teeth?
Often patients with eating disorders are embarrassed to see their dentist because of oral issues they may be experiencing. Bad breath, sensitive teeth and tooth erosion are just a few of the signs that dentists use to determine whether a patient suffers from an eating disorder. For those with bulimia, harsh stomach acid from frequent vomiting wears away tooth enamel increasing the risk of tooth decay; and the effects of anorexia, especially the lack of nutrients consumed, can weaken the jaw bone which also weakens teeth and leads to tooth loss.
According to the Institute of Dental Research, 28% of bulimia cases are first diagnosed during a dental exam.
Dentists who detect patients with eating disorders may recommend therapists and teach the patients how to minimize the effects of purging. Dr. Stover instructs patients who are actively purging not to brush their teeth immediately after vomiting, as it can brush the acid deeper into teeth and gums.
“Strong stomach acids can soften tooth enamel, and by vigorously brushing, the tooth enamel may scratch causing further damage,” he says. “Instead, I advise patients to immediately rinse their mouths with regular tap water to help remove acids or rinse with an alcohol-free fluoride mouthwash, which will provide additional protection against stomach acids. Patients should wait at least an hour after purging before brushing their teeth.”
Signs Of An Eating Disorder In The Mouth
By understanding the etiologies of eating disorders, recognizing the mouth warning signs, and intervening when appropriate, dental professionals can help the millions of Americans with these deadly diseases start down the road to recovery. According to the Institute of Dental Research, 28% of bulimia cases are first diagnosed during a dental exam.
A routine dental checkup can reveal oral signs of these diseases to a dental professional. Dentists are also able to tell if a person is relatively new or is a chronic purger. Some of the warning signs they look for include:
- Tooth decay
- Tooth enamel erosion
- Gum pain / bleeding gums
- Dry mouth
- Chronic sore throat
- Inflamed esophagus
- Tender mouth, throat, and salivary glands
- Teeth that are worn and appear almost translucent
- Palatal hemorrhages
- Decreased saliva production
- Enlarged parotid glands
- Problems swallowing
- Jaw alignment abnormalities
- Cracked lips
- Sensitive teeth
- Mouth sores
We Can Help
Intervention by loved ones, friends, and medical and dental professionals can spur someone to seek eating disorder treatment. Early detection of the disease may ensure a smoother and successful recovery period for the body and the teeth. Including a dentist in the health care team can help ensure that recovery is successful for the entire body. The key is to help direct individuals with an eating disorder in the direction of professional help, and that’s where The Meadows Ranch can make a difference.
The Meadows Ranch has treated eating disorders for more than 20 years. We know recovery from an eating disorder is possible. Based on feedback from patients, families and professionals, the vast majority of our patients remain committed to a life of health, balance and purpose.
For additional information about the treatment of eating disorders, please call to speak to an admissions coordinator.
The dental changes seen in many people with bulimia are often recognisable. Frequent vomiting may cause your salivary glands to swell and the tissues of your mouth and tongue to become dry, red and sore. People with bulimia may have chronic sore throat and small hemorrhages under the skin of the palate.
Frequent vomiting can erode your tooth enamel, especially on the tongue side of the upper front teeth. This sharply increases the risk for decay in these areas and can make these teeth sensitive to temperature. Severe erosion can lead to changes in your bite, or the way your upper and lower teeth come together. Your back teeth can be reduced in size and some teeth can even be lost eventually. Tooth erosion can take about three years to become obvious, but not all bulimics experience it.
Many people with bulimia may be malnourished, which can cause anemia, poor healing and increase the risk of periodontal disease.
During the treatment of your eating disorder, it may take a while to control the episodes of induced vomiting. To minimise damage done by stomach acid during episodes of vomiting, rinse your mouth with baking soda mixed in water. You also should rinse with a mouthwash containing .05 percent fluoride, which your dentist dental professional can prescribe recommend. Don't brush your teeth immediately after vomiting because stomach acid weakens tooth enamel and brushing can cause erosion of the enamel. When you do brush, use a toothpaste that contains fluoride. Fluoride helps strengthen teeth.
To help dry mouth, drink water to keep your mouth moist. There are also saliva replacements your dentist can prescribe. Your dentist dental professional can prescribe recommend daily fluoride treatments with prescription extra-strength rinses, or gels or pastes.
Effects of Bulimia on Teeth
This image shows discoloured, yellow, eroded teeth that can result from eating disorders.
At the DentistYour Dental Visit
If you are bulimic, your dentist dental professional may give you fluoride treatments during your dental visits and may prescribe a fluoride rinse gel for home use. Visit your dentist regularly; he or she can detect decay or infections. It is important to have regular dental checks to make sure that your mouth is healthy.
Dental treatment can be an important part of treatment for your bulimia. Your dentist dental professional will work with your health care team and together you can coordinate dental treatment with treatment for the eating disorder. If you have severe tooth damage and are still undergoing treatment for bulimia, your dentist dental professional may be able to give you an appliance that covers your teeth and protects them from stomach acids.
Once your bulimia is under control, you may need to have some of your teeth restored. If the enamel loss is stopped at an early stage, it can be replaced using materials called composite resin or amalgam. More severe erosion will require tooth extraction. Lost teeth can be replaced with bridges or implants.
Some conditions tend to occur with bulimia. For example, three-fourths quarters of bulimics have serious anxiety disorders, and many experience depression. People with bulimia may also develop alcohol or drug dependencies. These conditions can also affect your dental health and any medications to treat them may affect your dental treatment plan. Make your dentist aware of any medications you are taking, as well as their doses.