Eating disorders are an incredibly common illness that affects all walks of life regardless of age, gender, race, geographic location or socioeconomic status. In fact, the American Dental Association and the National Eating Disorders Association estimates that about 30 million men and women suffer from eating disorders at some point in their lives. And, although it may sound strange, dentists are often the first people to identify signs of eating disorders in their patients and can play a pivotal role in early intervention.
Why would that be? Although eating disorders can and do affect an individual’s overall health and wellness, the teeth and oral cavity are where some of the earliest and most prominent symptoms can present themselves. These symptoms can vary depending on the type of eating disorder as well. The three most common, or broadest categories, are:
Anorexia: Characterized by an extreme fear of gaining weight. Individuals will often severely restrict their food intake, which can also be combined with excessive exercise. In addition, it’s very common for anorexics to “purge” any food they do intake, often by vomiting but also through the use of diuretics, laxatives or enemas.
Bulimia: Characterized by periods of binge eating (overeating), or the intake of high quantities of food over a short period of time. Often these foods are high-calorie and high in carbohydrates, fats, and sugar. Bulimics combine binge eating with purging, using the same methods described above.
Binge Eating: Characterized by periods of binge eating but without purging or other weight loss behaviors.
As you can see, eating disorders have many similarities as well as many important differences. One of the major similarities is the lack of nutrition, either through the extreme restriction of food intake or in extreme overeating of unhealthy foods. This is also what causes some of the most detrimental effects on a person’s overall health, and particularly a person’s dental health.
Lack of nutrition makes teeth brittle and causes the development of sores in the oral cavity, as well as premature arthritis and osteoporosis in the jaw and teeth. These latter two issues also play a role in tooth decay, tooth loss, degradation of the jaw and pain in the temporomandibular joint, which is where the jaw hinges to the skull. Inadequate nutrition also weakens the gums and makes an individual more prone to gum disease, as well as gums that are swollen, receding, quick to bleed and shiny in appearance.
Purging through vomiting also has a severe impact on oral health. The stomach acid wears away at the dental enamel over time, making teeth more susceptible to cavities and breakage, as well as sensitivity to temperatures. Stomach acid can also re-shape the teeth over time, making them flatter and dingy in color, or even translucent. This thinning and wearing away of the biting surface is what makes the teeth more susceptible to breakage.
Treating an eating disorder can be difficult because of how multifaceted the disease is: it affects a person’s physical, mental, and emotional wellbeing. It also can’t be cured overnight, making it important for a person to have a solid support network of patient, supportive friends and family in order to make a complete recovery.
In addition, dental professionals also need to be gentle and supportive if they suspect a patient may have an eating disorder, and it’s crucial that they know where to guide patients for treatment and support. Although dental professionals cannot cure eating disorders, they can play a pivotal role in recovery by helping to heal the physical damage by improving the appearance of teeth, and providing gentle guidance to help the patient play an active role in improving the health of the gums and underlying bones by paying closer attention to their oral health. By reducing these physical “scars” of the disease, a patient may begin to feel better about themselves as they continue through mental, emotional, and physical rehabilitation with the rest of their medical team.
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